People with healthy bladders should be able to stay asleep for 6 to 8 hours without needing to get up to use the bathroom. This is because, during sleep, the body naturally produces less urine, reducing the need to empty the bladder and thus allowing the body to rest uninterrupted.
Unfortunately, about 1 in 3 adults over the age of 30 find themselves waking up two or more times throughout the night to urinate – a condition known as nocturia. Read on to learn more about what nocturia is, what it could mean about your health, and how to treat or manage symptoms.
People with nocturia typically wake up 2 or more times per night to urinate. This could be caused by nocturnal polyuria, a condition that causes the body to produce too much urine during the night. It could also be that the bladder is having problems retaining urine or it could be a combination of the two or something else entirely.
Nocturia can be considered a subset of overactive bladder (OAB). If you’re experiencing symptoms of nocturia, it’s important to seek medical attention as soon as possible. Not only does nocturia disrupt your sleep, which can have long-term physical and mental health consequences, but it can also be an indicator of an underlying health condition.
Though nocturia is commonly caused by OAB, as mentioned above, OAB is not the only condition that can cause excessive nighttime urination. Other potential causes of nocturia range from lifestyle-related to medical.
Excessive consumption of fluids, especially those that act as a diuretic, such as caffeine or alcohol, in particular when consumed close to bedtime
Medications, such as those prescribed for high blood pressure, especially diuretics (”water pills”)
Urinary tract infection (UTI)
Bladder or pelvic organ prolapse
Tumors in the bladder, prostate, or pelvic area
Obstructive sleep apnea
Neurological disorders such as multiple sclerosis, stroke, Parkinson’s disease or spinal cord injury
Congestive heart failure
Hypercalcemia (high blood calcium level)
Interstitial cystitis (painful bladder syndrome)
Getting the right treatment depends on obtaining an accurate diagnosis of the underlying cause of your nocturia symptoms. It’s crucial that you carefully discuss your symptoms, medical history, and relevant lifestyle information with your doctor to determine whether you need to be treated for OAB or a different condition.
To recap our exploration of what is nocturia, it’s a condition in which a person regularly wakes up two or more times to urinate during the night. It is not the same as enuresis, also known as bed-wetting, which is more typical in children and is often outgrown.
Many healthy people may experience isolated episodes of excessive nighttime urination, particularly in conjunction with high fluid consumption. However, nocturia may constitute or indicate a serious health problem for those who experience these symptoms chronically or who have experienced a recent inexplicable onset of symptoms.
If you’re experiencing nocturia alongside any of the other OAB symptoms below, you may have a medical condition and will want to seek medical advice:
Frequent urination – You urinate 8 or more times per day, or so often that it disrupts your life
Urgency – Your urges to urinate are sudden and feel uncontrollable
Urgency incontinence – Your urges to urinate are sudden, uncontrollable, and sometimes lead to leakage of urine.
A bladder diary is an important diagnostic tool. Keep a careful record of your nocturia symptoms, including when they started, how often you get up throughout the night, and how much urine you produce. Your doctor will need this information to perform an accurate differential diagnosis.
Depending on the cause of your nocturia, there is hope for alleviation or even elimination of symptoms. Some people use a combination of the management methods outlined below. If you are diagnosed with OAB, care providers typically take a step-wise approach, starting with noninvasive lifestyle changes and moving up to more advanced interventions as needed.
Nocturia symptoms associated with OAB may be alleviated through habit changes, including:
Reducing or restricting fluid intake, especially caffeine and alcohol and especially close to bedtime
Elevating your legs above the level of your heart for a couple hours in the afternoon or using compression socks – this helps with nocturia caused by fluid buildup in the legs
Napping during the day – short naps can alleviate the fatigue and concentration problems caused by sleep interruption and can also help liquids re-absorb into the bloodstream (i.e., away from the bladder)
When lifestyle changes aren’t enough, some care providers turn to medication to treat OAB-related nocturia. However, it’s important to note that finding the right medication for your symptoms can take a lot of trial and error. Since many medications carry side effects, you’ll want to make sure you weigh the pros and cons of trying different medications.
Beyond lifestyle changes and medication, advanced therapies, including surgeries and implants, can address the problem more directly. This is because many cases of OAB are linked to problems in communication between the brain and the bladder.
Advanced therapies like sacral neuromodulation from Axonics® provide gentle stimulation between the brain and the bladder and bowel to restore normal communication.
The consequences of nocturia on one’s sleep health can severely impact one’s quality of life. If you’ve been unable to manage your nocturia symptoms with habit changes and other lower-tier interventions, you may want to discuss advanced therapies and nocturia solutions with your care provider. Learn more about Axonics’ therapies today.