Now that the weather is starting to be uncomfortably cold, leaving a warm, cozy bed seems even harder than before. Especially if the disruption that rips you from the comfort of your heated blanket and comforter is having to pee in the middle of the night. For most, this is an every-once-in-awhile problem that happens after chugging water or juice before going to bed. For others, waking up in the middle of the night to go is a chronic issue that interrupts healthy sleep and could be a sign of further urinary problems.
What is Nocturia?
Waking up during the night has a medical term – nocturia. According to the Cleveland Clinic, “Nocturia is a condition in which you wake up during the night because you have to urinate.” For many that suffer from this condition, they are waking up multiple times a night to go. This is a huge nuisance and actually a fairly common one. “1 in 3 adults over the age of 30 make at least two trips to the bathroom every night,” according to the National Association for Continence. There are two types of nocturia: Nocturnal Polyuria and Global Polyuria. Global is an overproduction of urine at all times of the day, not just nighttime or during sleep. Nocturnal, on the other hand, is the overproduction of urine at night and is usually diagnosed when “nighttime urine volume that is greater than 20-30% of the total 24-hour urine volume,” according to the International Continence Society. It is also important to note that like most urinary problems, nocturia is more likely to develop as we age. This is due to several reasons, varying from medical history and lifestyle choices, to other forms of incontinence.
Both men and women can develop problems with having to go in the middle of the night, but there may be different reasons for it. Men may experience nocturia as a result of an enlarged prostate, medically known as benign prostatic hyperplasia (BPH). Women may experience nocturia as a result of menopause, childbirth, or pelvic organ prolapse (POP). There are also risk factors that are not linked to sex. These risk factors and other causes of nocturia include:
- High fluid intake
- Untreated diabetes
- Congestive heart failure
- Edema of lower extremities (swelling of the legs)
- Sleeping disorders such as obstructive sleep apnea (breathing is interrupted or stops many times during sleep)
- Certain drugs, including diuretics (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D
- Drinking too much fluid before bedtime, especially coffee, caffeinated beverages, or alcohol
Another cause of nocturia is a condition called low nocturnal bladder capacity, in which the bladder is unable to hold the same amount of fluid at night as it is during the day. This problem is usually linked to other urinary or bladder complications, like the following:
- Bladder obstruction
- Bladder overactivity
- Bladder infection or recurrent urinary tract infection
- Bladder inflammation (swelling)
- Interstitial cystitis (pain in the bladder)
- Bladder malignancy
People may also experience what is called mixed nocturia, in which case, all three kinds (global, nocturnal, and low nocturnal bladder capacity) of nocturia symptoms are present. As mentioned before, nocturia is more than just an annoyance for millions of people, especially older adults. Chronic disruption of sleep can have a serious impact on both mental and physical health, so it is imperative to reach out to a healthcare provider to find a solution that works.
If you start to notice your nighttime bathroom habits affecting your quality of life, it’s suggested that you start to keep a diary to note every time you go. This will aid your doctor or other healthcare providers in properly diagnosing you and finding the appropriate treatment that works. For older adults, getting up and going to the bathroom in the night may not always be possible, resulting in leaks and accidents. To help prevent damage to furniture and irritation to the skin, try a mattress cover, using absorbent pads, liners, or undergarments, and using a wash meant for sensitive skin. In addition, there are things you can do during the day to help reduce the amount of fluid you have in your body at night, which in turn, could reduce the number of nighttime bathroom trips. According to NAFC, you can take the following precautions to help nocturia:
Restriction of Fluid Intake – Naturally, limiting the intake of fluids in the evening results in a decreased amount of urine produced at night.
Afternoon Naps – This can help reduce fluid build-up by allowing liquid to be absorbed in the bloodstream. When awakening from a nap, you can use the bathroom and eliminate excess urine.
Elevation of Legs – Like naps, elevating your legs helps redistribute fluids so it can be reabsorbed into the bloodstream.
Compression Stockings – Creating an effect similar to elevating your legs, these elastic stockings exert pressure against the leg while decreasing pressure on the veins. This allows fluids to be redistributed and reabsorbed into the bloodstream.
There are also a number of medications that may be prescribed to you by your doctor, like Darifenacin or Oxybutynin. As mentioned before, nocturia is oftentimes mixed with other incontinence or bladder problems like OAB or Stress Urinary Incontinence that lead to leaks during the day, especially in women. For those women suffering from light bladder leaks during the day, pantyliners, pads, and undergarments are available to absorb urine throughout the day with frequent changes. Revive®, a reusable bladder support device was designed for women with SUI to reduce leaks for up to 12 hours a day. Find yours in the feminine hygiene aisle at a retailer near you!