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Nocturia -

Waking up more than once during the night to pee? It sounds like you might be suffering from nocturia. Millions of people are affected by it worldwide.

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Nocturia -

It's also referred to as nocturnal urinary frequency. It occurs in all genders and ages, despite being more common in older people.

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Nocturia -

In those over the age of 30, around one in every three people suffers from it. Waking up once isn't considered unusual, but more frequent trips to the bathroom at night could be a sign of something more serious.

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Frequent urination -

In contrast, peeing too much during the day, which can lead to less bathroom trips at night, is called frequent urination.

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Frequent urination -

While needing to pee a lot during the day can be inconvenient, nocturia can lead to sleep disturbances that really impact a person's health and quality of life.

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Common, but not inevitable -

Although nocturia is a common disorder, it's not an inevitable part of getting older. In many cases, there are steps that can be taken to lessen bathroom trips and improve sleep.

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Definition -

A person is considered as having nocturia if they need to pee more than once per nightly sleep cycle.

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Bed-wetting -

Nocturia shouldn't be confused with bed-wetting, as it involves waking up and realizing you need to pee. Bed-wetting occurs when urination happens involuntarily, without the sensation of having a full bladder.

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A symptom, not a disease -

Nocturia isn't a disease in and of itself. It's the sign of something that's going on inside the body. You should be able to sleep a solid six to eight hours without taking multiple bathroom trips.

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Diuretics -

Excess production of fluid at night may be due to consuming diuretics, such as coffee, alcohol, or certain medications, close to bedtime. Diuretics enhance urine production.

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Peripheral edema -

It can also be caused by a buildup of fluid in the legs—called peripheral edema—that moves when a person changes their sleeping position.

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Circadian rhythm -

There is some evidence to suggest that the circadian rhythm of older people makes them produce more urine at night, making them more prone to nocturia.

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Obstructive sleep apnea -

Disorders including obstructive sleep apnea, which results in pauses of breath in the middle of the night, reduce the airflow in the body, causing hormonal changes. These changes can, in turn, cause nocturia.

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Swollen prostate -

If the prostate is swollen, it might act as an obstruction, causing bladder problems. If the bladder doesn't fill properly, or doesn't empty fully when you pee, this can cause nocturia.

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Menopause -

Fluctuating hormones in menopause can affect urination. Nocturia is one of the most common genitourinary symptoms in women going through menopause.

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Pregnancy -

Nocturia also occurs during pregnancy, becoming more common as pregnancy progresses. Around 40-50% of people experience bladder control problems in pregnancy.

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Other health conditions -

Some health conditions cause you to need to wake in the night to pee. They include: polyuria, diabetes, high blood pressure, heart disease, prostate obstruction, and restless legs.

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Other health conditions -

If you're not sure what the underlying cause is, speak to a healthcare provider so they can rule out or treat the condition that's behind the nocturia.

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Treating the underlying condition -

Treating the underlying condition causing the nocturia is the first thing to do, to manage the symptom of needing to pee several times per night.

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Lifestyle changes -

Regardless of what's causing your nocturia, there are also some lifestyle changes you can implement, that should help decrease how frequently you need to pee at night.

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Drink less fluids -

Drinking less fluids in the afternoon and evening will help reduce the need to pee in the middle of the night. Caffeinated and alcoholic beverages, in particular, should be avoided.

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Physical activity -

Physical inactivity has been associated with reduced bladder capacity. By keeping fit and active, you can curb those nighttime bathroom trips.

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Pelvic floor exercises -

There are specific exercises (particularly in Pilates) that help you strengthen your pelvic floor muscles. A strong pelvic floor can improve nocturia.

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Afternoon naps -

Naps allow your bloodstream to absorb liquid. In other words, you'll need to use the bathroom after your nap, helping to reduce the amount of nighttime trips.

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Sleep hygiene -

Good sleep hygiene means practicing healthy sleeping habits. These can include maintaining a consistent sleep schedule, practicing relaxation techniques beforehand, and having minimal light and noise exposure.

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Comfortable bedding -

For your best night's sleep, ensure your bedding is comfortable and warm, while the room temperature remains cool. Keep devices as far away from the bed as possible.

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Leg elevation -

Elevate the legs an hour or more before bed. This can help reduce the resorption and conversion of peripheral edema to urine during sleep time.

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Wear compression socks -

Wearing compression socks while you sleep will help with fluid distribution in the body while you get some shut-eye, reducing the need to pee.

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Further tests -

Nocturia isn't serious, but the condition underlying it might be. If you've implemented lifestyle changes but you're still suffering, talk to your healthcare provider. They might send you for further tests, such as urinalysis, a blood test, bladder scan, cystoscopy, or urodynamic testing. 

Sources: (The Guardian) (Cleveland Clinic) (Urology Care Foundation) (Sleep Foundation)

See also: Urinary tract infections—the foods you should and shouldn't eat

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