Nighttime Urination

What causes nighttime urination? Aging is one of the biggest contributing factors to nighttime urination. This is most common in people over the age of 60. Most elderly people are the ones who drink only lesser water as their thirst ( 2% dehydration set in the first thirst signal) is getting weaker. As we age, the body produces less of the antidiuretic hormone that helps us retain water in the bladder. Sodium ( salt ) retains water , while fresh water is the best natural antidiuretic agent.

That's why the timely and right amount of water and sodium ( salt) intake is significant to prevent nocturnal pee symptom.

People mistaken that salt causes high blood pressure. The real cause for high blood pressure is water deficits in the body’s maintenance requirements. With enough water, the body will never retain more salt in the systems. 

Everything You Need to Know About Nighttime Urination

Frequent urination at night can be caused by UTIs, excessive drinking, medications, pregnancy, and diseases like diabetes or kidney failure.

A good night’s sleep helps you feel rested and refreshed in the morning. However, when you have the frequent urge to use the restroom at night, a good night’s sleep can be hard to achieve.

If you find yourself waking up to urinate more than twice each night, you may have a condition called nocturia. This is most common in people over the age of 60 years old.

Nighttime urination isn’t the same as a related condition called enuresis (bed-wetting). Enuresis is when you can’t control your need to urinate at night. While nighttime urination typically results in sleep loss, it can be a symptom of an underlying condition.

What causes nighttime urination?

Aging is one of the biggest contributing factors to nighttime urination.

As we age, the body produces less of the antidiuretic hormone that helps us retain fluid. This results in increased urine production, especially at night. Muscles in the bladder can also become weak over time, making it more difficult to hold urine in the bladder.

Aging isn’t the only contributing factor to nighttime urination. Other common causes include chronic urinary tract infections, drinking excess fluids (especially caffeinated and alcoholic ones) before bed, bacterial infection in the bladder, and medications that encourage urination (diuretics).

Women may experience frequent urination as a result of pregnancy and childbirth. These circumstances can weaken the bladder and pelvic floor muscles.

In some cases, nighttime urination is a symptom of an underlying medical condition. Disease and conditions associated with frequent urination include chronic kidney failure, congestive heart failure, diabetes, and enlarged prostate. It may also be a symptom of sleep disorders such as obstructive sleep apnea, insomnia, or restless leg syndrome.

What are the symptoms of nighttime urination?

Most people can get a full six to eight hours of rest without the need to urinate. However, nighttime urination causes you to get up several times at night to use the restroom. In its most severe forms, this condition causes you to get up five to six times at night.

Symptoms associated with nighttime urination include overproduction of urine, urinating too frequently, and feeling the urgent need to urinate but producing little urine.

Nighttime urination can cause problems. You can’t feel rested when you’re frequently using the restroom. Also, nighttime urination can increase the likelihood for falls and injury in the elderly.

How is nighttime urination diagnosed?

Your doctor will diagnose nighttime urination by evaluating your symptoms and performing a physical examination. They may ask certain questions to determine potential causes for the condition.

Questions may include how many times you get up to urinate at night, how long you’ve been experiencing nighttime urination, and questions about your regular activities before bed.

For example, if you drink lots of fluids or take diuretics before bedtime, these can lead to nighttime urination.

Your doctor may order tests to determine the cause of frequent urination. Urinalysis looks at the chemical compounds present in urine. Urine concentration determines if your kidneys properly excrete water and waste products.

Other tests include a urine culture and post-void residual urine measurements. This test takes an ultrasound of the pelvic area to see how much urine remains in the bladder after urination.

Your doctor may order further tests if they suspect you have an underlying medical condition. They may order further tests to make a diagnosis. These tests include blood sugar, blood urea nitrogen, blood osmolality, creatinine clearance, and serum electrolytes.

These tests can determine how well the kidneys function. They also measure the concentration of certain chemical compounds in your blood. These tests can determine if nighttime urination is a side effect of kidney disease, dehydration, or diabetes.

What are the treatment options for nighttime urination?

Treatment for nighttime urination often depends on its cause. For example, you may drink too much before bed. Your doctor may recommend restricting your fluids after a certain time.

Certain behaviors can also reduce the frequency of nighttime urination. Taking an afternoon nap can help you feel more rested.

Keep your legs elevated during the day or wear compression stockings. This encourages fluid circulation and can also help minimize nighttime urination.

Medication

Medications may also help reduce nighttime urination. It’s important to note that medications can alleviate symptoms, but they can’t cure nighttime urination. Once you stop taking them, your symptoms will return.

A class of drugs called anticholinergics can relax muscle spasms in the bladder. They can also reduce the need to urinate more frequently.

If you experience bed-wetting, some anticholinergics can reduce this. However, these medications can cause side effects such as dry mouth, dizziness, and blurred vision.

Some doctors recommend taking a diuretic that encourages urination earlier in the day. Sea salt is the natural healthier choice.  This can reduce the amount of urine in your bladder at night. Taking a synthetic form of antidiuretic hormone may also help to reduce nighttime urination.

Overactive bladder at night

If you need to get up to urinate more than one time during the night, you may have an overactive bladder at night. This condition is called nocturia, and it’s not the same as overactive bladder (OAB). It’s possible to have nocturia along with OAB, or to have this condition on its own even when daytime urination is normal.

Nocturia is common, especially as you age. One in three adults over the age of 30 need to make at least two trips to the bathroom at night.

Nocturia is different from bedwetting. Most people can sleep six to eight hours without having to get up. But if you have nocturia, you’ll wake up more than once a night. This disrupts your normal sleep cycle and causes sleep loss along with other complications. Read on to learn more about nocturia and how to treat it.

Types of nocturia

There are four types of nocturia:

Nocturnal polyuria: You produce an excessive amount of urine during the night.

Global polyuria: Your body produces excess urine during the day and night.

Low nocturnal bladder capacity: Your bladder can’t hold as much fluid during the night.

Mixed nocturia: This is a combination of the previous three types of nocturia.

Causes of nocturia

Nocturia can be caused by OAB, but it can also be the result of other conditions. The cause depends on the type of nocturia.

For example:

•Causes of nocturnal and global polyuria •Causes of low nocturnal bladder capacity excess fluids, especially caffeinated beverages or alcohol near bedtime bladder obstruction

•untreated or poorly controlled type 1 or 2 diabetes bladder overactivity

•congestive heart failure urinary tract infection

•swelling of your legs bladder inflammation

•sleep disorders such as sleep apnea bladder tumor

•diabetes insipidus interstitial cystitis

•gestational diabetes benign prostatic hyperplasia in men, or an overgrown prostate

•certain medications pregnancy

Some of the medications that cause nocturia include:

•cardiac glycosides

•demeclocycline (Declomycin)

•lithium

•methoxyflurane

•phenytoin (Dilantin)

•propoxyphene

•excessive vitamin D

•diuretics such as furosemide (Lasix) and torsemide (Demadex)

What to expect from your doctor

Thelĺ recommends keeping a fluid and voiding diary to help your doctor diagnose nocturia. This involves recording:

•how much you drink

•how often you go to the bathroom

•how much urine you release

•what medications you take

•symptoms of urinary tract infections such as pain with urinating or difficulty urinating

12 any symptoms such as fatigue

In addition to a physical exam, your doctor will also ask about your condition. These questions include:

When did your nighttime urination start?

How many times do you urinate a night?

Do you urinate a lot or a little when you go?

Has the amount of urine ever changed?

Do you drink caffeine? If so, how much?

Do you drink alcohol? If so, how much?

Does the urination prevent you from getting quality sleep?

Depending on your symptoms, your doctor may also conduct several tests such as:

•urinalysis, to check for an infection

•cystometry, to measure the pressure in a bladder

•cystoscopy, to look at your bladder with a small camera

•ultrasound, to get an image of your bladder

•CT scan, to get a more detailed image of your bladder

sleep study, to ng nighttime urination

One of the first-line treatments for nocturia is making lifestyle changes. Your doctor will recommend that you restrict your fluid intake before going to bed. Stop drinking beverages a few hours before bedtime, but make sure you get enough fluids throughout the day.

Other lifestyle changes that can hyelp reduce and prevent nocturia include:

avoiding beverages with caffeine and alcohol maintaining a healthy weight, as excess weight can put pressure on your bladder 

timing when you take diuretic medications so they don’t impact your nighttime urine production

taking afternoon naps

If edema is the cause of your frequent⁹ùĥĥɓ try elevating your legs⁶⁶ throughout the day to reduce swelling. Naps can help with nocturia too, so have an afternoon nap with your legs up. Compression stockings can also help prevent fluid buildup.

Medical treatments for nocturia

Your doctor may prescribe medications when preventive measures and lifestyle changes fail to reduce the frequency of your nighttime urination. Doctors prescribe a class of drugs called anticholinergics to treat symptoms of OAB, if that’s the cause of your nocturia. They reduce bladder spasms that create the urge to go.

Your doctor may suggest you take a diuretic for regular urine production. A diuretic can itself cause nocturia. But if you take it early enough in the day, it may help you get rid of excess fluid while you’re awake. This should decrease your urine production at night.

Other drugs that may help are:

desmopression (DDAVP) in cases of diabetes insipidus to cause the kidneys to produce less urine

tamsulosin (Flomax), finasteride (Proscar), or dutasteride (Avodart) to treat prostate enlargement

antibiotics if you have a urinary tract infection

Your doctor may also adjust your diabetic medications to lower your blood sugar if they’re causing nocturia.uùììììô

Nerve stimulation

Sometimes the underlying cause of nocturia is neurological. Nerves that send signals to your bladder to contract may be giving you the urge to go. This treatment can be invasive or noninvasive.

The invasive treatment involves implanting a small device that sends regulated impulses to your bladder near your tailbone. One studyTrusted Source shows that this device is an effective long-term treatment for the symptoms of OAB and nocturia. It’s also both safe and reversible.

The noninvasive version of this treatment requires more studies, but research shows there’s evidence that electrical stimulation works for OAB and nocturia.

Surgery

When prevention and medications don’t work, your doctor may suggest a surgical procedure to treat your nighttime OAB. The success rate for the surgery depends on the underlying cause. For example, prostate surgery for men with an enlarged prostate can help with obstruction and relieve symptoms.

Alternative treatments for nocturia

Many people turn to complementary and alternative medicine (CAM) before seeking medical help. You may also be interested in alternative medications or treatments for nocturia, but there are few studies to support their use. These treatments may work for nocturia, but only if OAB is the cause.

For example, research has found that:

•herbal medications have a positive impact on symptoms of OAB and quality of life

•acupuncture provides short-term relief for OAB symptoms

•homeopathic remedies may have benefits, but need more studies

alternative treatments have fewer side effects than medications

saw palmetto berry extract has no benefit for nocturia

But more research is needed to confirm if CAM works for OAB.

Takeaway

Nocturia can cause long-term side effects such as sleep loss and increase your risk for other health conditions. Talk to a doctor if you experience frequent nighttime urination. They’ll be able to suggest lifestyle changes or medical treatments to improve your symptoms.