Nocturia is described as excessive urination at nights. Excessive urination at nights (nocturia) is when you wake up more than once to use the bathroom during the 6-8 hours sleeping time.
Nocturia is commonly referred to as nocturnal urinary frequency and tends to increase in prevalence as you age.
It affects both men and women but severity of nocturia can be exasperated by different reasons.
While it’s completely normal for people to wake up once to urinate, more than that can be a sign of something else happening.
Causes of Nocturia:
1. Age: Nocturia correlates with aging and the associated decline in kidney function and decreased ability to concentrate urine.
2. Prostate Problems in men: Having an enlarged prostate may contribute to nocturia, it’s much more complicated than that since women do not have prostates and nocturia is equally prevalent in men and women.
Nocturia is based on multiple factors that require careful evaluation in order to sort out and treat appropriately.
It comes down to these three factors:
1. Nighttime urine production by the kidneys.
2. Urinary bladder capacity.
3. Sleep status.
In the elderly people excessive nighttime urine production is a factor almost 90% of the time.
Types of Nocturia:
Nocturia can be classified into 3 types and they are:
1. Global polyuria (making too much urine, day and night).
2. Nocturnal polyuria (making too much urine at night).
3. Nocturnal Urinary frequency.
1. Global Polyuria: Global Polyuria is a condition where someone urinates more than 3,000mL in 24 hours and it is not restricted to nighttime.
In cases of polyuria, your body makes too much urine throughout the day. Polyuria can be caused by:
a. Increased fluid intake.
b. Type 1 diabetes.
c. Type 2 diabetes.
d. Gestational diabetes.
2. Nocturnal Polyuria: Nocturnal polyuria is when your body makes too much urine, but only at night.
You urinate regularly during the day or even experience a reduced urine output.
This may be related to fluid retention, which is then reversed when you lay down. Some causes of nocturnal polyuria include:
a. Congestive heart failure.
b. Diets high in sodium.
c. Increased fluid intake before bed.
d. The use of certain medications.
f. Sleeping disorders like sleep apnea.
g. Edema or swelling of the lower legs.
3. Nocturnal urinary frequency: This is the third most common type of nocturia that describes someone who urinates in small amounts or urinates more frequently.
Urinating in smaller amounts makes it difficult to fully empty the bladder, thus causing a person to wake up multiple times throughout the night. Urinating more frequently occurs when someone is unable to fill their bladder completely prior to feeling the urge to urinate.
If you have difficulty emptying your bladder completely, your nocturnal urinary frequency can be caused by:
a. Bladder obstruction.
b. Benign prostate.
If you experience the urge to urinate more frequently due to the inability to completely fill your bladder, your nocturnal urinary frequency may be caused by:
a. Overactive bladder.
b. Bladder infection.
c. Kidney Infection.
d. Bladder malignancy.
e. Recurring urinary tract infections.
f. Inflammation of the bladder.
Ways to improve frequent urination:
1. Emptying your bladder before bedtime: Ensuring that there is as little urine in your bladder as possible right before bed can help eliminate the need to get up to urinate at night.
2. Intentional nocturnal and late afternoon dehydration: Ensure that you are consuming enough fluids during the day, but limit them in the 2-4 hours before you go to bed.
3. Salt restriction: In people with a high salt intake, a reduction in salt reduces the chances of nighttime urination.
4. Limit intake of caffeine and alcohol: Caffeine increases bladder activity and therefore can cause nighttime urination, especially if consumed later in the day.
Alcohol can function as a bladder irritant and should be avoided as well.
5. Medication timing: Different medications, especially diuretic medications, can impact nighttime urine production.
Note that it is extremely important to consult with your doctor before making any changes to your medication.
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