Ananya Bhattacharjee Writer. Musician. Mother. Reading, music and travelling are all time favourites. Been into ‘writing’ from the last 10 years and have become an everlasting love since I started.

Nocturia or Frequent Urination! Is it Normal?

3 min read

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Nocturia is the frequent need to get up in the middle of the night and urinate. This is a common cause of sleep loss in people, and especially among adults. Few researchers believe that one visit to the bathroom per night is within the normal limits, and two or more visits events per night may be associated with daytime tiredness. However, people who suffer from severe Nocturia may wake up to pee five or six times at night.

Causes of Nocturia

There are several causes of Nocturia, from lifestyle choices to medical conditions.

Medical Conditions

The most common medical conditions that cause Nocturia are urinary tract infection (UTI) or a bladder infection. These infections lead to frequent burning sensations in the bladder and urgent urination tendency throughout the day and night.

Other medical conditions that lead to Nocturia include:

  • An infection of the prostate
  • A bladder prolapse
  • Overactive bladder (OAB)
  • Tumors in the bladder and prostate
  • kidney infection
  • Obstructive sleep apnea
  • neurological disorders like multiple sclerosis (MS), Parkinson’s disease, or spinal cord compression

Nocturia is also common in people suffering from heart failure, liver failure, or diabetes. Pregnancy and diuretic medications are also associated with Nocturia.

Medications

Medications like diuretics (water pills), which are used to treat high blood pressure, cause Nocturia in patients. A patient must seek emergency medical care if the person loses the ability to urinate or if the person no longer can control urination.

Nocturia progresses with age. As the human body gets older, the bodies produce a less antidiuretic hormone which retains body fluid. With decreased production of this hormone, the body produces more urine at night. Also, older people are more likely to suffer from Nocturia. It is because their bladder tends to have more fluid holding capacity with age.

Symptoms of Nocturia

Frequent urination at night or nocturia symptoms include

  • excessive urination (the need to urinate too much),
  • frequent urination (regular visits to the bathroom for different reasons),
  • urinary urgency (the need to urinate without effective result),
  • or reduced urine.

Nocturia occurs when the biological clock of the person makes the daytime urination pattern to happen during night time. Sometimes, the nocturia condition may also occur because of drinking too many fluids, and especially caffeine before sleeping.

How to diagnose it:

The patient and the healthcare specialist would want to learn more about the cause of nocturia. As such, the patient will be asked about the symptoms and health history. The diagnosis is also done by asking the patient to maintain a bladder diary to track the things like what amount and the kind of liquids one drinks and the trips to the bathroom. This will be helpful for suggesting useful treatments of nocturia.

The healthcare specialist may also require more information about the condition and would suggest:

  • Urine culture and urinalysis
  • Blood test
  • Bladder scan
  • Cystoscopy
  • Urodynamics testing
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Treatment of Nocturia

If a person is suffering from Nocturia, they should consult a doctor soon and follow the prescribed therapy. When consulting a doctor, the patient should bring a record of the number of times the person is urinating, a history of the sleeping habits as well as any daytime fatigue the person may be experiencing. The condition can be diagnosed by diagnostic tests like urinalysis, cystometry, neurological tests, and ultrasound. The doctor would prescribe medications after tests and evaluations.

Tips for Nocturia

  • A person suffering from Nocturia should follow the below-mentioned tips:
  • Drink a reasonable amount of liquid throughout the day
  • Try to drink the maximum amount of liquid foods in the day. 
  • Cut down on any drinks around the last two hours before going to bed. Avoid drinks like alcohol, coffee, or tea hours before going to bed, as these liquids stimulate urine production. 
  • Maintain a diary of how much water you drink, when, and what you drink. This would be helpful both for you and the doctor to tackle nocturia conditions.

 When to visit the doctor:

You should make an appointment with a doctor if you’re urinating more frequently or and if you are witnessing the following symptoms:

  • Nocturia is disrupting sleep and everyday activities
  • You experience other urinary problems or worrisome symptoms

Natural home remedies:

Lifestyle and behavioural changes are the first treatment of nocturia. Natural remedies for nocturia include the following:

Dietary changes and fluid management

Avoid red wine and chocolate as it may worsen the symptoms. Dietary changes include cutting out several known food irritants from the diet and also limiting the intake of fluids. Foods to avoid

  • Alcohol
  • Artificial sweeteners
  • Caffeine
  • Chocolate
  • Citrus fruits and juices
  • Corn syrup
  • Cranberry juice
  • Dairy
  • Sodas and fizzy drinks
  • Spicy foods
  • Sugar and honey
  • Tomatoes
  • Vinegar

Bladder control techniques:

Retraining and controlling the bladder is often recommended to reduce nocturia. There are several ways to do this:

  1. Scheduled urination: A person with nocturia should maintain a diary of urinary habits and based on the tracking, they can schedule trips by an additional 15 minutes to the usual urination times. This is important as in due course of time the person can gradually increase the time period between bathroom visits.
  2. Delayed urination: Each time the urge to urinate occurs, one should try to delay the urination for at least 5 minutes. Relaxation techniques like deep breathing would help.
  3. Double-void technique: This technique is for the people who thinks their bladder is not fully empty. For the person willing to double-void, they should:
  • Sit on the toilet, leaning slightly forward
  • Rest the hands on the knees or thighs
  • Urinate as normal
  • Remain on the toilet and wait 30 seconds
  • Lean slightly further forward and urinate once more

Kegel contractions: These contractions involve strengthening the pelvic floor muscles, that are primary to control urinary flow. A person should practice squeezing these muscles for around 10 seconds and then relax for 3 seconds. This technique should be repeated 10 times. A person should around three sets of 10 repetitions regularly.

Lifestyle changes:

  • Quitting smoking: Smoking would worsen nocturia. Coughing fits that occur in smokers may also increase leaking.
  • Maintaining a healthy weight: Excess weight puts additional pressure on the bladder and pelvic muscles. Maintaining a proper and healthy weight range is essential to control the bladder.

Though there is no scientific research or proof of an effective cure of Nocturia, some people believe that homeopathic medicines, hypnosis, or acupuncture methods can help treat Nocturia. One should seek advice from a trained practitioner if Nocturia occurs. 

Ananya Bhattacharjee Writer. Musician. Mother. Reading, music and travelling are all time favourites. Been into ‘writing’ from the last 10 years and have become an everlasting love since I started.

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