With advancing age, people often find themselves getting up more often at night to urinate. This might at first seem like a minor annoyance, but if it becomes too frequent, it can compromise sleep quality. Poor sleep, in turn, can lead to multiple health problems such as increased daytime fatigue, decreased alertness, depression and impaired brain function.
The medical term for frequent nighttime urination is nocturia.
Question: How does a doctor diagnose nocturia?
Answer: When someone regularly needs to rise two or more times a night to urinate, they are considered to have nocturia. However, nocturia may not be considered to be a health problem until the frequency of nighttime urination increases to a level that compromises healthful sleep.
Q: How common is nocturia?
A: Estimates of nocturia prevalence range from 2 percent to 18 percent of young adults age 20 to 40. But, more than 50 percent of those over age 70 have nocturia. For a variety of reasons, nocturnal urine flow generally increases with age.
Q: What causes nocturia?
A: Nocturia can be a symptom of a related health problem such as diabetes, congestive heart failure or kidney or liver disease. However, nocturia also can develop for less serious and less obvious reasons associated with common changes that occur with aging. Nocturia can develop due to a variety of changes in body function that prevent the bladder from being able to hold a normal amount of urine without triggering the urgency to urinate. Many medical disorders, including psychiatric conditions, can trigger the tendency for excessive urine production at night.
Q: How is nocturia managed or treated?
A: Whether nocturia requires management or treatment depends on its severity and cause. Management can include a variety of approaches. Fairly simple measures can help lengthen the span of sleep. For example, fully emptying the bladder right before bedtime and avoiding evening consumption of caffeine, alcohol or excessive fluids can help.
During the day, some people tend to accumulate fluid in their lower legs, sometimes resulting in swelling around the ankles. When they lie down to sleep, the accumulated fluid re-enters the blood and increases urine production. For these people, it might be helpful to elevate their legs a couple of hours before bedtime to allow excess fluid to return to the blood and then be filtered into urine before bedtime.
Some drugs aggravate nocturia. Especially if you are on a diuretic blood pressure medication, it is important to discuss with your physician appropriate timing of your medications as related to nocturia.
When nocturia is not manageable by lifestyle adjustments and impairs sleep excessively, drug treatments that slow urine flow at night can lengthen the initial sleep period and allow more quality sleep time.
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Joannie Dobbs, Ph.D., C.N.S., and Alan Titchenal, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.
