Sleep is so important for good health. Nothing destroys a good night’s sleep than getting up multiple times a night to urinate. Nocturia is the medical term for excessive urination during the night. Most people don’t need to wake up during the night to urinate and can sleep uninterrupted for six to eight hours. 1 in 3 adults over the age of 30 make at least two trips to the bathroom every night. And while the majority of those who are significantly affected with nocturia are usually over the age of 60, it can happen at any age.
Women generally experience nocturia as a consequence of childbirth, menopause, and/or pelvic organ prolapse. In men, nocturia can be directly attributed to an enlarged prostate gland.
Additional factors that can contribute to nocturia in both sexes include: Diuretic medications, caffeine, alcohol, overactive bladder, excessive fluids before bedtime, or fluid redistribution as may occur in men and women with heart disease.
Sometimes nocturia may be a symptom of a greater problem. Certain conditions can cause urine to be passed in the evening and during sleep. Such conditions include diabetes mellitus, high blood pressure, heart disease, vascular disease, restless leg syndrome and insomnia.
The treatment of nocturia may be as simple as a few lifestyle changes.
Naturally, limiting the intake of fluids in the evening results in a decreased amount of urine produced at night.
After noon naps of 20-30 minutes help reduce fluid build up by allowing liquid to be absorbed in the bloodstream. When awakening from a nap, you can use the bathroom and eliminate excess urine.
Elevating your legs like naps, helps redistribute fluids so it can be reabsorbed into the blood stream.
Compression stockings create an effect similar to elevating your legs. Elastic stockings exert pressure against the leg while decreasing pressure on the veins. This allows fluids to be redistributed and reabsorbed into the bloodstream.
Medications to treat nocturia
Different medicinal options exist to alleviate and even treat nocturia. These may be used alone or combined with some of the behavioral modifications listed above, which has been proven to be more effective. A word of caution about medications: Used alone, studies have confirmed that the medication works only as long as it is taken. Once off the medication, relapses are quite common.
Anticholinergic medications (Vesicare, Ditropan, Enablex) are prescription medications that are effective for treating nocturia associated with bladder over activity. The main side effects with anticholinergic medications are dry mouth, dizziness, and blurred vision.
Another drug, Mybetriq, is helpful as it relaxes the bladder at night and allows the bladder to hold more urine.
If this first line drug therapy is considered ineffective, one or more of the following may be prescribed.
Desmopressin or vasopressin, is a nasal spray that works on the kidneys to reduce urine production at night. Noctiva is taken daily, approximately 30 minutes before going to bed. The U.S. Food and Drug Administration today approved Noctiva (desmopressin acetate) nasal spray for adults who awaken at least two times per night to urinate. Noctiva is the first FDA-approved treatment for this condition.
Bottom Line: Nocturia can be a debilitating problem for many people as it creates chronic sleep impairment. However, with proper management, motivation, and dedication this condition can be overcome for a better quality of life.