About Nocturia

John Tiong, MPharm, PhD, RPh

Nocturia is the complaint that an individual has to wake up at night one or more times to void [International Continence Society]. It is a condition that has gained medical attention over the recent years due to the long term health complications associated with it.

Finding your sleep disturbed at night because you have to wake several times to pee? Turns out, you’re not alone. Well, not least if your spouse’s sleep is also affected by your nightly bathroom visits. Kudos to all the ever so tolerant partners who quietly put up with the squeaking from the other side of the bed and worst still, a toilet flush!

Night urination (or medically known as nocturia), is a common medical condition that can affect both men and women. If you think it affects only the elderly, you are seeing only half the picture. As a matter of fact, nocturia can affect both the young and the old although it does get more common with age due to various health conditions.

For crying out loud, what’s the big deal with peeing at night?

Urinating once a night occasionally is probably acceptable to most and truth be told, I do wake up to pee sometimes especially if I had too much to drink before bed time.

Nevertheless, it does seem to ruffle feathers (yours and perhaps your partner) when you consistently have to wake up several times just to empty your bladder. This can lead to sleep fragmentation or sometimes inability to return to sleep.

So how bad can that be? Well, studies have shown that chronic sleep fragmentation or sleep deficit is linked to a host of social and health problems including:


  • Cognitive and memory impairment
  • Mood disturbance and depression
  • Reduced quality of life
  • Risk of falling, traffic accidents and occupational hazards
  • Risk of cardiovascular disease and diabetes
  • Lowered immunity
  • Risk of Alzheimer’s disease (latest study)

That does sound distressing in the long run! So what are the common causes of nocturia?

Now, before jumping to the conclusion that you have nocturia, let’s get some facts right; there is a difference between:

(a) waking up at night because you need to pee

(b) conveniently taking a leak  during night awakenings.

Just so you know, (a) is what nocturia is all about. One thing is for sure though, you’re not getting much sleep either way.
The following are the most common causes of nocturia:

Heart andkidney problems
Drinking largeamount of fluids
 

  • Nocturnal polyuria: A condition associated with excessive production of urine at night due to low production of vasopressin (a hormone which causes water reabsorption from the kidneys) at night especially among the elderl
  • Overactive bladder: you bladder contracts to expel urine before it is filled up to its normal capacity
  • Benign prostatic hyperplasia: enlarged prostate in male which obstructs the flow of urine through the urethra causing a reduced bladder capacity due to incomplete voiding
  • Excessive consumption of water at night
  • Drinking alcohol, coffee or tea before bedtime
  • Taking diuretic medications (medication which makes you lose water through urination) in the evening or at night
  • Heart failure, sleep apnea, diabetes mellitus and diabetes insipidus

Alright, let’s cut to the chase. What should I do if I suspect I have nocturia?

The most obvious things to do would be to avoid drinking too much water before bedtime. Need I say more about the consumption of alcohol, coffee and tea at night? If you are on diuretic medication, take it during the day (your doctor or pharmacist should have counselled you on this). 

If you are still experiencing frequent night time urination despite having done all the above, please do speak to your doctor about this. Don’t lose sleep over it (pun intended) since it is a manageable medical condition. 

To top it off, please buy your partner a nice and expensive dinner if your nocturia is affecting his or her sleep. Start counting your blessings for having such patient partner. Oh ya, alcohol is still a no-no over dinner or else you’re going to risk buying more dinners!


References:

  • Van Kerrebroeck et al. Neurourol Urodyn 2002;21:179–183
  • Fonda D. BJU Int 1999;84(suppl 1):13–15
  • Wein et al. BJU Int 2002;90(suppl 3):28–31
  • Irwin et al. Eur Urol 2006;50:1306–1314
  • Coyne et al. BJU Int 2009;104:352-360
  • Bosch JL & Weiss JP. J Urol 2010;184:440–446
  • Kupelian et al. Eur Urol 2012;61(1):78-84
  • Weiss et al. BJU Int 2013;111:700–716