One of the most troublesome conditions affecting both men and women is awakening at night to urinate.  Certainly getting up once or twice is tolerable but when the number exceeds 4 or 5, then the sleep is disturbed and those who have the condition wake up lethargic and definitely not well-rested.  This blog will discuss the common causes of nocturia and some of the treatment options.

The medical term for awakening at night is referred to as nocturia.  It is a common condition usually most common in men and women after age 50.  It is estimated that 1 in 3 adults over the age of 50 make at least two trips to the bathroom every night. And while the majority of those who are dealing with nocturia are usually over the age of 60, it can happen at any age.

There are two major categories of nocturia:

  1. Nocturnal Polyuria. This occurs when there is an overproduction of urine at night.
  2. Global Polyuria. A major cause of nocturia that consists of both day and nighttime urine overproduction.

The causes
Women generally experience nocturia as a consequence of childbirth, menopause, and/or pelvic organ prolapse when something is coming out “down there”. In men, nocturia is usually the result of prostate gland enlargement.

Additional factors that can contribute to nocturia or make it worse include:
diuretic medications, or water pills, caffeine, alcohol, and consuming excessive fluids before bedtime.

Other Causes
Sometimes nocturia it is a symptom of a greater problem. Such conditions include: diabetes mellitus, high blood pressure, heart disease, congestive heart failure, restless leg syndrome, and insomnia.

The evaluation
Your doctor will take your history, perform a physical examination, and conduct a few tests such as a urinalysis.

Treatment
Perhaps the easiest suggestion is to limit drinking liquids several hours before going to sleep.  This will decrease the urine volume produced and can reduce the nocturia.

Medical treatment
If the problem is due to an overactive bladder, then there are oral medications such as Ditropan, Mybetriq, and Vesicare, which are effective but have side effects such as constipation, blurred vision, and increase in blood pressure with Mybetriq.

Nocturia and Prostate Gland Enlargement
In most men after the age of 50 there is an enlargement of the prostate gland which restricts the flow of urine from the bladder to the outside of the body.  As a result, men with enlarged prostate glands are not able to empty the bladder completely and get up at night in order to urinate.   The treatment for the enlarged prostate gland consists of medication and now there is a minimally invasive treatment called UroLift which uses an implant of a suture to open the prostate and allow improvement in urine flow and improve the ability to empty the bladder and significantly reduce the nighttime voiding.

Bottom Line: Getting up at night can significantly impact a man or women’s quality of life because of the altered sleep cycle.  However, treatment is available.  If you are bothered by nocturia, talk to your doctor.

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