Excessive Urination at Night (Nocturia): Causes and Treatment

Health Line

2 days ago

Nocturia, or nocturnal polyuria, is the medical term for excessive urination at night. Nighttime peeing is considered excessive if it's disruptive to your sleep.
During sleep time, your body produces less urine that is more concentrated. This means that most people don't need to wake up during the night to urinate and can sleep uninterrupted for 6 to 8 hours.
However, some people may need to urinate more often during nighttime hours. And this frequent need to pee during the night may require treatment if it's causing long-term sleep deprivation.
While it is more common among older adults, nocturia can occur at any age. Read on to learn more about nocturia, its causes, symptoms, treatment, and prevention strategies.
What causes nocturia?
Nocturia can happen as a result of certain lifestyle choices or medical conditions.
Medical conditions
A variety of medical conditions can cause nocturia. Common causes of nocturia are a urinary tract infection (UTI) (UTI) or bladder infection. These infections cause frequent burning sensations and urgent urination throughout the day and night. Treatment requires antibiotics.
Other medical conditions that can cause nocturia include:
Nocturia is also common in people with organ failure, such as heart or liver failure.
Pregnancy
Nocturia is a fairly common symptom of pregnancy. It can develop at the beginning of pregnancy, but it also happens later, when the growing womb presses against the bladder.
Medications
Some medications may cause nocturia as a side effect. This is particularly true of diuretics (water pills), which are prescribed to treat high blood pressure, congestive heart failure, or any type of fluid retention.
You should seek emergency medical care from a doctor if you lose the ability to urinate or if you can no longer control your urination.
Lifestyle choices
Urinating too much over 24 hours is called polyuria, which can be caused by excessive fluid consumption, typically more than 40 milliliters per kilogram (mL/kg) per day. As part of that, you may also have nocturia or excessive urination at night.
Alcohol and caffeinated beverages are also diuretics, meaning drinking them causes your body to produce even more urine. Therefore, consuming alcohol or caffeinated beverages in excess can lead to nighttime waking and needing to urinate.
Other people who have nocturia may have developed a habit of waking up during the night to urinate.
How do doctors diagnose nocturia?
Diagnosing the cause of nocturia can be difficult. Your doctor will need to ask a variety of questions. The doctor will also usually ask you to record what you drink and how much, along with how often you need to urinate in a 24-hour period.
Questions your doctor may ask you also include:
When did the nocturia start?
How many times per night do you have to urinate?
Are you producing less urine than you did before?
Do you have accidents, or have you wet the bed?
Does anything make the problem worse?
Do you have any other symptoms?
What medications are you taking?
Do you have a family history of bladder problems or diabetes?
They may also have you undergo testing such as:
blood sugar test to check for diabetes
other blood tests for blood counts and blood chemistry
urinalysis
urine culture
fluid deprivation test
imaging tests, such as ultrasounds or CT scans
urological tests, like cystoscopy
tests to check if your bladder is fully emptying when you urinate
How is nocturia treated?
If your nocturia is caused by a medication, taking the medication earlier in the day may help.
Treatment for nocturia can sometimes include medications such as:
anticholinergic drugs, which help lessen the symptoms of an overactive bladder. However, recent research has associated these drugs with an increased risk of dementia in older people.
Beta-3 adrenoceptor agonists, like mirabegron (Myrbetriq), can help relax the bladder muscles and reduce symptoms of overactive bladder
desmopressin (Nocdurna), which causes your kidneys to produce less urine at night
However, nocturia can be a symptom of a more serious condition, such as diabetes or a UTI, that could worsen or spread if left untreated.
Nocturia due to an underlying condition will usually stop when the condition is successfully treated.
What can you do to prevent nocturia?
There are steps you can take to lessen the effects of nocturia on your life.
Reducing the amount of liquids you drink 4 to 6 hours before going to bed can help prevent you from needing to urinate at night.
Avoiding drinks that contain alcohol and caffeine may also help, as can urinating before you go to bed.
Some foods, such as chocolate, spicy foods, acidic foods, and artificial sweeteners, can irritate the bladder.
Kegel exercises and pelvic floor physical therapy can help strengthen your pelvic muscles and improve bladder control.
Pay close attention to what makes your symptoms worse so you can try to modify your habits accordingly. Some people find it helpful to keep a diary of what they drink and when.