Nocturia: How to treat an overactive bladder at night

Simply put, at night, nocturia is unnecessary urination. The disorder includes waking up early in the evening to urinate.

This disorder has several different causes which can make it difficult to diagnose.

Nevertheless, there are many therapies available once the causes are identified. There are several ways to help avoid nocturia, as well as suggestions to sleep well with the condition.

Nocturia vs. overactive bladder

Nocturia is often confused with a condition called overactive bladder (OAB).

A ma walking to the toilet at midnight
People with nocturia can produce an average amount of urine overall, but often need to take several night-time trips to the bathroom.

OAB is caused by the bladder muscle’s early and uncontrolled spasms which make a person urinate when their bladder is not actually full. This means routine all day urination, and even during the night.

Although people with OAB can experience frequent urination at night, people with nocturia appear to experience urination only frequently at night.

Many people with nocturia generate a regular amount of urine in general, but they actually produce a lot of urine at night.

Treatment for nocturia

The nocturia treatment depends on its cause, so there may be many different treatments for the work.

For example, if an infection causes nocturia, antibiotics may help clear the symptoms. When a medication triggers it, physicians may consider adjusting the medication of the individual, or simply suggest that they take it earlier that day.

Of example, in some cases where an person with nocturia also has an enlarged prostate, surgery can be required. More intensive care may also be required for nocturia caused by other serious conditions, such as diabetes, cancer or heart failure.

The key thing to remember is that to treat nocturia you need to recognize and treat the underlying condition.

Doctors can also recommend nocturia-treated medications. To reduce the amount of urine produced, antidiuretics such as desmopressin can be used. Other medicinal products that may help are anticholinergic or anti-muscarinic, such as:

  • darifenacin
  • festerodine
  • oxybutynin
  • solifenacin
  • tolterodine
  • trospium

Estrogen creams can also be given to women to treat stress incontinence.

People with nocturia induced by lifestyle choices may find the symptoms go away as they change their behaviors. However, if the symptoms continue, it might be time to see a doctor to ensure that an underlying medical condition is not causing them.

Tips for sleeping well

Most physicians and urologists may advise people to limit the amount of alcohol and caffeine they consume during the day.

Even if these drugs are not the cause of the condition, they are also diuretics and can worsen symptoms. Doctors can also recommend people with nocturia drink less liquids at night and before bedtime.

It is also important to avoid foods that are rich in liquids, and foods that serve as diuretics. Examples may include:

cranberry and citrus juices
Avoiding diuretics such as cranberry and citrus juices may alleviate some symptoms of nocturia.
  • melon
  • cucumber
  • cranberry juice
  • soda
  • soup
  • citrus drinks, such as lemonade, orange juice, and grapefruit juice
  • tomatoes and other acidic foods
  • spicy foods
  • artificial sweeteners
  • chocolate

Maintaining a meal log is an useful tool for many. Writing down what is consumed everyday will help establish a link between symptoms and problem foods.

There are also several individuals who benefit from exercising their bladder to help regain control of their contractions. If the bladder is used to contract every hour to inform the body that it’s time to urinate, the practice will also continue.

Over time, the bladder can be conditioned to move urine every 2-4 hours instead, or kept overnight. It is best done, with a doctor’s supervision.

Causes of nocturia

Since nocturia causes range from simple lifestyle decisions to serious medical conditions, diagnosis can often be difficult. Nocturia is most common in adults over 60 years of age but can occur at any age.

Medical conditions can cause symptoms of nocturia, and people can expect their doctor to ask them about their symptoms to help determine the causes.

Possible nocturia factors and medical conditions include:

There are other more unusual causes, too, such as autonomic dysreflexia and cystic medullary disease. People should always speak to do a complete and thorough diagnosis with their doctor.

Lifestyle choices influencing nocturia include:

  • excessive fluid consumption before bed
  • overhydration throughout the day
  • alcoholic beverages
  • caffeinated beverages

Another thing to remember is that the practice of waking up during the night to urinate may also change the inner clock of the body. Also if someone has stopped drinking liquids before bed, they may still wake up to urinate simply because at that time of night their body is used to doing so.

Diagnosing nocturia

It’s not unusual for people to go to the bathroom at night, especially when they drink extra fluids before bed. Normally, during the night the body produces less urine to help a person get a full night’s sleep. This is also one indication why morning urine is more concentrated.

People who wake up early to urinate over once a night experience nocturia. This may interfere with sleep habits and may be a symptom of a health problem.

For certain cases, the symptoms of nocturia may be identical but the causes may be different. And, to understand their root cause, a doctor may want to ask questions and track the symptoms.

Doctors may ask several questions about the nocturia to people who come to see them, such as:

A man waking up from sleep
A doctor may ask how many times a person wakes up to urinate per night, as well as if they experience any incontinence.
  • How many times do they urinate each day?
  • How many times do they wake up to urinate?
  • Did the symptoms of nocturia come with any other symptoms?
  • Does the body produce less or more urine than before?
  • What makes the symptoms worse? What makes the symptoms better?
  • Is there a personal or family history of bladder problems, kidney diseases, or diabetes?
  • Are there any medications they are taking that may cause these symptoms?
  • Do they experience incontinence or wet the bed during the night?

Doctors may ask patients to undergo regular tests, as well as the questioning, such as:

  • urine culture samples
  • blood sugar tests
  • fluid deprivation tests
  • blood urea tests

If cysts, stones, or an enlarged prostate are believed to be the cause of nocturia, a doctor may want to do an ultrasound as well.

Outlook

People with nocturia in their lives may see it as an annoyance. It could also be found embarrassing.

Luckily, there are several different treatment strategies, such as medications, and the root cause of the symptoms healing. There are also options and behaviors about lifestyle that can help ease the symptoms.

In most cases the underlying cause behind the symptoms can be identified and handled with caution and the advice of a doctor.

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