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(regular urination throughout the night)

Studies suggest that nocturia, or nighttime urination, by people of all ages could be a sign of a much larger problem. Nocturia, defined as two or more episodes of urination during the night, increases with age, and is associated with other conditions including diabetes, cardiovascular disease, hypertension, and antidepressant use. It can be disruptive to your sleep and negatively impact the quality of your life. It is seen in one-third of adults.

Nocturia is divided into four main categories: polyuria, nocturnal polyuria, nocturnal urinary frequency, and a mixed type involving aspects of any or all the previous three categories.

  • Polyuria is an excessive amount of urine produced each day, possibly due to the kidneys trying to flush out some substance such as sugar (glucose) in diabetics with elevated blood sugars that are filtered into the urine. Some of the causes of polyuria include drinking excessive fluid and poorly controlled diabetes … like type 1, type 2, diabetes insipidus (a form related to pituitary disease), or a pregnancy related gestational diabetes.
  • Nocturnal polyuria is excessive urine formation produced only at night with daytime urine creation being normal or decreased. Due to an underlying medical condition, daytime fluid retention which travels up to be filtered by the kidneys releases when you lie relatively flat, and leg swelling goes down. Some of the causes of nocturnal polyuria include congestive heart failure, edema/fluid retention in the legs, sleep apnea (a sleep disorder), some medications (diuretics/water pills), excessive fluid drinking right before laying down, consuming caffeine or alcohol, and excessive sodium/salt in the diet.
  • Nocturnal urinary frequency is the need to urinate numerous times during the night. When the bladder cannot empty completely during urination or fill completely, it requires more frequent emptying. Some people wake frequently due to a sleep disorder (sleep apnea) and then mistake this awakening for arising from the need to urinate.

Diagnostic testing for nocturia may include:

  • Detailed history and physical examination – your AUCNY doctor will request details about symptoms, personal and family medical history, social history including smoking habits, and perform a general examination of the body with special emphasis on the bladder area including rectal/pelvic exam
  • Blood test
  • Urine test
  • Cystoscopy – a procedure in which a thin “camera” tube is inserted into the urethra to diagnose and treat any suspected abnormalities.

Treatment Options

Your AUCNY urologist will determine the cause of the symptoms and recommend therapies. Treatment options include:

  • Avoid large amounts of fluids, caffeine, alcohol, diuretic medications in the evening.
  • For leg swelling, elevate your leg during the daytime and use compression stockings.
  • Prescription medications to treat the underlying medical cause of the symptoms, such as overactive bladder, control of sugar levels in a diabetic, or congestive heart failure evaluation may be prescribed.

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