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Nocturia: How do I cope with frequent nighttime urination?

Nocturia is the physical obligation to frequently urinate throughout the night and it affects nearly two-thirds of adults aged 55 to 84, at least a few nights per week. A mild case makes a person wake up at minimum twice during the night; in severe cases, a person may get up as many as five or six times. Unfortunately, this can cause notable sleep deprivation and daytime fatigue.

tired woman sleeping on her arm on her desk next to a cup of coffee, a laptop, notebooks and folders.

Nocturia becomes more prevalent with age because as we get older, our bodies produce less of an antidiuretic hormone that allows us to hold urine. If there are lower concentrations of this hormone, our bodies produce more urine at night. Additionally, the bladder tends to lose holding capacity as we age, which means older people are more likely to suffer from medical problems that affect the bladder. 

Nocturia has numerous possible other causes, including other medical conditions (urinary tract infection, multiple sclerosis, sleep apnea, enlarged prostate, liver failure), disorders such as heart failure or diabetes, and medications (especially diuretics). Some cases are exacerbated or even caused by excessive fluid intake after dinner, especially drinks containing caffeine or alcohol.

Therapies for nocturia fall into three categories: behavioral interventions, treatments to correct medical causes, and medication. The first step is to try to distinguish the underlying cause and correct it. If this is unsuccessful, your doctor may try behavioral approaches such as cutting down on how much you drink in the two hours before bedtime. If the nocturia persists, your doctor may prescribe a medication to treat your overactive bladder. The most commonly prescribed medication is desmopressin which mimics the antidiuretic hormone. Relaxant agents such as tolterodine (Detrol) and oxybutynin (Ditropan) can be effective if the problem stems from increased contractions of the bladder.

It helps to talk with your health care provider to learn what is causing your nocturia because nocturia is not a disease in itself but a symptom of something going on in your body. You may learn that your nocturia is fairly easy to manage, on the other hand, your healthcare provider may discover your nocturia is caused by something more serious. Either way, you want to talk to your health care provider if you relate to these symptoms. 

If you’re you need help managing your nocturia or if you haven’t been diagnosed but suspect you might have nocturia, please give our office a call to schedule an appointment at 530-345-0064, extension 281. Nocturia can be manageable with the right treatment plan and symptoms can diminish when the underlying conditions causing the nocturia are properly addressed. 

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