Medication As A Last Resot
Desmopression , anticholinergic medicines , and diuretic medicines are some common medical treatments. However, most doctors prefer these to be a last resort for nocturia and prefer to treat the underlying cause instead.
In those cases, treating the underlying insomnia is whats required, rather than treating the bladder, which might be an innocent bystander, Malhotra says. Nocturia might seem like a nuisance, or it might seem trivial, but in some cases, its a marker of more serious conditions. If you think you might have a problem, go talk to your doctor, because it may be a symptom of a bigger issue that can be addressed.
The good news is that nocturia often improves with long-term lifestyle changes, including sleep hygiene. Research suggests these several sleep tips can help reduce nocturia:
- Spending fewer awake hours in bed, as longer periods of being awake can increase chances of needing to pee.
Cause Of Nocturia: An Enlarged Prostate
As men grow older, something called benign prostatic hyperplasiaor an enlargement of the walnut-shaped prostate glandcan occur. This can be due to changing levels of hormones, including less testosterone production or an accumulation of dihydrotestosterone.
An enlarged prostate gland can cause pressure on your bladder, making you think it needs emptying more often than it does, says Dr. Phillips. A bigger-than-usual prostate can also cause other urinary symptoms, like issues starting or stopping your flow, a weak stream, or the feeling you didn’t complete empty your bladder after peeing.
An enlarged prostate can be treated with drugs like Flomax, Myrbetriq or anticholinergics that relax the bladder muscles, as well as the UroLift procedure.
What Are The Symptoms Of Nocturia
Normally, you should be able to sleep six to eight hours during the night without having to get up to go to the bathroom. People who have nocturia wake up more than once a night to urinate. This can cause disruptions in a normal sleep cycle.
Symptoms of nocturia can include:
- Waking up more than once a night to urinate.
- Urinating more volume .
- Fatigue, sleepiness even after waking up. This occurs because the frequent urinations can interrupt your sleep cycle.
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Why You Are Leaking Urine
- You Cant Wake During the Night
Between the ages of 2 and 6, most people develop the ability to wake during the night if the body senses that the bladder is full. However, if an individual is a very heavy sleeper, this can mean that they dont wake up if they need the toilet, meaning they may go while they are asleep.
Epidemiologic evidence from several studies has shown that urinary incontinence is 50 % more common in women with Diabetes than those with normal glucose levels. High blood sugar can cause an increase in the amount of urine produced, resulting in urgency and more frequent urination.
A combination of pressure on the bladder, hormones and the tear of childbirth means your pelvic floor muscles can suffer. As a result, you are likely to have a weak bladder, and can occasionally leak urine during the night and day.
What Natural Remedies Can Treat Bedwetting At Home
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful.
- Reduce evening fluid intake. The child should try to not take excessive fluids, chocolate, caffeine, carbonated drinks, or citrus after 3 p.m. Routine fluids with dinner are appropriate.
- The child should urinate in the toilet before bedtime.
- Set a goal for the child of getting up at night to use the toilet. Instead of focusing on making it through the night dry, help the child understand that it is more important to wake up every night to use the toilet.
- A system of sticker charts and rewards works for some children. The child gets a sticker on the chart for every night of remaining dry. Collecting a certain number of stickers earns a reward. For younger children, such a motivational approach has been shown to provide significant improvement in most children with a low relapse rate .
- Make sure the child has safe and easy access to the toilet. Clear the path from his or her bed to the toilet and install night-lights. Provide a portable toilet if necessary.
- Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet. Others argue that pull-ups help the child feel more independent and confident. Many parents limit their use to camping trips or sleepovers.
The parents’ attitude toward the bedwetting is all-important in motivating the child.
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How Normal Is Peeing In The Middle Of The Night
If your bladder acts as a middle-of-the-night alarm clock, you might be curious whether its a cause for concern.
Turns out youre in good company if youre wondering. Is it normal to pee in the middle of the night? is one of the most common questions that , a urologist with Indiana University Health, said he gets asked in his practice.
In general, if you are waking up to pee once during the night, its likely that is normal for you, Rivera said. The kidneys main function is to filter out toxins from the bloodstream and concentrate those toxins into urine. According to Rivera, this is done continuously during the day we are typically every two to four hours depending on hydration status and fluid consumption but at night, the body releases hormones to concentrate the urine more than during the daytime. Hence why we dont typically wake up as much at night to urinate.
But if you are peeing more than once during the night or running to the bathroom is disrupting your sleep, you might need to examine other areas of your waking life.
Here are a few of the most common reasons you may be getting up to pee, whether theyre considered normal and expert advice on what to do about them.
What Causes Bedwetting In Children
Nighttime wetting is often related to slow physical development, a family history of bedwetting, or making too much urine at night. In many cases, there is more than one cause. Children almost never wet the bed on purposeand most children who wet the bed are physically and emotionally normal.
Sometimes a health condition can lead to bedwetting, such as diabetes or constipation.
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How Will My Child’s Bed
Most children outgrow bed-wetting without treatment. However, it’s up to you and your doctor to decide if your child needs treatment. There are two kinds of treatment for bed-wetting: behavioral therapy and medicine. Whichever treatment is chosen, it’s most successful when the parents, the child and the doctor work together to be supportive for the child. A diary that keeps track of wet and dry nights is helpful during treatment. It will help you and your doctor see your child’s progress. It will also remind your child about how well he or she is doing during the treatment.
How Is Nocturia Diagnosed
To help your healthcare provider diagnose nocturia, you can keep a fluid and voiding diary. This is a two-day record of how much you drink, how often you have to go the bathroom and how much you urinated . You should also record any medications you are taking, any urinary tract infections and any related symptoms. Your healthcare provider will review the diary in order to determine the possible cause of and treatment for the nocturia.
Your provider may ask you the following questions:
- When did this condition start?
- How many times do you need to urinate each night?
- Is there a large or small volume of urine when you void at night?
- Has there been a change in urination output ?
- How much caffeine do you drink each day, if any?
- Does frequent urination during the night keep you from getting enough sleep?
- Do you drink alcoholic beverages? If so, how much each day?
- Has your diet changed recently?
In addition to reviewing your voiding diary, your doctor may order a urinalysis to examine your urine for infection.
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Types Of Nocturnal Enuresis
Persistent Primary Nocturnal Enuresis is a condition which starts during childhood, where night time dryness has not been achieved for longer than six months. About 2 3% of adults over 18 years of age have this type of nocturnal enuresis. Adult Onset Secondary Enuresis is defined as nocturnal enuresis in which night time dryness has been achieved at some point in life. Dryness may have occurred for many years but then night time wetting suddenly begins at an older age.
What Does Nocturnal Enuresis Mean
Nighttime incontinence, bedwetting in adults, bladder weakness at night all terms used to describe nocturnal enuresis. Involuntary leakage of urine during the day i.e. when awake is called urinary incontinence according to the definition of the International Continence Society 1. If this involuntary urination occurs during sleep i.e. mostly at night experts referred to it as enuresis or nocturnal enuresis.
Bedwetting does not only occur in children and adolescents many adult women and men have also experienced uncontrolled emptying of the bladder during sleep. However, if a person is bedwetting this does not mean they are necessarily incontinent. Occasional, uncontrolled urination during sleep is not a cause for concern. From a medical point of view, enuresis is only diagnosed in people over the age of 5 if nocturnal enuresis occurs twice a month for at least a period of three months2,3 or regular urine leakage during sleep.
Nocturia constant urge to urinate at night is not urinary incontinence
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Cause Of Nocturia: Not
Alcohol is a diuretic, which increases your urine production, so drinking it late in the day could lead to excessive nighttime urination. Drinking too many fluids at night, regardless of what type, can also lead to nocturia.
Jason M. Phillips, M.D., a urologist with North Coast Urology, recommends cutting out all fluids two to four hours before bed and steering clear of alcohol in the evening to prevent late-night bathroom trips if you’ve been bothered my nighttime peeing.
You’re Low On This Hormone
“With aging comes a natural loss of antidiuretic hormone,” says Tobias Köhler, MD, chair of urology at Illinois’s Memorial Hospital. This hormone helps your kidneys control their fluid levels. The less of the hormone you have, the more you pee. Köhler says this natural hormone loss usually starts around age 40, but often becomes noticeable much laterduring your 60s or 70s. “There are some drug therapies, but a lot of people just deal with it,” he says.
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Surgical Treatment For Adult Bedwetting
The involvement of surgery when attempting to treat severe detrusor overactivity is limited and should only be considered when all other less invasive treatment options have proven to be unsuccessful. All of the procedures mentioned below have associated risks that must be considered and discussed with a healthcare professional.
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Sacral Nerve Stimulation. Sacral nerve roots are stimulated by neuromodulation, a process where neurotransmitters control various neuron groups. This increases the external sphincter tone causing the detrusor muscle neurons to stop activity. When detrusor muscle neurons have a decreased activity level the muscle will not contract constantly, which ultimately causes less frequent urination episodes. SNS is recommended for people with moderate to severe urge incontinence and for whom other treatments have not been helpful or for whom prescriptions are contraindicated.
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Clam Cystoplasty. This is a surgical treatment where the bladder is cut open and a patch of intestine is placed in between the two halves. The goal of this procedure is to reduce bladder instability and increase bladder capacity.
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Detrusor Myectomy. This process is also known as autoaugmentation that involves removing a portion or all of the exterior muscle surrounding the bladder. It intends to strengthen bladder contractions while reducing the number of them.
What Happens If It Doesn’t Stop
Bedwetting, also called nocturnal enuresis, is only a problem if it’s a regular occurrence. Some people have never experienced a dry period since they were kids. For others, bedwetting comes back to them after years of never having even one accident. According to the National Association for Continence, 2% of the U.S. population experiences recurring bedwetting.
If you’re a teenager, it’s likely that your system is just a little slow and that your body will learn to coordinate itself with time.
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Producing Excess Urine At Night
Producing excess urine at night is known as nocturnal polyuria, and it is estimated to be a contributing cause for up to 88% of cases of nocturia.
For some people, excess urine production occurs throughout the day and night. This condition, called global polyuria, is most often tied to excess fluid intake, diabetes, and/or poor kidney function. Diuretics, including medications and substances like alcohol and caffeine, can cause enhanced urine production as well.
Elevated amounts of urine production that occurs only at night can occur when fluid intake goes up at night. It can also occur when peripheral edema swelling or fluid accumulation in the legs relocates after a person moves into a lying position. Coexisting medical problems can contribute to peripheral edema and thus raise the risk of nocturnal polyuria.
Some research indicates that changes to the bodys circadian rhythm cause older adults to have a greater proportion of their daily urine production occur at night, which may be a contributing factor to their higher rates of nocturia.
Causes Of Bedwetting In Adults
There are two types of bedwetting:
- Persistant primary nocturnal enuresis is a condition that begins in childhood and is when someone hasn’t experienced nighttime dryness for longer than 6 months. There is evidence to show that this kind of bedwetting is hereditary.
- Adult-onset secondary enuresis is for people who have experienced dryness but then experience a recurrence later in life.
According to Dr. Margaret Stearn, if you’ve just started bedwetting after a long period of being dry, some of the underlying causes could be:
- A urinary tract infection, which can make it difficult for the bladder to hold urine
- Alcohol, coffee or diuretic medicines, which all cause production of more urine and can irritate the bladder
- Sleeping tablets – Sometimes these cause sleep so deep the body doesn’t wake up when it recognizes that it needs to go
- Diabetes – Lots of urine can be a symptom of diabetes. If the diabetes is treated, this problem goes away
- Stress and anxiety
- Some medications
- A spinal cord injury
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Could It Be Something Else
See a doctor if you’ve tried to control the problem but it’s not getting better. Other medical issues can cause your bladder to hold less than it should. These include:
- Bladder tumor
Conditions that can cause your body to make too much urine include:
- Diabetes
- Liver failure
- Neurologic diseases like multiple sclerosis, Alzheimerâs and Parkinsonâs
If you have an underlying health issue and you get it treated, that may stop the nighttime peeing problem. But you may need medication to help with that, too.
When To See A Provider
Because enuresis can be the result of another underlying medical condition, experts recommend that all adults experiencing nighttime bedwetting see a healthcare provider as soon as possible. They’ll be able to review your medical history, discuss symptoms, and perform any tests needed to get an accurate diagnosis, and they can rule out any other serious medical conditions. From there, you’ll be on the road to the best treatment option.
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Nocturia Or Frequent Urination At Night
Millions of Americans are affected by a frequent need to urinate during the night. This is known as nocturia, and it is often cited as a cause of sleep disruptions. Though frequently thought of as a problem in elderly people, it can impact people of all ages.
Trips to the bathroom can cause fragmented sleep, excessive daytime sleepiness, and an elevated risk of dangerous falls. Nocturia has numerous potential causes and can be connected to a range of serious health issues.
Although nocturia is common, it shouldnt be accepted as inevitable. In many cases, steps can be taken to reduce bathroom trips and improve sleep. Understanding the basics about frequent nighttime urination, including its causes, consequences, and treatments, can be a first step for people of any age to sleep better and with less bothersome nocturia.
What Are Other Health Risks Related To Nocturia
The consequences of frequent urination at night go beyond just poor sleep. For older adults, nocturia creates a higher risk of falls, especially if they are rushing to get to the bathroom. Studies indicate that fall and fracture risks increase by 50% or more for people with two or more nighttime bathroom trips.
Nocturia has been associated with reduced scores on quality of life measurements as well as negative health conditions including depression. Beyond specific negative impacts, nocturia has also been connected to higher overall mortality although further research is necessary to fully understand this correlation.
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You Have Prostate Problems
A man’s prostate doesn’t stop growing until the day he dies. “If you live long enough, you will have prostate issues,” Wexler says. An enlarged prostate can pinch a man’s urethra closed, making it difficult for him to fully empty his bladder. That can make him feel like he has to urinate all the time, Wexler says. The good news: Prostate-related peeing problems usually have nothing to do with prostate cancer, he says. There are also drug or surgery treatments available if your enlarged prostate is causing urinary issues that are too annoying to ignore.
