Nocturia is the medical phrase for getting up at night to urinate.
Nocturia, broadly speaking, can be caused by two things:
A patient may also have a combination of nocturnal polyuria and low nocturnal bladder capacity.
We’ve found that the best way to distinguish between these two underlying causes is to have our patients complete a 24-hour bladder dairy. What this diary entails is recording how much one urinates, what time one urinates, and why one urinates for each urination over a 24-hour period (including the night-time). The bladder diary helps us differentiate between the three aforementioned causes: making too much urine at night, having a small bladder capacity at night, or some combination of the two.
Patients can trace nocturnal polyuria to a number of potential causes, including: drinking too much fluid in the evening, eating foods that contain high fluid contents (e.g. fruits), problems with hormonal regulation, cardiac problems, and sleep apnea. Additionally, swelling in the legs, called peripheral edema, can result in fluid mobilizing and being converted to urine when a patient lies down, also resulting in night-time urination(s).
If in-office evaluation reveals that a patient does in fact produce too much urine at night (nocturnal polyuria), we may recommend fluid restriction. Other times, we will tell patients to keep their legs elevated in the afternoon to mobilize the fluid and minimize the amount of swelling in their extremities. Alternatively, we have given patients water pills (diuretics) during the daytime to maximally mobilize the fluid in their bodies before they go to sleep. Patients with hormonal problems may be evaluated with multiple tests and may even need an endocrinologic workup.
There are multiple reasons a patient may have a smaller bladder capacity at night-time. For women, the most common reason is overactive bladder. This problem can typically be treated with medications initially.
Nighttime urination is typically is a curable problem. However, improper evaluation can often send patients down the wrong treatment path. Therefore, we strongly believe in an individualized approach which begins with a voiding diary. After this diary is complete we can provide more concrete solutions to the problem.
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