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5 Things to Know About Night-Time Bathroom Breaks

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Posted by Steven Sterious, MD

bathroom night

We’ve all gotten up in the middle of the night to use the bathroom at one point. However, if you are routinely getting up two or more times a night to urinate, that’s a sign of a condition called nocturia.

Most of the people who deal with nocturia are over the age of 60, but I see patients of all ages who are affected by it.

Nocturia may sound like a minor inconvenience, but it can actually cause bigger problems or be a symptom of other conditions. So it’s important to get any urinary symptoms checked out by a urologist.

Here are five important things that I want people diagnosed with nocturia to know. 

Nocturia isn’t a disease. It’s a signal that something else is going on in the body. And it’s a condition that’s worth discussing with a specialist. Disrupted sleep can impact your quality of life and make even the most stoic people grumpy, groggy, or unproductive. Over time, a lack of good sleep can even contribute to other health problems.

Here are some questions I am often asked by people diagnosed with nocturia.

What causes nocturia?

Nocturia can be triggered by lifestyle habits, medications, or underlying health conditions. Anyone can develop nocturia due to:

  • Drinking too much fluid before bed, especially caffeine or alcohol
  • Making a habit of getting up to use the bathroom, even if you don’t necessarily need to go
  • The timing or dosage of medications like diuretics, lithium, cardiac glycosides, demeclocycline, methoxyflurane, phenytoin, propoxyphene, or excessive amounts of vitamin D

Nocturia can also be a symptom of other health conditions, such as:

  • Bladder stones or inflammation
  • Complications from childbirth
  • Diabetes
  • Heart or vascular disease
  • High blood pressure
  • Hormone changes that occur during menopause
  • Interstitial cystitis — a condition that causes chronic pain and pressure in the bladder
  • Nocturnal polyuria — when the body produces too much urine at night
  • Prostate obstruction — when the prostate restricts the flow of urine through the urethra
  • Reduced bladder capacity, which happens to many people as they age
  • Restless leg syndrome — when you have a strong urge to move your legs at night
  • Sleep disorders
  • Swelling of the legs
  • Vaginal or pelvic prolapse — when organs from the pelvis slip from their usual position into the vagina

There’s no one clear cause of nocturia. In fact, with most of my patients, I see multiple factors that contribute to their symptoms.

How can I prepare to talk to my doctor about nocturia?

Your care team will take a medical history, including asking about family history and your medication usage, so come to your appointment with that information. 

In addition to being prepared for these questions, it also helps if you bring a bladder diary. A bladder diary is a simple record of your hydration and urination.

For a week, track what kind of fluids you take in, when, and how much. Write down how often you use the bathroom during the day and at night, and take note of any bladder leaks. That kind of information is a powerful tool to help your doctor identify patterns and triggers.

At your appointment, you can expect a physical exam, and you’ll need to give a urine sample. It will be tested to determine the contents of your urine, which can help pinpoint what’s causing the nocturia. You might also have a blood test, a bladder scan, or a cystoscopy (a test where your doctor uses a scope to look inside your bladder). Your care team will use all of this data to determine a personalized course of action for you.

What are the treatment options for nocturia?

In my experience, the first step in treating nocturia is to address any underlying conditions that may be contributing to the problem. From there, I look at lifestyle changes and medications.

Daily habits can make a real difference with nocturia. I often recommend that people with nocturia:

  • Restrict fluids prior to settling down for the night. It’s important to drink plenty of fluids during the day, but limiting fluids in the two to four hours before bed can decrease nocturia. Generally limiting alcohol and caffeine can help as well.
  • Practice good sleep hygiene. Stick with a consistent sleep schedule. Make your bedroom a dark, comfortable space, and reserve the bed for sleeping and sex.
  • Manage medications. Diuretics make you use the bathroom more, so if you have to take one for a health condition, use it at least six hours before bedtime.
  • Elevate legs or use compression socks. Fluid buildup in the legs can contribute to nocturia. Using elastic compression socks or simply keeping your legs elevated can help redistribute fluids back into the bloodstream.
  • Enjoy an afternoon nap. A short nap can be energizing after a night of poor sleep. It can also allow liquids to be absorbed into the bloodstream.

Tracking these lifestyle changes and your nocturia symptoms in a journal can help you and your care team figure out what’s going on and find the best treatments for you.

If lifestyle changes aren’t doing enough to address nocturia, there are medications that may be beneficial. I commonly prescribe medicines that: 

  • Help the kidneys produce less urine
  • Treat bladder muscle problems, including spasms and overactive bladder
  • Regulate urine production (diuretics) 
  • Treatment of any underlying conditions, and making good lifestyle choices, can help improve nocturia.

What’s the most important thing I can do to address my nocturia?

Discuss it with your doctor.

It’s easy to think of nocturia as nothing more than a nuisance, but it can impact your well-being and be a symptom of other issues. Frank conversations and a simple physical exam can help you get healthy and well-rested.

I advise my patients to pay attention to what improves their ability to sleep through the night and what can cause problems. Dealing with nocturia is usually a long-term project, and staying on top of good habits is key. So is tracking your progress and staying in contact with your care team.

Put nocturia to bed for good

At Temple Health, we are your partners. Our team of expert urologists has extensive experience with urinary issues, and we work closely with providers from all specialties to collaborate on comprehensive patient care. If nocturia is disrupting your sleep, we can help.

Request an appointment with a Temple Health urologist or call 800-TEMPLE-MED (800-836-7536) today.

Helpful Resources

Looking for more information?

Steven Sterious, MD

Steven Sterious, M.D., Professor, Urology/Urologic Oncology, Fox Chase Cancer Center, is a general urologist with a focus on benign prostatic hyperplasia. His patient base is varied with numerous urologic diseases including kidney stones, erectile dysfunction, men’s health, low testosterone, as well as endoscopic management of bladder cancer as well as kidney stones.  

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