We all know how important sleep is. Even if you aren’t aware of the critical physiological things going on while you sleep (for example, the endocrine system, renal system and digestive system are all regulated by the sleep cycle), most of us know that we simply feel and perform better when well rested. We’re more alert, less moody, more energetic and generally can concentrate and remember things better when we’ve gotten enough shut-eye.
This is why having to get up in the middle of the night to use the bathroom is more than just annoying. If you’re losing sleep due to frequent urination, then you’re at risk for other health issues associated with poor sleep. The medical word for having to “go” in the middle of the night is nocturia. Unfortunately, nocturia becomes more common with increasing age. A poll by the National Sleep Foundation found that two-thirds of adults age 55 – 85 experience nocturia a few times each week.
One of the easiest things a person can do to reduce nocturia is limit evening fluid intake. Remember that whatever goes in must come out, and if fluids are going in late in the evening it is likely they will need to come out while you’re sleeping. It is also important to think about the type of fluids you are consuming. Drinks containing caffeine, alcohol and artificial sweeteners are known bladder irritants and should be avoided in the late afternoon and evening.
For some patients, nocturia may be a result of an overactive bladder. These people often have bothersome daytime voiding symptoms as well, including frequency, urgency and sometimes incontinence. These symptoms can be the result of a decreased bladder capacity, and patients may benefit from a medication that allows the bladder to hold more and thereby decrease the number of nighttime voids.
In women with nocturia and urge urinary incontinence, strengthening the pelvic floor muscle through pelvic floor or “Kegel” exercises has been shown to reduce nocturia episodes.
While there are multiple urologic causes for nocturia (please ignore this highlight)it is important to remember that there are also various underlying medical conditions that can contribute to this problem, including congestive heart failure, diabetes, sleep apnea and peripheral edema (swelling in arms or legs). For patients with lower extremity edema, wearing compression stockings during the day and elevating the legs at night can mobilize fluids and help prevent nocturnal fluid redistribution.
The good news is that there are ways to manage nocturia and help you get the sleep you need. We want you to have sweet dreams, not bathroom visits, so talk with your doctor. Find a Roper St. Francis urologist near you.
By M. Francie James, MD, a urologist with Roper St. Francis Physician Partners