Nocturia

Nocturia is the condition in which there is frequent urge of urination in the night or at times wetting of the bed. There are several types and causes of nocturia.

Beware:

  • Some of the known causes of Nocturia:
  • Frequent urine production in the body.
  • Greater than the normal amount of urine production. (greater than 2ltrs).
  • Lower nocturnal bladder capacity.
  • Mixed noturia: Nocturnal polyuria and low nocturnal bladder capacity.
  • Poor sleep.
  • Family history of diabetes/ bladder infections.

Types & Causes:

  • Polyuria: Frequent and over production of urea.
  • High intake of fluid.
  • Untreated type 1/ type 2 diabetes.
  • Occurrence during pregnancy gestational diabetes.
  • Diabetes insipidus.
  • Nocturnal Polyuria: Frequent and over production of urea at night.
  • Sudden stop/ interrupted breathing at night.
  • Heart failure ie congestive.
  • Edema of legs.
  • Side effects of diurectic drugs containing glycosides, excessive vitamin D, demeclocycline, propoxyphene, lithium, methoxyflurane, phenytoin.
  • High intake of fluid/ coffee/ alcohol, etc before bedtime.
  • Low Nocturnal Bladder Capacity: Urine holding capacity of bladder reduces at night.
  • Obstruction/ inflammation/aching in bladder.
  • Overactivity observed in the bladder.
  • Recurrent UTI.
  • Bladder pain known as interstitial cystitis.
  • Non cancerous malignancy of the bladder.

When to approach your doctor?:

  • Frequent wetting of bed.
  • Having to wake up twice or more times at night to urinate.
  • Reduced production of urine.

Diagnosis Tests:

  • Urine culture.
  • Maintaning & studying a bladder void diary.
  • Fluid deprivation test.
  • Blood sugar test.
  • Blood urea test.

Nocturia Treatment:

  • Cause Specific Medications:
  • Reduce the over reactive bladder, Urinary incontinence: tolterodine, anticholinergic, oxybutynin, solifenacin, antimuscarinic agents.
  • Regulate urine production: diurectis like bumetanide, furosemide.
  • Reduce urine production at the kidneys: desmopressin ( side effect in old age/ high risk patients-dilutional hyponatremia- ie risk of maintaining appropriate serum sodium concentration levels)
  • Surgery: For overreactive bladder
  • Surgery for the correction of a pelvic organ prolapse.
    Cystoplasty of clam.
  • Detrusr myectomy.
  • Scaral nerve stimulation.

Patient’s Participation:

  • Wear water compression stalking.
  • Avoid high fluid intake before bedtime. (water, caffiene, and alcohol).
  • Timely intake of prescribed medicines. (take mid- to late afternoon, six hours before bedtime).
  • Take afternoon naps.
  • As an exercise, tme and again, elevate the legs (helps prevent fluid accumulation).
  • Healthy, nutritious lifestyle.

How Does Nocturia Affect the Daily Life?:

  • Irritability, increased intolerance levels due to sleep deprivation.
  • Fatigue and reduced stamina.
  • Dullness and sleepiness throughout the day negatively impacting the productivity.
  • Cognitive dysfunction.
  • High risk of accidents due to reduced levels of alertness and awareness.
  • Life span reduction.
  • Healthy balanced meals.

Prevention & Precaution is Better than Cure:

  • Healthy balanced meals.
  • Avoid fatty foods.
  • High intake of fibrous foods.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient.