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