• Nocturia is waking up more than once in night for urinating after going to sleep.
  • Waking up more than once at night for urinating leads to sleeplessness, fatigue, poor concentration daytime, anxiety etc.
  • Nocturia can be due to increased urinary frequency at night-time or increased urine production at night (Global or Nocturnal polyuria).

Global Polyuria – Patient passes more urine during day time as well. Causes include uncontrolled blood sugars, diabetes insipidus (lack of vasopressin hormone).

Nocturnal polyuria – patient passes more urine only during night-time. Various reasons for increased urine output at night include congestive cardiac failure, varicose veins, sleep apnea, swelling lower limbs, drinking lot of fluid before sleep, taking certain medications that increase urine production etc.

Nocturnal frequency – Some patients may not be producing more urine at night but may wake up more often from sleep for urination due to urinary tract infection, OAB (overactive bladder), Prostate enlargement (Read BPH (Enlarged prostate) Symptoms) , small bladder capacity, stroke, interstitial cystitis etc.

Diagnosis is made by doctor after recording detailed history from patient. Patients are usually given a chart to record his drinking and urination habits over whole 24 hour, called bladder diary. Increased urine production need thorough workup to rule out heart condition, diabetes, snoring habits, lower limb edema etc. Certain conditions such as prostate enlargement need ultrasonography tests to look for prostate size. Urine infection is ruled out by taking urine sample for testing.

Treatment of nocturia is as per the underlying cause identified. Restricting fluid intake after evening and Passing urine immediately before sleep is advised. Changing the schedule of diuretic drug, wearing compression stockings during daytime, control of diabetes etc are helpful. Nocturia secondary due to cardiac dysfunction, snoring needs respective consult from cardiologist and ENT specialist. Symptoms due to prostate enlargement may need medicine or surgery for prostate. Patients experiencing increased frequency due to infection are treated with antibiotics. Certain medications such as anticholinergics and beta agonist are helpful in controlling increased frequency. Increased urine output at night is treated with desmopressin medication.

Published by Dr Varinder Attri

MS MCh (PGI Chandigarh), Urologist and Andrologist

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