Nocturia (Night-time urination)

Nocturia (Night-time urination) - What it is

Nocturia refers to the need to wake up to pass urine at night, followed by a return to sleep. This becomes more common as we grow older. It is acceptable to do this once a night, but waking up twice or more a night could be a symptom of an underlying medical condition.

Nocturia (Night-time urination) - Causes and Risk Factors

There are many possible causes of nocturia, and often a combination of more than one of these factors result in Nocturia.

Some of the causes of nocturia include:

Ageing
Pregnancy
Lifestyle habits

Excessive fluids intake
High salt intake
Drinking just before bedtime
Consuming alcohol and/or caffeine – especially evening time

Underlying medical conditions

Uncontrolled diabetes
Heart failure
Kidney and Liver problems

Sleep disorders

Obstructive Sleep Apnoea (OSA)
Insomnia

Medications

Diuretic agents
Mood stabilisers
Some blood pressure and diabetes medications

Urinary tract conditions

Benign prostatic hyperplasia (BPH)
Overactive bladder
Urinary tract infection (UTI)

Nocturia (Night-time urination) - Diagnosis

When should I see a Urologist?

If you are waking up 2 or more times at night, consult your family physician to exclude underlying medical problems and for adjustments of your existing medications. You may be referred to a Urologist to evaluate for urinary tract problems.

Symptoms that may suggest a urinary tract problem include:

Difficulty passing urine
Slow and/or Interrupted urine flow
Sensation of incomplete bladder emptying
Frequent urination
Urgency – difficulty delaying urination due to a strong urgent sensation

If you have symptoms suggestive of an underlying urinary tract problem, you can book an appointment to see one of our specialists.

What can I expect when I see a Urologist?

You doctor will speak to you to find out more about the type of symptoms you are experiencing, and perform a clinical examination. Some of the routine tests you may be asked to do include:

Urine tests to exclude UTI
Uroflowmetry
Bladder diary – a 3-day record of your fluids intake and output

You may be referred to different specialists for further evaluation if your doctor suspects that you have underlying medical problems.

Nocturia (Night-time urination) - Treatments

The causes of Nocturia are diverse, and the management plans are tailored to the individuals. The core strategies include:

Managing lifestyle habits

Reduce dietary salt intake
Avoid fluids consumption before sleep – at least 2 hours before bedtime
Avoid alcohol/caffeine in the evening
Taking you evening dose diuretic medication at earlier timing

Treating underlying medical conditions
Adjusting medication schedule
Treating urinary tract problems
Desmopressin – if you are prescribed this medication, you will require regular blood tests to monitor sodium levels

You can embark on the lifestyle modifications strategies as above to improve your Nocturia. Your doctor will have a more detailed discussion with you on the appropriate management plans during your consultation.