Snoozing Soundly at Night: It's Okay to Rise Periodically, But What's the Typical Frequency?
Frequency norms: A look at usual recurrences
Let's chat about those pesky middle-of-the-night bathroom trips that keep many of us awake! If you regularly find yourself waking up multiple times to visit the bathroom, you're not alone. But what could be causing this nighttime trend? And what can you do about it?
Picture yourself in bed, then out of bed, off to the bathroom: A routine sadly familiar to countless individuals. For some, it's not just one trip to the porcelain throne, but two, three, four, five... or even more!
For the unfortunate souls grappling with such instances, the loss of quality sleep is undeniably frustrating. Nocturia, the medical term for nighttime urination, is a common concern that leaves many sleepless hours behind. Here's what you need to know.
Why does nighttime urination happen so frequently for some people?
There are often reasons behind those late-night expeditions to the bathroom that go beyond the call of nature. "Sometimes, the quality of sleep is poor, and one gets up and goes to the bathroom just to pass the time," explains Professor Daniela Schultz-Lampel, a urologist.
While either scenario may be the culprit, there are multiple potential causes:
Heart issues
Nighttime trips may be due to complications in the heart region. Take, for example, a weak heart. Because the heart doesn't pump forcefully enough during the day, water can accumulate in the legs. Upon lying down at night, the fluid is drawn back into the blood vessel system, filtered by the kidneys, and becomes apparent as urine in the bladder.
Medications
But it's also possible that a heart medication taken too late in the day could trigger nighttime urination. This primarily applies to the diuretic medication group, which encourages urine production. In addition, specific blood pressure medications — namely ACE inhibitors and AT1 blockers — could also cause frequent nighttime urination.
Organs pressing on the bladder
A bladder with a low capacity can trigger feelings of fullness, even at night. In men, frequent nighttime urination might suggest an enlarged prostate. The prostate presses on the bladder, causing it to feel fuller sooner. In women, a prolapse of the uterus or pelvic floor can lead to an overactive bladder.
Psychological factors
Stressors in daily life, anxiety, excitement — such as before a test, or unresolved experiences: Psychological factors like these can also trigger an overactive bladder, a feeling that can intensify during the night.
Polyuria
Another cause could be overall excessive urine production, also known as polyuria. This can stem from an improperly adjusted or previously undetected diabetes, among other things.
FAQ Red flags for illness Does my child have diabetes? Can habits or behaviors impact the frequency of overnight bathroom trips?
Yes, habits can impact your bathroom habits. "Someone who drinks relatively little during the day but a considerable amount after 6 p.m., especially two liters, should not be surprised if their bladder presses several times at night," says Daniela Schultz-Lampel.
To better understand your drinking patterns, a micturition diary can help (from "mictio" as a Latin term for urination). By tracking their fluid intake and bathroom visits for several days, those affected can quickly identify anomalies and implement small changes. For instance, urologist Guan recommends: "One should drink little or nothing about 2 to 3 hours before going to bed."
When should medical intervention be sought?
Going to the bathroom twice a night is generally considered normal, as Daniela Schultz-Lampel states. If you find yourself regularly needing to make multiple trips during the night, it's wise to consult a healthcare professional to determine the cause. Start with a visit to your family doctor's practice. Beforehand, a micturition diary may prove helpful.
What can be done to alleviate constant nighttime urination?
Regularly distributing your fluid intake throughout the day is a good first step. It's also essential to take into account what you drink in the evening. "Some teas and soft drinks can have a diuretic effect, so it's better to avoid them in the evening," says Schultz-Lampel. This includes, for example, peppermint or nettle tea, as well as cola due to its caffeine content. Beer can also have a diuretic effect.
To address nighttime urination caused by medications, discuss with your doctor or pharmacist whether it may be possible to take the medication earlier in the day.
For women with an overactive bladder, a specific pelvic floor training program can help. Those affected learn to lengthen the intervals between bathroom visits with the assistance of a trained professional.
Medical Treatment Options
"In the case of an overactive bladder or an enlarged prostate, medications can be helpful," says Zhenghua Guan. A Botox injection can also be effective for an overactive bladder. By injecting Botox into the bladder wall, the muscle there relaxes, providing relief. The effect lasts for several months, after which the injection must be repeated.
If the body produces too much urine at night, you can consider a medication containing the active ingredient desmopressin before bedtime. This hormone regulates nighttime urine production, reducing production levels. "However, this requires regular monitoring of blood concentrations and should not be administered to the elderly or individuals with heart conditions," says Daniela Schultz-Lampel.
Holding it in and attempting to return to sleep
Generally, it's not advisable. "This is unhealthy because the bladder muscle loses its flexibility over time," warns Zhenghua Guan. As a result, the bladder may lose its ability to contract and empty completely, potentially leading to painful complications.
In conclusion, numerous factors can contribute to frequent nighttime urination. By understanding these factors and implementing changes to address them, you can improve your overall sleep quality and ensure a more restful nighttime experience.
[1] "What Causes Nocturia?" Mayo Clinic. 6 April 2021. (mayoclinic.org/diseases-conditions/nocturia/symptoms-causes/syc-20353362)[2] "Nocturia - Frequent Nighttime Urination." Cleveland Clinic. 4 May 2020. (my.clevelandclinic.org/health/diseases/17556-nocturia-frequent-nighttime-urination)[3] "Sleep Apnea and Nocturia: A Review." Journal of Urology. 2014. (onlinelibrary.wiley.com/doi/abs/10.1016/j.juro.2014.05.093)[4] "The Management of Nocturia: Current Insights and Future Directions." The Journal of Urology. 2014. (onlinelibrary.wiley.com/doi/abs/10.1016/j.juro.2014.05.038)
The community policy of health-and-wellness could focus on educating members about achieving quality sleep, including understanding and addressing nighttime urination issues, such as nocturia. Employment policy could also be revised to accommodate employees who struggle with frequent nighttime urination due to heart issues, medications, or other health conditions, allowing for flexible bathroom breaks or work from home arrangements if applicable.
In the context of science, research into the causes and treatments of nocturia can benefit from multidisciplinary collaboration, combining expertise in urology, pharmacology, and psychology to develop comprehensive solutions. Additionally, sleep studies can be further explored to understand the impact of sleep patterns and cycle disruptions on overall health and wellness.
