Alternative Treatments For Nocturia
Many people turn to complementary and alternative medicine before seeking medical help. You may also be interested in alternative medications or treatments for nocturia, but there are few studies to support their use. These treatments may work for nocturia, but only if OAB is the cause.
For example, research has found that:
- herbal medications have a positive impact on symptoms of OAB and quality of life
- acupuncture provides short-term relief for OAB symptoms
- homeopathic remedies may have benefits, but need more studies
- alternative treatments have fewer side effects than medications
- saw palmetto berry extract has no benefit for nocturia
But more research is needed to confirm if CAM works for OAB.
Always talk to your doctor before trying a supplement or alternative treatment. Certain CAM treatments can cause unintended side effects, especially if youre already taking medication.
Minimize Urine Production At Night
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This one is pretty obvious, but its important. As we age, we tend to not be able to hold as much in our bladder, which can make us have to use the bathroom more often even if were drinking the same amount as we always have before. Be careful not to limit your fluids too much, but do watch what youre eating and drinking in the few hours before bed to ensure youre not falling asleep with an already too full bladder.
Avoid excessive fluid intake 4-6 hours before bed
Avoid caffeine after the morning and limit alcohol at night. Both alcohol and caffeine can make urine more acidic which can irritate the lining of the bladder, causing you to need the bathroom more frequently.
Empty your bladder before bed.
Take any medications that may act as diuretics earlier in the day if possible .
In This Video Urogynecologist Lauri Romanzi Md Explains How You Can Avoid Urinating At Night If You Have Overactive Bladder
If you have overactive bladder, your nighttime routine may look a lot like this: teeth brushed? Check. Face washed? Check. Bladder emptied? Check. Maybe one more time just in case. Bladder emptied again. Check?
Then you scurry off to bed with another question mark hanging over your head, wondering how many more bathroom trips youll need to make later that night. Nocturia, or frequent nighttime voiding, is a common symptom of overactive bladder. Most people can sleep through the night without urinating, but more than one-third of adults suffering from nocturia make at least two trips to the bathroom every night.
Nighttime urgency and frequent nighttime voiding is probably one of the worse health impacts of overactive bladder, says Lauri Romanzi, MD, a urogynecologist in New York City. It interferes with sleep, and anything that interferes with sleep night after night is not good for your health.
To help limit frequent nighttime urination, try these tips:
1. Watch your fluid intake. Drinking a lot of liquid during the day, especially late in the day, can increase your likelihood of getting up in the middle of the night to go. Modify the pace and the timing of your fluid intake so that you avoid drinking in the late afternoon and early evening, says Dr. Romanzi. Here are tips to make sure youre drinking the right amount of water for your body. And whatever you do, dont make this drinking mistake that makes overactive bladder worse.
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Spinal Cord Diseases And Injuries
Bladder problems are common among multiple sclerosis patients and include urgency of urination, an overactive bladder, and a bladder that does not fully empty. Diet modifications and nerve stimulation procedures may be able to help patients control these issues. Other neurological conditions are closely associated with frequent urination in women too, especially if a spinal cord injury is involved. In healthy women, messages are sent from the bladder to the brain when the bladder is full. But with a spinal cord disease or injury, these messages may not be sent or received.
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How To Know For Sure
Itâs important to know for sure if you have diabetes. Itâs a serious condition that can lead to many other health problems. Your doctor can use several kinds of blood tests to diagnose diabetes or rule it out.
A1c. Also called a glycated hemoglobin test, this measures your average blood sugar level for the past 2 or 3 months. You donât need to fast or drink anything special for this test. An A1c level of 6.5 or higher shows you have diabetes. Below 5.7 is normal.
Oral glucose tolerance. After you fast all night, you give a blood sample both before and 2 hours after you finish a sweet drink. Blood sugar levels of more than 200 mg/dL after 2 hours means you have diabetes. Less than 140 mg/dL is normal.
Random blood sugar. You give blood at a random time. A level of 200 mg/dL or higher shows diabetes.
You’ll need these done twice to make a firm diagnosis.
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Why Do I Have Pain In My Lower Abdomen When I Pee
Acute Retention of Urine. If you are having frequent urination and lower abdominal pain, please know it is save to be considered due to cystitis until proven otherwise. Cystitis or urinary tract infection is the most common cause of abdominal pain and frequent passing of urine with or without burning sensation.
Urinary Tract Kidney And Bladder Infections
One of the most common causes of frequent urination is a urinary tract infection, or UTI. More than half of women experience one or more UTIs in their lifetimes, many of which occur by a womans early 20s. UTIs are commonly caused by bacteria getting into the urinary tract from sexual intercourse or improper wiping while using the toilet. However, the frequent burning urination associated with a UTI can also occur during pregnancy, in women with immune system disorders, and from simply holding the bladder for a prolonged period of time. A specific type of UTI is a kidney infection that develops in the bladder or urethra and moves to the kidneys. If you are taking antibiotics for a UTI but your symptoms are not improving, you may have a kidney infection. Accompanying symptoms include nausea, vomiting, and blood in the urine. Most bladder infections are caused by bacteria, and these are a type of UTI. Bacteria can enter the bladder through stool and from other areas of skin through the urethra. Because womens urethras are shorter than mens, females are more prone to bladder infections and experience frequent urination.
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Medical Treatments For Nocturia
Your doctor may prescribe medications when preventive measures and lifestyle changes fail to reduce the frequency of your nighttime urination. Doctors prescribe a class of drugs called anticholinergics to treat symptoms of OAB, if thats the cause of your nocturia. They reduce bladder spasms that create the urge to go.
Your doctor may suggest you take a diuretic for regular urine production. A diuretic can itself cause nocturia. But if you take it early enough in the day, it may help you get rid of excess fluid while youre awake. This should decrease your urine production at night.
Other drugs that may help are:
- desmopression in cases of diabetes insipidus to cause the kidneys to produce less urine
- tamsulosin , finasteride , or dutasteride to treat prostate enlargement
- antibiotics if you have a urinary tract infection
Your doctor may also adjust your diabetic medications to lower your blood sugar if theyre causing nocturia.
What Are The Symptoms Of Nocturia
Normally, you should be able to sleep six to eight hours during the night without having to get up to go to the bathroom. People who have nocturia wake up more than once a night to urinate. This can cause disruptions in a normal sleep cycle.
Symptoms of nocturia can include:
- Waking up more than once a night to urinate.
- Urinating more volume .
- Fatigue, sleepiness even after waking up. This occurs because the frequent urinations can interrupt your sleep cycle.
Producing Excess Urine At Night
Producing excess urine at night is known as nocturnal polyuria, and it is estimated to be a contributing cause for up to 88% of cases of nocturia.
For some people, excess urine production occurs throughout the day and night. This condition, called global polyuria, is most often tied to excess fluid intake, diabetes, and/or poor kidney function. Diuretics, including medications and substances like alcohol and caffeine, can cause enhanced urine production as well.
Elevated amounts of urine production that occurs only at night can occur when fluid intake goes up at night. It can also occur when peripheral edema swelling or fluid accumulation in the legs relocates after a person moves into a lying position. Coexisting medical problems can contribute to peripheral edema and thus raise the risk of nocturnal polyuria.
Some research indicates that changes to the bodys circadian rhythm cause older adults to have a greater proportion of their daily urine production occur at night, which may be a contributing factor to their higher rates of nocturia.
Changes In Your Reproductive System
Bladder pain in women may also be a result of thinning vaginal skin, says Karl Luber, MD, a urogynecologist and a founder of the female pelvic medicine and reconstructive surgery fellowship program at UCSDKaiser Permanente in San Diego.
This is called atrophy and its most common when menopause deprives the tissues surrounding the vagina of estrogen, he explains. Oral estrogen doesnt help, but a vaginal estrogen cream may ease symptoms.
Talking with your doctor about bladder pain and discomfort can help determine where the problem really lies, Dr. Luber says.
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What To Expect At Your Office Visit
Your provider will perform a physical exam and ask questions such as:
- When did the problem start and has it changed over time?
- How often do you urinate each night and how much urine do you release each time?
- Do you ever have “accidents” or bedwetting?
- What makes the problem worse or better?
- How much fluid do you drink before bedtime? Have you tried limiting fluids before bedtime?
- What other symptoms do you have? Do you have increased thirst, pain or burning on urination, fever, abdominal pain, or back pain?
- What medicines are you taking? Have you changed your diet?
- Do you drink caffeine and alcohol? If so, how much do you consume each day and when during the day?
- Have you had any bladder infections in the past?
- Do you have a family history of diabetes?
- Does nighttime urination interfere with your sleep?
Tests that may be performed include:
- Blood sugar
Treatment Of Nocturnal Polyuria
General measures that reduce excessive urine production at night include:
- Reduction in fluid intake in the 4-6 hours before going to bed.
- This includes eating foods with a high fluid content such as fruit, vegetables, salads, soup earlier in the day.
Other treatments for excessive urine production at night include:
- Use of a diuretic in the 6 hours before going to bed.
- This causes increased urine production in the hours after the diuretic medication is taken. The aim is to expel the excess fluid in the afternoon and early evening rather than overnight.
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How To Stop Frequent Urination At Night
Treating nighttime urination will often depend on the cause of it:
- If you are drinking excessive amounts of liquid before you go to bed, the doctor may recommend that you restrict your fluids after a certain time. Its recommended that you take afternoon naps so you feel more rested. Elevate your legs during the day or wear compression stockings to allow fluid circulation.
- Medications can reduce the symptoms of nighttime urination. Your doctor may prescribe a class of drugs called anticholinergics to relax muscle spasms in the bladder and reduce frequent urination. These medications can include side effects, including dry mouth, dizziness, and blurred vision. Other doctors may prescribe diureticsthis promotes urination earlier in the day to reduce the amount at night.
Reducing Salt Intake May Help With Nocturia
A team of researchers presented the results of their recent study at the 83rd Annual Scientific Meeting of the Japanese Circulation Society. According to their findings, trips to the toilet to urinate at night may be linked to excessive salt intake and high blood pressure.
Our study indicates that if you need to urinate in the night called nocturia you may have elevated blood pressure and/or excess fluid in your body, says study author Dr. Satoshi Konno, of the Division of Hypertension at the Tohoku Rosai Hospital in Sendai, Japan.
Previous research showed that excessive daily salt intake and hypertension have a negative impact on nocturia. In Japan, people generally consume significantly more salt than those in Western countries, and for this reason, the Japanese population may be at higher risk of developing high blood pressure.
Though people in other countries tend to have different eating habits when it comes to salt, the results of these studies suggest that appropriate control of salt intake and blood pressure might be important for the treatment of nocturia, regardless of nationality.
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What Happens When Aldosterone Activity Is Low
Hypoaldosteronism is a medical disorder associated with low levels of aldosterone. There are many causes of this disorder, including adrenal gland failure, cancer, use of certain water pills, infection of the adrenal gland, and use of certain blood pressure medications. When low aldosterone levels occur, there is a significant loss of sodium in the urine. This can result in dehydration and a drop in blood pressure. The individual will develop extreme fatigue, lethargy and can even go into shock. These changes can be prevented by increasing ones intake of sodium chloride, also known as table salt.
Questions Your Doctor Will Ask
If you decide to make an appointment to consult your urologist regarding nocturia, the doctor will likely have multiple questions for you in order to properly diagnose. Having the answers to the following questions ready will help you and your doctor quickly develop the right treatment plan:
The more detail you have, the more helpful it is for the physician in making a diagnosis and finding the root cause of the issue.
Bottom Line: Nocturia should be investigated to determine its cause, which may often be related to conditions other than urinary tract issues. Nighttime urination is not only bothersome, but may also pose real health risks. Chronically disturbed sleep can lead to a host of collateral wellness issues.
If you are routinely waking up at night to urinate, especially if it is happening more than once per night, we recommend setting up an appointment with your urologist. To set up an appointment with one of our physicians or to see a list of our locations, please contact us.
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What Is Nocturnal Polyuria
Nocturnal polyuria or increased urine production at night is defined as an increased night-time urine output when the total 24-hour urine output is normal. High night-time urine is defined as:
- Greater than 20% of the daily total in young adults
- Greater than 33% of the daily total in older adults
- Between 20-33% of the daily total in middle age
Nocturnal polyuria is present in up to 80% of people with nocturia and can only be diagnosed with the assistance of the bladder diary.
Is There A Causal Relationship
The researchers enrolled 3,749 residents of the town of Watari who had undergone an annual health check in 2017 and gathered information about their blood pressure levels and nocturia using questionnaires.
The data showed that getting up in the night to urinate was associated with a 40 percent greater chance of having high blood pressure, and the risk of hypertension rose significantly as the number of nocturia events per night increased.
Dr. Konno says that the results do not prove a causal relationship between nocturia and hypertension, and they may not apply to people who live outside Japan. The relationship may be influenced by various factors including lifestyle, salt intake, ethnicity, and genetic background, the researcher explains.
Hypertension is a national disease in Japan. The average salt intake in Japan is approximately 10 grams per day, which is more than double the average salt intake worldwide . This excessive salt intake is related to our preference for seafood and soy sauce-based food, so salt restriction is difficult to carry out, says Dr. Mutsuo Harada, the conferences press coordinator.
Dr. Harada adds that early detection and management of hypertension are crucial to prevent heart disease. It is important to research and understand the cause of nocturia in patients because this disorder can not only result from urinary organ problems it may also be caused by diseases such as hypertension.
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