Nocturia (nocturnal enuresis) is a medical term for excessive urination especially at night and during sleep. This is a medical condition and a symptom of any of the different types of urinary disorder. This is a secondary bedwetting syndrome marked by involuntary loss of urine and is common in the elderly.
Bedwetting is prevalent in children from age 0 to about 4 years old. A child’s bladder reaches maturity by the time the toddler is potty trained, usually at age 5. Although every child’s bladder matures at different age, children generally stop bedwetting by the time they reach 6 years old. When a child suddenly starts bedwetting again after a long period of being dry then parents should start to worry.
Healthy individuals are usually able to sleep for at least six to eight hours without waking up from sleep for urinating. However, people suffering from this syndrome wake up more than once at night to pass urine. This can disrupt normal cycle of sleep in individuals. It is one of the major signs of Nocturia. In a person with this disorder the body produces a large amount of urine while he or she sleeps. There may be release of a high volume of urine that can even be more than 2 litres every day. The person finds it unable to hold high volume of urine at night and is forced to wake up and urinate.
What Causes Nocturia?
The following factors are regarded as some of the main causes of Nocturia.
- Bed-wetting issues: Children and individuals who have suffered from bed-wetting problems in the past can suffer from this disorder. The fear of accidentally bed wetting can also make a person hypersensitive to even minor urinating sensations.
- Drinking excess liquids: Drinking a high amount of liquids before going to bed can also result in high amount of urine in bladder. This can be easily resolved by limiting amount of liquid intake before bedtime. Avoiding intake of caffeine or alcohol can also prevent this problem.
- Medicinal Side Effects: This condition may also result from side effects of medications. Diuretics, drugs that increase the flow of urine, can make the body shed excess fluids and may be directly responsible for this disorder. Other drugs that are used for treating bipolar disorders and cardiac conditions can also result in this condition. However, the benefits of these drugs far outweigh side effects like Nocturia. Demeclocycline, Cardiac Glycosides, Phenytoin, Lithium, Propoxyphene, Methoxyflurane and high intake of Vitamin D can also result in development of this disorder.
- Pregnancy: This condition is also common due to frequent urination in both early and late pregnancy. In such cases, the disorder usually goes away with the resolution of the pregnancy. In some people, gestational diabetes may also arise and lead to this disorder.
- Disorders: The disease may also arise due to the presence of conditions like Prostate Gland enlargement, kidney infection, bladder infection and cardiac disorders such as congestive heart failure, prostate cancer and kidney failure. It is also common to find Nocturia in diabetes sufferers. Enlargement of the prostate gland often results in serious health conditions. Edema of lower limbs (inflammation of the legs) can also lead to this syndrome.
- Sleep Apnea: Sleep Apnea is a serious cause of this disease. It arises when there is a cessation in breathing of a person for a few seconds for several times during a night. This may lead to light sleep and prompt a person to get up and release urine.
This abnormal syndrome can be cured with the aid of medicines and lifestyle modifications. Some common Nocturia medications are diuretics like Furosemide and Bumetanide that help in influencing urine production. Imipramine is also used to reduce production of urine. Desmopressin (DDAVP) also helps in treatment for nocturia by influencing the kidneys in producing lesser amount of urine. Anticholinergic drugs may be used to reduce the symptoms arising due to an overactive bladder. Lifestyle modifications for this disorder generally involve:
- Reducing intake of fluids, such as caffeinated beverages, coffee and alcohol, in the evening – especially in the hours to go before sleep.
- Limit intake of diuretics to specific times such as in mid- afternoon and six hours before bedtime at night.
Patients of this syndrome are also advised to take afternoon naps. They are recommended to elevate the legs while sleeping and wear compression stockings, which help in preventing accumulation of fluids in the bladder.
Authored By : Dr. Mahendra Jain
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