Getting up at night to pass urine
Are you getting up often at night to pass urine?
Getting up at night can be a sign that something is not working well with your bladder or prostate. However, if you are passing urine often only at night, you will likely need further evaluation with a bladder diary. This is a link to a bladder diary which should be completed for at least 3 days and can be measured with any measuring jug (aim for a litre measuring jug so that you do not spill when measuring).
Your body is designed to release hormones at night so that you do not pass as much urine. If you are passing more than a third of your output over 24 hours overnight then you have a condition called nocturnal polyuria which means passing too much urine at night).
Common causes of nocturnal polyuria include:
Diabetes: Diabetes can cause the kidneys to produce too much urine, especially at night. This is because high blood sugar levels can damage the kidneys and make them less able to reabsorb water.
Diabetes insipidus: Diabetes insipidus is a condition that occurs when the body does not produce enough of the hormone vasopressin (also known as antidiuretic hormone). Vasopressin is responsible for telling the kidneys to retain water. Without enough vasopressin, the kidneys produce too much urine, even at night.
Heart disease: Heart failure can cause fluid to build up in the body, including in the legs. When you lie down at night, this fluid can shift to the kidneys, causing them to produce more urine.
Medications: A number of medications can cause nocturnal polyuria, including diuretics, which are used to treat high blood pressure and other conditions. Diuretics work by flushing excess fluid from the body, which can lead to increased urination at night.
Prostate problems: An enlarged prostate gland can block the flow of urine, causing the bladder to become overfull. This can lead to frequent urination, both during the day and at night.
Age: As you get older, your bladder capacity decreases and your kidneys become less efficient at filtering waste products. This can lead to increased urination, especially at night. Typically, the older a person gets the more times they pass urine overnight.
Other medical conditions: Other medical conditions that can cause nocturnal polyuria include sleep apnea, overactive bladder syndrome, and kidney disease.
Treatment for nocturnal polyuria depends on the underlying cause. For example, if you have diabetes, your doctor may need to adjust your diabetes medication. If you have heart disease, your doctor may need to prescribe medication to help reduce fluid retention. If you are taking a medication that is causing nocturnal polyuria, your doctor may be able to switch you to a different medication
In some cases, lifestyle changes can help to reduce nocturnal polyuria. For example, it is important to drink plenty of fluids during the day, but to avoid drinking too much fluid in the evening. It is also helpful to limit alcohol and caffeine intake, as these substances can increase the amount of urine people pass.
If you are experiencing nocturnal polyuria, it is important to see a doctor to rule out any underlying medical conditions. Once the cause of your nocturnal polyuria is identified, your doctor can recommend treatment options to help you manage your symptoms.
Mr Ivo Dukic is a consultant urological surgeon who offers personalised consultations. You can schedule an appointment with him for expert, bespoke advice through his Top Doctors profile or make an appointment through the Priory Hospital, Edgbaston, Circle Health Group or at Stourside Hospital, Stourbridge, Ramsay Healthcare.