Nocturia: Causes, Symptoms, and Management

Nocturia, common among seniors, is a condition that involves frequent nighttime urination, disrupting sleep and causing daytime fatigue. While occasional nighttime urination is normal, experiencing it more than once a night may indicate an underlying issue.

Studies indicate the prevalence of Nocturia among seniors aged 60 to 70 is 11% to 50%, increasing to 80% to 90% among those over 80, with approximately 30% reporting two or more episodes per night.

The need to wake for nocturnal urination heightens fall risk among seniors, potentially resulting in hip fractures, stressing the need to have assistance available for seniors with mobility issues. Home health care is a good option as caregivers, CNAs and Home Health Aides are on hand for standby assist for night time trips to the toilet or to assist with urinary “accidents” for seniors who may not make it to the toilet in time.

CAUSES:

  • Nocturnal polyuria: the overproduction of urine during the night. International Continence Society defines this type of Nocturia as a nightly urine volume of more than 20–30% of the total 24-hour urine volume.
  • Global polyuria: a significant cause of Nocturia that involves excessive urine production both during the day and at night.

Other causes of Nocturia include:

  • Diuretic medicines
  • Caffeine
  • Overactive bladder treatment
  • Alcohol
  • Excessive fluids before bedtime
  • Lower nocturnal bladder capacity

Some underlying medical conditions that can also cause Nocturia include:

  • Diabetes mellitus
  • Diabetes insipidus
  • High blood pressure
  • Heart disease
  • Congestive heart failure
  • Vascular disease
  • Sleep disorders
  • Insomnia

SYMPTOMS

  • Frequent urination: Seniors may wake up more than two times during the night to urinate.
  • Disrupted sleep: Nocturia can lead to fragmented sleep patterns, causing seniors to experience daytime fatigue and impaired cognitive function.
  • Urgency: the sudden and intense urge to urinate, often leading to difficulty falling back to sleep.
  • Incontinence: In severe cases, seniors may experience involuntary urine leakage during the night.

MANAGEMENT

  • Lifestyle modifications: caregivers can monitor and encourage seniors to limit fluid intake before bedtime and avoid caffeine or alcohol to help reduce nighttime urination.
  • Medication management: reviewing and adjusting medication regimens with a healthcare provider can mitigate the effects of medications that exacerbate Nocturia.
  • Bladder training: Implementing scheduled voiding routines and pelvic floor exercises can improve bladder control and reduce nighttime urination frequency.
  • Addressing underlying conditions: Treating underlying medical conditions such as diabetes, UTIs, or prostate enlargement can help with nocturia symptoms.
  • Absorbent Briefs: Available in reusable and disposable formats, these provide a reliable solution for managing nocturnal incontinence, and allowing uninterrupted sleep.
  • Skincare Products: Homecare providers and caregivers can apply skincare solutions for seniors, helping to avoid potential skin irritation and soreness associated with Nocturia.

Nocturia can significantly impact the quality of life for seniors, affecting their sleep patterns and overall well-being. However, with proper management strategies and the support of home healthcare and experienced caregivers, seniors can effectively manage Nocturia and improve their sleep and overall quality of health.

Allcare Home Health Agency, Inc. offers in-home assistance in the Raleigh/Durham area 24X7 and 365! Call (919) 301-0236 for more information.

References:
Lightner, D. J., Gomelsky, A., Souter, L., & Vasavada, S. P. (2019, September 1). Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment 2019. Journal of Urology Adult Urology.
Kallas, H. E., Chintanadilok, J., Maruenda, J., Donahue, J. L., & Lowenthal, D. T. (1999). Treatment of Nocturia in the elderly. *Drugs & Aging, 15*(6), 429-437.
Anon (2024). What is Nocturia?: National Association for Continence
Kujubu, D. A., & Aboseif, S. R. (2007). Evaluation of Nocturia in the elderly. *The Permanente Journal, 11*(1), 37-39.
D’Ancona, C. D., Haylen, B. T., Oelke, M., Herschorn, S., Abranches-Monteiro, L., Arnold, E. P., … de Wachter, S. (2019). An International Continence Society (ICS) Report on the Terminology for Adult Male Lower Urinary Tract and Pelvic Floor Symptoms and Dysfunction. Neurourology and Urodynamics. Advanced online publication.