Nycturie

Nycturie, commonly referred to as nocturnal urination, is the condition characterized by waking one or more times during the night to urinate. It is a frequent complaint, especially among older adults, and can significantly disturb sleep and daytime functioning. Nycturie can result from various mechanisms, including increased urine production at night, reduced bladder capacity, or a combination of both.

Two main pathophysiological patterns are recognized. Nocturnal polyuria occurs when a large proportion of daily urine production happens at night, often related to aging, cardiovascular conditions, diabetes, or certain medications. Reduced nocturnal bladder capacity can result from detrusor overactivity, bladder outlet obstruction (notably in men with benign prostatic hyperplasia), or other bladder disorders. Sleep disorders such as sleep apnea can also contribute by fragmenting sleep and increasing nocturnal awakenings.

Diagnosis typically begins with a detailed medical history and a bladder diary or frequency–volume chart kept for 24 to 48 hours to quantify nocturnal voids, nighttime urine production, and fluid intake. A physical examination and urinalysis help rule out infections, stones, or blood in the urine. Additional tests may be ordered to assess kidney function, blood sugar, and in some cases imaging or referral to a urologist.

Management focuses on treating underlying causes and reducing symptom burden. Lifestyle measures include limiting evening fluids, avoiding caffeine and alcohol before bed, and managing edema. Treatment of conditions such as sleep apnea, diabetes, or heart failure is important. Pharmacologic options for bladder symptoms include antimuscarinics or beta-3 agonists, and desmopressin may be considered for selected patients with nocturnal polyuria. Where appropriate, addressing benign prostatic hyperplasia with medical or surgical therapy can reduce nocturnal symptoms. Effective management often improves sleep quality and daytime well-being.