nocturie

Nocturie, commonly referred to as nocturia in medical literature, is the need to wake during the night to urinate after going to bed. It is a symptom, not a disease, and can affect sleep quality and daytime functioning. Nocturie is common in adults and becomes more prevalent with age; estimates vary, but many individuals experience one or more awakenings at night for urination.

Causes are typically categorized into nocturnal polyuria (excess urine production at night), reduced nocturnal bladder capacity (bladder capacity limited by aging, detrusor overactivity, or outlet obstruction), or a combination of both. Contributing factors include age-related changes, diuretic medications, caffeine or alcohol intake, obesity, heart failure, diabetes, sleep disorders such as sleep apnea, prostatism in men, urinary tract infections, and other conditions causing fluid shifts such as leg edema.

Evaluation involves thorough history and physical, review of medications, and a bladder diary recording fluid intake and voiding times over several days. Investigations may include urinalysis, blood tests (electrolytes, kidney function), and assessment for nocturnal polyuria. Imaging or ultrasound may be used to assess bladder or post-void residual urine if indicated. When sleep disorders are suspected, specialist referral or sleep studies may be appropriate.

Management focuses on underlying causes and symptom relief. Behavioral and lifestyle measures include limiting evening fluids, avoiding alcohol and caffeine, shifting diuretic timing if possible, and bladder training. Treatments for nocturnal polyuria may include low-dose desmopressin for selected patients after risk assessment for hyponatremia; caution is advised in older adults. For men with benign prostatic obstruction, urological therapies or medications may help. Addressing sleep disorders and comorbidities such as heart failure or diabetes is integral. The condition is often treatable, and improvement can enhance sleep and quality of life.