Nocturia is a common urinary symptom where individuals in their 60s frequently wake up one or more times during sleep to urinate. This condition affects over 70% of Koreans in this age group. However, it can significantly disrupt a peaceful night’s sleep, making it crucial to address it promptly. Let’s explore the causes of nocturia and strategies to alleviate its symptoms.
Main Causes of Nocturia
The primary factors contributing to nocturia encompass bladder dysfunction associated with aging, diabetes, and stress. When nocturia becomes severe, it has the potential to disrupt sleep and diminish overall sleep quality. Our bodies produce a hormone called “vasopressin,” crucial in urine concentration. During nighttime, vasopressin secretion increases, resulting in urine concentration and a reduced likelihood of experiencing nocturia. However, in cases of vasopressin deficiency, the kidneys struggle to concentrate urine, leading to excessive urine production and, subsequently, nocturia.
The Relationship Between Hypertension and Nocturia
Individuals experiencing nocturia should exercise caution, as they may unknowingly develop hypertension. A study conducted by a Japanese research team unveiled that those with nocturia faced a 40% higher likelihood of hypertension compared to individuals without this condition. Furthermore, the research indicated that the risk of hypertension rose in tandem with the frequency of nocturia episodes. Excessive sodium intake can also play a role in this scenario. When sodium concentration in the blood exceeds normal levels due to high sodium consumption, it can trigger thirst and heightened fluid intake, potentially resulting in nocturia.
Is It a Natural Phenomenon Due to Aging?
While many individuals view nocturia as a natural consequence of aging, it’s crucial to recognize that severe cases of nocturia, disrupting sleep, can significantly impact daily life. Therefore, it’s essential to pinpoint the precise underlying cause and seek appropriate treatment. It’s worth noting that in the elderly population, nocturia can lead to depression and an increased risk of fractures resulting from falls, highlighting the need for caution and timely intervention.
Keeping a Urination Diary Can Help
Maintaining a urination diary is critical in pinpointing the root cause of nocturia. This diary documents the timing and quantity of daily urination, with measurements ideally taken using a measuring cup. By analyzing the urination diary, if the volume of urine expelled during the nighttime hours after going to bed exceeds 20% (for younger individuals) or 33% (for older individuals) of the total daily urine output or surpasses the maximum urine output recorded in the diary, it is classified as a case of nocturia.
Treatment for Nocturia
As previously discussed, nocturia results from reduced vasopressin secretion, making its treatment centered around a medication known as desmopressin, a synthetic analogue of vasopressin. Desmopressin, unlike vasopressin, boasts an extended duration of action and exhibits a more potent antidiuretic effect. This substance is also utilized in managing primary nocturnal enuresis in children and has proven effective in addressing nocturia in adults.
Lifestyle Habits for Preventing Nocturia
Several steps can be taken to prevent nocturia. Firstly, it’s advisable to avoid consuming fluids after dinner. Limit fluid intake in the period leading up to bedtime, and make sure to urinate before going to bed. Furthermore, it’s wise to avoid carbonated beverages containing caffeine, which can enhance diuretic effects and increase urine production. Adopting a diet with bland foods can also be beneficial. Additionally, reducing daytime naps is recommended, as even if nighttime sleep is disrupted, it can help minimize the occurrence of nocturia.
Usually Appears in Combination with Frequent Urination
Nocturia can affect the body’s immune system and may be associated with other medical conditions. It is frequently observed alongside conditions involving frequent urination. This correlation arises from the fact that urinary tract infections such as cystitis, overactive bladder, female urethral syndrome, and various other urinary system disorders can be contributing factors to the onset of nocturia.
Reduce Fluid Intake Before Bed
Excessive fluid intake is often the leading cause of nocturia, and reducing it can be beneficial. Adults’ recommended daily fluid intake typically ranges from 1.5 to 1.8 liters. Consuming more than this amount or drinking substantial quantities of water before bedtime may contribute to nocturia. To mitigate this issue, it is advisable to gradually consume fluids in smaller increments rather than large quantities all at once. Additionally, it is wise to refrain from consuming foods high in fluid content, including water, for at least two hours before going to bed. Such measures can help improve the condition.
Normal Adult Daily Urine Output
A typical daily urine output for a healthy adult is approximately 1 liter. When the total urine output over a day falls below 700cc, it is categorized as “oliguria,” indicating a lower-than-normal urine volume. Conversely, if the daily urine output exceeds 1500cc, it is characterized as “polyuria,” signifying excessive urination. A diagnosis of ‘nocturia’ is made when more than 30% of the total daily urine output occurs during nighttime hours. Furthermore, a typical adult urinates between 100-250cc per void. If the amount of urine per urination consistently falls below 100cc, it may indicate an issue with the bladder.
Are There Differences Depending on Age and Gender?
The prevalence of nocturia tends to increase with age. While it affects around 16% of individuals in their 40s, this figure rises significantly to 40-50% for those in their 60s and further increases to approximately 55% among individuals in their 70s. In children with delayed growth and development, reduced hormone secretion can lead to nocturia. Interestingly, there isn’t a substantial difference in the occurrence of nocturia between genders. Typically, men are more inclined to seek urological care and treatment, whereas women may be less likely to visit healthcare facilities. If you suspect you have a urinary disorder, it’s crucial to seek medical attention for an accurate diagnosis and appropriate management.
By. Shin Young Jeon
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