Nocturia – common cause of a poor night’s sleep

On World Sleep Day, scientists are highlighting the main reason that people are waking up at night – nocturia (the need to get up and urinate more than once during the night).

 

It often has one or more contributing factors such as an overproduction of urine, reduced bladder capacity; certain illnesses and medications are also potential contributors.

 

Although it is most common in older adults, nocturia can affect people of all ages and frequent sleep disturbances significantly impact daily living and can be a sign of more serious health conditions.

 

“Nocturia’s disruption to deep sleep results in reduced productivity and alertness that can affect multiple areas of an individual’s life during the day,” said Jens-Peter Nørgaard, Medical Director of Ferring Pharmaceuticals and Professor of Urology at Ghent University, Belgium. “From making it difficult to manage a busy daily schedule to negatively impacting productivity at work, sleep disruption has significant impact far beyond fatigue or night-time inconvenience.”

 

The effect that sleep disruption can have was measured recently in a study by Nokia Health, which designs smart health devices and apps. Of the over 19,000 people surveyed it was shown that frequency of nightly awakenings was the most important factor in getting a good night’s sleep – more than the total duration of sleep or the time people went to bed.

 

Frequent sleep interruptions are important as uninterrupted sleep is needed to sustain physical (including the immune system), mental and emotional health.

 

“People often ignore sleep disturbance from nocturia, but this can produce significant disruption to daytime functioning,” said Dr. Andrew Krystal, Professor of Psychiatry and Behavioral Science at University of California, San Francisco. “It is important this is discussed with a healthcare professional, as this disruption is not just harmful in itself but can also be an indicator of more serious health conditions.”

 

The impact of sleep disturbances can also lead to greater risk of serious health conditions such as increased risk of diabetes, weakened immune systems, high blood pressure and heart disease.

 

Lifestyle changes (see the full Wikipedia article at https://en.wikipedia.org/wiki/Nocturia)

Although there is no cure for nocturia, there are many actions people can take to manage their symptoms.

 

Prohibiting the intake of caffeine and alcohol has helped some individuals with the disorder.

 

Compression stockings may be worn through the day to prevent fluid from accumulating in the legs, unless heart failure or another contraindication is present. Drugs that increase the passing of urine can help decrease the third spacing of fluid, but they could also increase nocturia.

 

A common action patients take is to not consume any fluids hours before bedtime, which especially helps people with urgency incontinence. However, a study on this showed that it reduced voiding at night by only a small amount and is not ideal for managing nocturia in older people. For people suffering from nocturnal polyuria, this action does not help at all because of irregular AVP levels and the inability to respond with the inhibition of increased voiding. Fluid restriction also does not help people who have nocturia due to gravity-induced third spacing of fluid because fluid is mobilised when they lie in a reclining position.

 

17 March 2018.

 

 

17 March 2018.