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Nocturia


 One in five of Australian men aged 40 or over and a third of men aged 70 and over have overactive bladder syndrome.

Men who regularly get up more than once a night to pee could be suffering from a range of health conditions, many of which can be treated if GPs look for them, according to University of Adelaide researchers.

The condition, known as "nocturia", is one sign of "overactive bladder syndrome".

"The need to urinate at night is a problem with urine storage, and this disrupts sleep. It is an indication of and can also exacerbate other health conditions," says Professor Gary Wittert, Head of the Discipline of Medicine at the University of Adelaide and Director of the University's Freemasons Foundation Centre for Men's Health.

"Nocturia, combined with the sensation of not being able to hold on (urgency), or frequent urination, suggest the presence of overactive bladder syndrome. .

In a new paper being published in an upcoming issue of the Journal of Urology and now online, researchers say that the presence of lower urinary tract symptoms, although commonly thought to relate to the prostate, may have more to do with factors outside of the bladder and prostate.

"These urinary problems are associated with other conditions, such as sleep apnoea, depression or anxiety, and obesity," says the lead author of the paper, Dr Sean Martin from the University of Adelaide's Freemasons Foundation Centre for Men's Health.

"The good news is that many of these problems are treatable or modifiable, and we've seen in our study that men can overcome their urinary problems if the underlying issues are correctly managed."

Professor Wittert says: "Nocturia and overactive bladder syndrome are also risk factors for type 2 diabetes and cardiovascular disease.

"Often when a man presents to his GP about urinary problems, the first assumption is that it's all because of the prostate. However, our message is: men who are suffering from any of these water-works problems are also likely to be suffering from a range of other health problems that should be looked for and managed. In this way, men have a greater chance of reversing their bladder problems and potentially preventing more serious disease." 


What is Nocturia?

Nocturia is when a person has to wake up at night to pass urine. If this happens more than twice a night, it can be a problem.

Nocturia is common in older people. It can cause problems in day-to-day life. It can upset your sleep and often affect your health if it goes on for long and repeated times.

Having to wake up once or more each night to pass urine increases as you age.

WHAT ARE THE COMMON CAUSES OF NOCTURIA?

Bladder control problems are mainly caused by damage to pelvic floor muscles and the tissues that support them.

In healthy young people, a hormone called antidiuretic hormone stops the kidneys making much urine during sleep.

But this anti diuretic hormone decreases with age , so the kidneys make as much or even more urine during sleep as they do in the day. This means the bladder will need to be emptied more often through the night.

Some people think if they cut down how much water they drink through the day they may cut down on night-time problems. But this is not the correct thing to do because it makes the urine more concentrated and thereby causing urinary tract infections,shrinking the bladder and actually cause you to go to the toilet more at night.

HOW DO YOU KNOW IF YOU HAVE NOCTURIA?

You should talk to your doctor if you think you have Nocturia. It may not be a simple health problem.

To find out more about your Nocturia, your doctor may ask you about:

  • your past health;
  • bladder problems;
  • the drugs you take (such as, what time you take your fluid tablets); and
  • broken sleep.

HOW CAN NOCTURIA BE TREATED?

It is important that any causes of Nocturia get treated or that you are referred to the right specialist.

Some treatments could be:

  • cutting back on how much caffeine and alcohol you drink, mainly before going to bed at night;
  • checking the times you take fluid tablets;
  • wearing support stockings for swollen ankles;
  • resting with your legs up, in the afternoon, for a few hours;
  • lighting your path to the toilet (such as a night light); and/or
  • placing a commode or bright coloured bucket for use at the bedside.

Your doctor may prescribe a nasal spray or drugs to cut down how much urine you make at night-time.

There are also patches that can be worn to work as the anti-diuretic to reduce bladder activity at night.

First move is to determine if indeed it is nocturia which means going to a doctor for diagnosis. Provide him with a record of your activity at night and give him symptoms along with any drugs you are taking.

He can then make a reasonable and accurate assessment of your condition.


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