The other day, a friend's parents were complaining that they don't sleep well. Added to the fact that they are older, they wake up many times to go to the bathroom, and in the morning they wake up quite tired. These complaints are more common than we think and have a name: adult nocturia. According to the International Continence Society, it is exactly defined as the need to wake up to urinate at least twice a night.
This problem, which affects sleep and quality of life, is more frequent as we age. It is estimated that three out of five people over the age of 70 suffer from it, although it can also occur at younger ages. And it affects men and women equally.
Two causes can give rise to nocturia: decreased bladder capacity and/or increased urine production, known as polyuria.
In the first case, we are talking about an organ with a capacity of between 300-600 ml, which in turn can be reduced by two factors: an anatomical alteration, which in men is most commonly due to benign hypertrophy of the prostate, and in women, obesity and pelvic organ prolapse. The second factor would be functional problems such as overactive bladder syndrome, cystitis, infections...
As far as polyuria is concerned, nocturnal urine production usually decreases due to the action of antidiuretic hormone, but as we get older, the release of this substance is reduced at night.
This is one of the main causes, although various diseases can also precipitate it –diabetes, edematous states caused by venous insufficiency or heart failure, arterial hypertension…–, increased fluid intake in the evening and caffeine consumption, alcohol or tobacco.
The management of nocturia should be considered individually, since many factors influence it. Here are some elementary tips.
In summary, although nocturia is very common in older people, it does not stop affecting sleep and, consequently, rest and quality of life. It is advisable to consult with the Primary Care professionals, who will make an individualized assessment, taking into account everything from life habits to the review of medications and other pathologies.
This article was originally published on The Conversation. Ana Isabel Cobo Cuenta is a tenured professor at the University of Castilla la Macha (UCLM). Antonio Sampietro Crespo is a specialist in Urology at the Health Service of Castilla-La Mancha
