Nocturia is when a person has to wake up at night to pass urine. It is a common problem.  It is even more common as we get older.

Nocturia can upset your sleep and put you at risk of falls when you get up in the dark to  pass urine. Also you may not be able to get back to sleep so you might not function as  well through the day. You may sleep in the day and then not be able to sleep well at night.  Such changes to your sleep patterns can make the problem worse. You may be more  aware of your bladder filling and feel like you need to pass urine more often.

Nocturia can be part of many common medical conditions, such as:

• heart problems
• kidney problems
• poorly controlled diabetes (Type 1 or Type 2)
• swollen ankles
• taking fluid tablets at night
• bladder infections
• an overactive bladder
• constipation as a full bowel can press on the bladder
• an enlarged prostate as this may not let the bladder empty out fully.

Other things that can lead to nocturia are:

• being pregnant
• changing your position from upright in the day to lying flat at night. This way, more blood flows through the kidneys.

This means more night time urine is made

• having broken sleep as you may go to the toilet just because you are awake consuming large amounts of fluid before going to bed at night
• drinking alcohol or caffeine drinks before going to bed at night. Caffeine is found in coffee, chocolate and cola or sports drinks.

Some people think if they cut down on how much fluid they drink through the day they  may reduce nocturia. This is not correct. Drinking too little can cause you to become  dehydrated. Being dehydrated makes the urine stronger (more concentrated). This can  upset the bladder and make you need to go to the toilet more often. Dehydration can also  lead to constipation.

Avoid being dehydrated as it can also cause:  

• low blood pressure
• lack of energy
• more risk of falls as you get older especially at night.

You should talk to your doctor if you have regular 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 medicines you take and what time you take them if
• you have broken sleep.

Your doctor might also:

• check if you have any of the common causes of nocturia
• check if you have any of the common medical conditions listed earlier
• test your urine for a bladder infection
• ask you to keep a chart to check:
  • what, when and how much you drink
  • when and how much urine you pass
  • when you go to bed and get up.
• arrange for urine and blood tests.

It is important to find the cause of nocturia. This allows the doctor to treat nocturia.  The doctor can then refer you to the right specialist if needed.

Some treatments could be:

• cutting back on how much caffeine and alcohol you drink, especially in the evening and before going to bed
• reviewing the times you take fluid tablets
• wearing support stockings for swollen ankles
• resting with your legs up for a few hours in the afternoon or evening.

Other tips include: 

• lighting the path to the toilet
• placing a commode or urinal to use next to your bed.

You may be referred to a continence nurse advisor or continence physiotherapist.  Your doctor may also refer you to a specialist. The specialist will discuss other treatments  with you. These may include medicines which treat the nocturia or medicines to treat the  cause of the problem.

You might be referred to a medical specialist such as a:  

• Geriatrician
• Urogynaecologist
• Urologist
• Renal physician.