Nocturia

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Nocturia means waking at night to pass urine. Waking once at night to pass urine is common especially as people get older. Having nocturia more than twice at night should be investigated by your healthcare professional. 

Nocturia can be associated with other health and medical conditions including neurological conditions, diabetes, enlarged prostate and Urinary Tract Infections. It can also lead to an increased risk of falling in the elderly. Assessment is important to find the cause of the problem. 

Is nocturia normal?

Nocturia can be an annoying symptom, as disturbed sleep can affect the quality of sleep we have, and in turn our quality of life. 

Nocturia can be associated with the effects of ageing on the urinary tract. The bladder often becomes smaller as we get older, and this combined with an increased urine output at night can result in the need to wake at night to pass urine. 

People who have swelling in the feet or legs at the end of the day can find that the swelling goes down overnight. The excess fluid is removed from the body as urine, and may result in nocturia.  

Questions to ask your health care professional: 

Am I producing excessive amounts of urine at night (polyuria)? 

A bladder diary (that records the number and volume of your drinks, when you had them and your bladder habits) can help to work out if the amount of urine passed at night is significantly higher than the day time volume. Your health care professional can help interpret the bladder diary to work this out. 

Is my bladder emptying properly?

This may require an ultrasound of your bladder to find this out. If your bladder does not empty properly there can be an increased risk of urinary retention and Urinary Tract Infections. Overflow incontinence may occur if the bladder is unable to empty properly and becomes overly full. 

The bladder may have difficulty in emptying if the bowel is full and pressing on the bladder. An enlarged prostate in men or a prolapse in women can also affect the bladder’s ability to empty properly.

Am I drinking too many drinks with caffeine in them?

Cola drinks as well as tea and coffee contain caffeine and this has a diuretic effect. 

Could my drinking pattern be affecting my bladder?

It is a good idea to spread your drinks out over the day. People who go out in the morning, and don’t drink when they are out may tend to have their tea and coffee in the afternoon or evening. Drinking mostly in the afternoon and evening is likely to result in urine mostly being produced in the afternoon and evening. Alcohol may also affect the bladder, and limiting alcoholic drinks can be helpful to reduce nocturia.  

Could my poor sleep be caused by something else?

Some people have their sleeping disturbed by a partner, family member or pet. Nocturia is being woken by a full bladder and having to get out of bed to go to the toilet. Other conditions such as painful joints that make sleeping difficult or depression may also cause people to be wakeful. 

Could my snoring or sleep apnoea be an influence?

Studies have shown that people who snore or who have sleep apnoea are at increased risk of developing nocturia. Measures to tackle snoring such as weight loss (where appropriate) can also reduce nocturia. 

Could my medicines be causing nocturia?  

Medicines such as diuretics are effective at removing excess fluid from the body. Incorrect timing of these medicines could result in nocturia, so check with your health care professional as to the best time of day to take your medicines. 

It is important for nocturia to be assessed. A current Australian Study is being conducted to find out how much a problem nocturia is in the community. The study will look at the most successful treatments and management for nocturia in Australia.  

Please contact us for further information and strategies to address nocturia. 

   

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Kylie – parent of a child that wets the bed 

Kylie rang our service as she was concerned about her five-year-old daughter, Mia, who was wetting the bed. Kylie had tried limiting Mia’s drinks in the late afternoon and evening and was also getting up at night to wake Mia and take her to the toilet.

Our advisor explained that it may take children until they around 5 ½ years old before they gain bladder control during sleep. Kylie was advised to encourage Mia to drink well throughout the day and was cautioned against cutting out drinks in the afternoon and early evening. Kylie was discouraged from waking Mia at night to take her to the toilet. Kylie was provided with information on obtaining a referral from Mia’s doctor to a bedwetting clinic if Mia continues to wet the bed past 5 ½ years of age.

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Anastasiya’s story

“As a mum of two young children, I have experienced the joys of two pregnancies and postpartum recoveries. I was shocked after the birth of my first child to discover that my pelvic floor muscles had become weak. I sought advice from Bladder and Bowel Health Australia and learnt the importance of exercising these muscles. This knowledge helped, and because I was better informed second time around, I have now fully restored the dignity of my body and truly enjoyed the changes - and my motherhood. Thank you, Bladder and Bowel Health Australia, for informing young families about bladder and bowel health issues.” 

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Doreen – carer of her husband who has dementia 

Doreen was becoming exhausted caring for her husband Tom, who has dementia. Tom was not always making it to the toilet on time and needed his trousers to be changed several times a day. Every day Doreen was also washing bedlinen and the four towels that Tom was laying on at night as he was soaking through his pull-up pants. 

Tom was receiving a high-level Home Care Package, and Doreen was able to arrange with their provider for some of Tom’s package to be allocated to funding continence assessment and management.  

Our advisor went to Tom’s home and conducted a thorough continence assessment. A continence management plan was developed with input from Doreen, and appropriate incontinence aids and linen protection were organised. Doreen is relieved that Tom’s incontinence has reduced, and her washing load has lessened. Doreen is now confident that she can continue caring for Tom in their home. 

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Gary – experiencing leakage after his recent prostate surgery 

Gary met with one of our Bladder and Bowel Health advisors, as he was concerned about his urine leakage that was persisting after his radical prostatectomy five weeks earlier.   

Gary discussed his concerns with the advisor and was reassured that he was making good progress towards regaining bladder control. This reinforced the information he had received from his urologist. Gary was encouraged to switch to a smaller incontinence pad rather than continuing to wear the pull- up incontinence pants he had worn since his surgery. The advisor arranged some smaller pads for him to trial and provided details on where he could buy them close to his home. 

Gary was encouraged to drink plenty of fluid (particularly water) and to increase his fruit and vegetable intake to avoid constipation. Gary was uncertain if his pelvic floor muscles were working properly and he was referred to a pelvic floor physiotherapist. Gary left the clinic in a brighter frame of mind, confident that he was improving and had clear strategies to further support his recovery.