The complaint of frequent urination at night is a condition that can be seen at any age, especially in elderly patients. This condition, which is a symptom rather than a disease, consists of a cycle of waking up for the need to urinate at night and returning to sleep after urinating. This condition, also called nocturia, is manifested by two or more urination complaints during the night. Nocturia is one of the most common urinary tract conditions, especially in elderly patients. Since a significant portion of patients who wake up to urinate at night have difficulty returning to sleep, this may cause different clinical problems. Obstructive sleep apnea causes frequent urination at night because it affects the release of certain hormones in the body. Nighttime melatonin is inversely proportional to the frequency of nocturia in older adults. The presence of underlying neurological disorders such as Parkinson's disease also leads to an increase in the severity of nocturia.
What are the Causes of Urinating at Night?
Nocturia, that is, frequent urination at night, is a condition that increases in direct proportion to age. Although it is more common in women between the ages of 18-49 than in men, the situation reverses at the age of 60 and is more common in men. About half of people between the ages of 50-79 have nighttime urination problems. Symptoms rarely occur between the ages of 50 and 59, meaning they don't occur every night. However, according to studies, it is estimated that men between the ages of 70-79 have problems with urination at least twice a night. Studies have revealed that the problem of frequent urination at night is more common in black and Hispanic men and women. In addition, most, if not all, women with nighttime urination problems also have other urinary tract complaints such as overactive bladder syndrome or frequent urination. Although nocturia is common in pregnant women, almost everyone recovers in the first three months after giving birth. As a result of scientific researches, it is possible to treat diseases such as obesity, uncontrolled hypertension or diabetes, restless legs syndrome and periodic leg movements, obstructive sleep apnea, reflux, benign prostate enlargement and congestive heart failure. It has been determined that squats may be the cause of frequent urination at night. It has also been determined that there is a relationship between nocturia and depression.
Is it normal to urinate frequently at night?
Urination should normally be less at night than during the day. Although there is no change in 24-hour urine output, excessive nocturnal urine production is called nocturnal polyuria. In this case, the volume of urine produced at night is more than 33 percent of the 24-hour urine volume. Since this may be a symptom of various serious diseases, it is absolutely necessary to apply to health institutions and have the necessary controls done. The decrease in the level of antidiuretic hormone, which provides an increase in water reabsorption from the kidneys, causes an increase in nocturnal urine output. Since other edematous conditions such as nephrotic syndrome or venous insufficiency and heart failure may cause frequent urination at night, it is important to evaluate individuals for these diseases. Increasing severity of complaints and worsening of the situation lead to various undesirable effects. Nocturia, which also negatively affects sleep patterns, can cause falls and bone fractures, especially in older adults. Falls associated with nocturia are due to several factors, including problems with balance and gait. Falling may occur in cases such as an attempt to go to the toilet at night and encountering obstacles on the way to the toilet. Falls in older individuals cause an increase in fractures in the hip and long bones, and therefore an increased risk of injury and even death. Fat embolization in long bone fractures is a life-threatening and fatal condition, as it can cause stroke and pulmonary embolism. can tolerate one urination and this is normal. However, urination more than 2 times during the night causes a decrease in sleep and quality of life and is associated with various negative conditions. For this reason, urinating 2 or 3 times a night is a condition that should be controlled in health institutions. Relationship between nocturia and depression can also cause various problems. In addition, frequent urination at night in men and women causes an increase in morbidity and mortality rates. Even in young people, the increase in the rate of nocturia was found to be associated with an increase in the death rate. Frequent urination at night is thought to affect the mortality rate because it is one of the symptoms of other health problems such as cardiovascular or lung diseases. Elderly patients with low weight and frequent urination at night have an increased risk of death compared to more severe patients. Therefore, it is very important to determine the cause of nocturia. For this reason, doctors learn the medical history of patients by asking a number of questions. As a result of the examinations and tests, other accompanying diseases or health problems are detected and treated.
How is the Treatment of Frequent Urination at Night?
Treatment of frequent urination at night depends on gender and underlying diseases. as it varies. However, the main purpose of treatment in both men and women is to reduce the frequency of nighttime urination and to minimize the effect of nocturia on social life, because the daytime social life of the patient whose nighttime sleep quality decreases will also be adversely affected. In order to reduce the nighttime urine output, the amount of fluid taken especially in the evening can be restricted. In addition, reduction in salt consumption is also important in patients with congestive heart failure. It is recommended to avoid consuming beverages such as caffeine and alcohol that increase urine output. Lifestyle changes such as compression stockings or keeping the legs elevated in the afternoon may be recommended for patients with edema in the legs. Urinating twice before going to bed, urinating by leaning slightly forward in a sitting position and urinating again after 20-30 seconds are beneficial for many patients who have difficulty in emptying the bladder. In order to reduce the effect of nocturia, it is recommended to have a slide or a potty by the bed, especially for people who have difficulty in going to the toilet at night. It is also important to ensure Apart from all these recommendations, Kegel exercises can also be done to strengthen the pelvic muscles, which are effective in keeping urine. Men who urinate frequently at night due to benign prostate enlargement are primarily prescribed medications to treat the underlying cause. Although prostate surgery provides a reduction in many symptoms in patients who do not benefit from drug therapy, the problem of frequent urination at night may be permanent in many patients after surgery. Therefore, surgical interventions are not the first choice in the treatment of nocturia. In women and men without benign prostatic enlargement, bladder relaxants are initially used. Vaginal estrogen therapy can be applied as a treatment option in women who have entered the menopause period. In people who do not have a clear result despite other drug treatments, a drug containing the active substance called desmopressin is used.
The problem of frequent urination at night can occur in any age group and may be a symptom of diseases that can lead to death. It is also dangerous, especially in the elderly, as it can cause falls while going to the toilet at night. For this reason, it is very important for people who urinate 2 or more times a night to apply to health institutions for the diagnosis of other underlying diseases and the treatment of nocturnal urinary problems.
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