Nocturia refers to waking up one or more times at night with the need to urinate. It is important in that it disrupts the person's daily performance and quality of life due to sleep disruption and difficulty in falling asleep again.
Frequency of nocturia: frequency of occurrence with age. increasing. It is seen mostly in men over the age of 50, but also in women. 55% of the patients are over the age of 45 and 90% are over the age of 70.
Causes of nocturia: 1) Type 1 and 2 Diabetes Mellitus
2) BPH (Benign Prostate Enlargement) and Prostate cancer
3) Overactive bladder
4) Congestive heart failure and diseases causing edema
5)Sleep apnea and snoring
6)Decrease in ADH hormone (Diabetes Insipidus)
7)Obesity
8)Estrogen deficiency &nb sp;
9) Psychogenic causes
Nocturia Diagnosis: For this, the amount of fluid consumed and the amount of urine excreted for at least 3 days should be measured and recorded (We call this a voiding diary, which is very important in diagnosis) In addition, PSA, Urinary Ultrasonography, Blood sugar measurements (Hunger, satiety, insulin resistance if necessary), Internal medicine examinations and examinations for cardiological and edematous diseases should be performed. Importance of Nocturia: Since most of the patients are in the older age group, nocturia is an important cause of home accidents. This is the reason why many patients trip and fall at night and may even lose their lives as a result of hip and extremity fractures.
Treatment: Treatment is done according to the cause. Patients with BPH should be started on α-blocking drugs, and if necessary, anticholinergic drugs and or PD-5 inhibitors should be added. Those who do not respond to this treatment should undergo TUR-P (closed prostate surgery). Those with heart failure should be treated and diuretic drugs should be removed during the day. Desmopressin should be given sublingually to those with ADH deficiency. Since this drug may cause sodium decrease, patients should have monthly sodium checks. Especially female patients are more sensitive to this drug and other side effects include nausea and diarrhea. Those with obesity should definitely lose weight through diet and exercise. Those with chronic venous insufficiency should be treated for edema. In those with sleep apnea, plasma atrial natiuretic peptide levels have been found to be high. Sodium restriction should be applied to them, and respiratory support should be given with devices specific to their actual disease. Changes in lifestyle are also necessary: tea at night. Coffee, alcohol and excessive fluid intake should be restricted. Heavy meals should be avoided in the evening. It is recommended not to use nicotine in cigarettes due to its stimulating effect.
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