What Is Nocturnal Polyuria?

Nocturnal polyuria is a condition that causes an overproduction of urine at night. It is a type of nocturia, a condition in which an individual wakes up at least twice during the night to go to the bathroom. Most people with nocturia are over the age of 60, but it can happen at any age. One in three adults over the age of 30 make at least two trips to the bathroom every night.

This article will discuss the symptoms and causes of nocturnal polyuria and explain how it is diagnosed. It will also explore treatment options and tools to cope.

Symptoms

The primary symptom of nocturnal polyuria is waking up at least twice each night to urinate. If you are not able to sleep consistently for six to eight hours each night because of a full bladder, talk to your healthcare provider about potential causes.

Causes

Some medical conditions cause people to wake up at night to urinate, so it is important to receive a full assessment from a healthcare provider, such as a urologist, to identify the cause of your symptoms. Underlying causes that a provider will look for fall into three categories, which are:

• Reduced bladder capacity: Bladder wall scarring from surgery, interstitial cystitis (inflammation of the bladder), bladder cancer, and urinary tract infections can cause nocturnal polyuria.
• Fluid balance: Consuming too much fluid before sleep can lead to nocturnal polyuria.
• Diuresis (increased urine production): Some medical conditions, such as diabetes, renal insufficiency (poor kidney function), heart disease, and obstructive sleep apnea (a blockage causing you to stop breathing during sleep), can cause diuresis and lead to nocturnal polyuria.
  

Diagnosis

A healthcare provider will review your medical history and perform a physical examination before diagnosing you with nocturnal polyuria. They'll ask about fluid consumption, urinary urgency and frequency, sleep habits, and any medications or supplements you're taking, as they could contribute to nocturnal polyuria.

If the cause of nocturnal polyuria is unclear after the history and physical exam, your provider may request that you keep a journal of your urinary habits to document the timing and volume of each void (each time you urinate). Nocturia is diagnosed if more than one‐third of the 24‐hour urine volume is produced during the night.

Additional testing, like a urinalysis (test to analyze urine), might be considered to ensure no underlying infections or diseases, like diabetes, cancer, or heart disease, are causing nocturnal polyuria. If bladder capacity is thought to be the issue, your provider may recommend a cystoscopy to examine your bladder internally and identify any structural causes for nocturnal polyuria.

Treatment

In 2017, the Food and Drug Administration (FDA) approved a medication called Noctiva, an internasal spray used approximately 30 minutes before bedtime. It works by increasing the absorption of water by the kidneys, so less urine is produced. Treatment for nocturnal polyuria is usually specific to the underlying cause:

• Bladder capacity: Treatments to improve bladder capacity include medications to decrease the urge to urinate, surgically increasing bladder size, or in some cases, replacing the bladder.
• Fluid balance: Treatments for fluid balance include limiting or eliminating fluid intake within a few hours of sleep. If excessive alcohol intake is contributing to multiple nighttime wakings to urinate, a healthcare provider may refer you to a specialist, such as a psychologist, for additional treatment.
  
• Diuresis: Treating underlying diseases that cause diuresis could improve or eliminate nocturnal polyuria.

Coping

Nocturnal polyuria can be a debilitating problem for many people since it can lead to chronic sleep impairment. However, proper management of this condition can help improve quality of life. In addition to treatments, here are some tools to help cope with nocturnal polyuria:

• Mattress covers protect the bed and serve as a barrier to make cleanup from nighttime incontinence (loss of bladder control) easier.
• Absorbent briefs are designed to absorb liquid and prevent leaking. Reusable and disposable products are available.
• Skin barrier products are available in a range of soaps, lotions, and cleansing cloths to protect the skin from irritation and soreness when a person experiences nighttime bedwetting.
• Afternoon naps can help reduce fluid buildup by allowing liquid to be absorbed into the bloodstream. You can use the bathroom to eliminate excess urine when awakening from a nap.
• Elevating your legs helps redistribute fluids to be reabsorbed into the bloodstream.
• Compression stockings exert pressure against the leg while decreasing pressure on the veins, which helps redistribute fluid for reabsorption into the bloodstream.
  

Summary

Nocturnal polyuria is when an individual produces too much urine at night and wakes up at least twice every night to use the bathroom. This condition creates sleep interruptions and can signify a more serious underlying medical condition. It is important to receive a thorough medical examination from a healthcare provider to identify and treat the cause of nocturnal polyuria. If treatment is ineffective, there are other options to manage nocturnal polyuria.

A Word From Verywell

Nocturnal polyuria can be very disruptive to your sleep and impact your overall quality of life. The symptoms may seem harmless (and they might be), but they could also be your body's way of telling you that an underlying problem needs to be addressed. If you're waking at least twice every night to urinate, talk to your healthcare provider to determine the cause of your nightly trips to the bathroom.