If you want to improve your chances of getting a good night’s sleep, it may be helpful to increase your physical activity throughout the day and reduce the occurrence of waking up at night to urinate. Occasional nocturia (the need to urinate at night) is usually not a major concern, especially if you have a healthy bladder.
However, if you find yourself waking up frequently to use the bathroom, it may be a sign of an underlying health issue. According to Dr. James Anaissie, a urologist practicing at Memorial Hermann in Houston, nocturia can be disruptive to your sleep and may indicate urinary bladder dysfunction.
There exist numerous potential etiologies for nocturia, and I shall provide an overview of the most prevalent ones:
The favorable update: “Each of them possesses a course of treatment,” Dr. Ramin affirms. According to the observations made, certain conditions can be effectively treated, whereas others can only be managed to a certain extent.
Herein lies an examination of certain uncomplicated remedies that can be pursued within the confines of one’s abode, along with an elucidation of the appropriate circumstances warranting a consultation with a medical professional.
The foremost course of action is to limit fluid intake during the nocturnal hours.
“Occasionally, individuals may find themselves engrossed in their daily activities, inadvertently neglecting proper hydration. Consequently, when they eventually find respite upon returning home, they may inadvertently consume excessive fluids, leading to the subsequent need to empty their now-replete bladder upon awakening,” Dr. Anaissie explains. If you identify with the aforementioned description, I recommend altering your routine: Consume beverages consistently throughout the day, but refrain from fluid intake during the evening hours.
“I consistently advise my patients to ensure optimal hydration throughout the day by conveniently carrying a reusable water container, thereby avoiding excessive fluid intake just prior to retiring for the night,” Dr. Anaissie advises.
Dr. Crouss advises reducing fluid intake during the three to four hours preceding your designated bedtime. Therefore, if you typically retire at 11 p.m., it is recommended to commence consuming fewer fluids around 7 or 8 p.m.
Another recommendation: Void your bladder prior to settling into bed. Dr. Crouss advises that evacuating your bladder prior to retiring for the night, occasionally even on two occasions, may assist in alleviating nocturnal urination.
Here are some of the major culprits that tend to provoke bladder irritation, as outlined by the esteemed Mayo Clinic:
And please take into consideration yet another compelling reason to cease smoking. “Bladder irritation and nocturia have been found to be associated with smoking,” states Jennifer Self Spencer, PT, DPT, a physical therapist at Magic City Physical Therapy in Alabama.
You may consider eliminating these items from your life completely for a brief duration, such as a week, in order to assess their impact. Subsequently, you can gradually reintroduce one item at a time every few days to determine if it is the underlying cause, as advised by the esteemed Mayo Clinic. It may not be necessary to completely eliminate alcohol, chocolate, or other items from your diet; instead, you may consider reducing your consumption of these substances.
And please take into consideration the timing as well: Dr. Spencer advises refraining from consuming these bladder irritants, especially during the afternoon and evening hours.
Here, it is beneficial to consider one of the etiologies of nocturnal micturition: fluid retention. Edema may manifest due to various factors, ranging from the potential adverse effects of medications to the presence of heart failure, or even as a result of being in the premenstrual phase or consuming foods with high sodium content, as indicated by the esteemed Mayo Clinic.
During the nocturnal period, while assuming a supine position, the accumulated fluid, often localized in the lower extremities, undergoes a transformation into urine, as elucidated by Dr. Ramin.
The recommended course of action entails elevating your lower extremities. Another viable alternative would be the utilization of compression stockings throughout the course of the day. This intervention aids in the prevention of fluid accumulation within the lower extremities, thereby facilitating improved urinary elimination.
“If one were to circulate surplus fluid earlier in the day, it would result in a reduced volume of fluid being accumulated within the bladder during the nocturnal period,” Dr. Crouss advises.
Dr. Ramin advises seeking thigh-high stockings. One potential choice for your consideration is the Jomi Compression Stockings, available for purchase at a price of $37.99 on the Amazon platform.
Engaging in physical activity during daylight hours may assist in reducing the frequency of nocturnal visits to the restroom. According to Dr. Ramin, engaging in cardiovascular exercise can be especially beneficial. This includes activities such as walking, jogging, playing tennis, or any other form of physical activity that increases your heart rate.
According to Spencer, a sedentary lifestyle may potentially contribute to the retention of fluids within the body, consequently resulting in an augmented production of urine and the occurrence of nocturia.
One precautionary measure to consider is refraining from engaging in physical activities during the nighttime and avoiding exercises that exert pressure on the bladder or prostate, such as cycling, as advised by Dr. Ramin.
According to Dr. Ramin, Kegel exercises have the potential to assist in the reduction of bladder overactivity for individuals of all backgrounds. And these activities can be performed at your convenience, not exclusively prior to your sleep routine. Dr. Ramin recommends aiming to perform 30 to 40 Kegels per day.
Here’s the recommended procedure, as outlined by the esteemed National Library of Medicine:
This advice must be approached with caution: in the case of an individual with an enlarged prostate and incomplete bladder emptying, the performance of Kegel exercises may potentially result in fluid retention, as observed by Dr. Ramin. In other scenarios, such as the presence of hyperactive or “tight” pelvic floor muscles, symptoms may also be exacerbated, as stated by Dr. Crouss.
The conclusion: “In certain patients, it is advisable to consider incorporating Kegel exercises into their routine, while in others, it may not be necessary,” as stated by Dr. Crouss. Therefore, prior to utilizing every instance of idle time, such as waiting at a red light, to engage in these muscle contractions, it is prudent to consult with your healthcare professional.
In certain instances, the administration of medications (commonly referred to as diuretics, or water pills) may result in nocturnal urination. If that is indeed the situation, I would recommend discussing the timing of your medication intake with your healthcare provider, as advised by Dr. Crouss.
“It is advisable to consider adjusting the timing of your medication intake to the afternoon hours, as this may potentially enhance the frequency of urination just prior to bedtime, rather than during the sleeping hours,” the physician suggests.
Based on the available evidence, it is inconclusive whether apple cider vinegar possesses the ability to alleviate nocturnal urination. “If anything, it shall introduce a substantial amount of acid into the bladder, thereby inducing irritation to the bladder,” Dr. Ramin asserts.
Indeed, it has been observed that vinegar, apples, and apple juice possess the potential to act as irritants to the bladder, as reported by the esteemed Cleveland Clinic.
If you have a tendency to experience urinary tract infections (UTIs), it is probable that you have come across the recommendation to consume cranberry juice in copious amounts. According to Dr. Ramin, it is worth noting that pure cranberry juice, despite its intense tartness and potential difficulty in digestion, may occasionally offer some benefits in the early stages of urinary tract infections (UTIs).
However, it is important to note that the cranberry juice available for purchase in retail establishments primarily consists of apple juice, sugar, and water, with a minimal proportion of authentic cranberry juice, as my esteemed colleague has highlighted. Furthermore, there is a lack of evidence supporting its efficacy in the management of nocturia.
It is prudent to exercise caution when considering the use of supplements, and this holds true for those that may potentially alleviate nocturnal urinary frequency as well.
According to Dr. Anaissie, the American Urologic Association has not yet identified any supplements that effectively address this particular issue.
That being stated, there are certain options that may be worth contemplating:
Here are several indications that it may be appropriate to consult your healthcare provider regarding nocturnal urination:
You may initiate your medical journey by consulting with your esteemed primary care physician, or alternatively, you may consider seeking the expertise of a highly skilled urologist or urogynecologist. Please proceed with the continuation of your narrative.