Marja Sprock, M.D. FACOG, FPMRS Board
Nocturia or waking up to
void, which is followed by going back to sleep, occurs
more frequently when we get older.
It is definitely a source
of significant bother to the patient, partner and what I
was not aware of the dog. One of my patients presented
because her dog Milly had become annoyed by the amount
of time she was woken up by her owner. Milly’s owner is
72, still very actively involved in the workforce and
her lack of sleep did initially not make her seek help.
What made her present was the realization that it was
even too much for her dog. Currently Milly is much
happier with her boss, since some medications did the
Among 18 to 49 year olds,
more women than men have nocturia; Men after 60 years of
age win the nocturia battle. The prevalence of twice
nightly or greater nocturia among men between 70 and 79
is nearly 50 percent.
When you have to get up
twice or more at night it starts to become a problem at
least for women.
Nocturia can be attributed
to any disorder or condition that causes one of the
- Low volume bladder
- Increased volume
of nighttime urinary output
- Sleep disturbance
It is very important to
differentiate between the different reasons for
nocturia, since the treatment is very different. If
Milly were barking the entire night, she would wake up
her boss, who may then decide to go to the bathroom.
Sleep apnea or having a male partner, who gets up to go
to the bathroom and wakes you up in the process, would
be another reason for a sleep disturbance. This is not
related to a bladder issue. On the other hand the
bladder may be overactive or have a reduced capacity.
There are different treatments for this from bladder and
muscle training to medications by mouth or in the
bladder like Botox® or nerve stimulation, either
temporary or more permanent. The owner of Milly has
been helped very much by a medication to treat her
overactive bladder. The medication may worsen the
condition if the bladder empties incompletely, so a
proper diagnosis is paramount
Nocturia can be
attributed to any disorder or condition that causes one
of the following
If the production of urine
is increased at night the treatment is different again.
Diseases like Parkinsonism, diabetes mellitus, nephrotic
syndrome and heart failure can increase the nighttime
urine production. Medications like diuretics if taken
between 1-4 PM will have a better effect on diminishing
the edema or swelling and will not interfere with your
night time sleeping. Also if you tend to drink a lot of
fluids, they will have to come out some time. Drinking a
large glass of water right before you get into bed may
taste good, but is not recommended if you’d like to be
asleep for a longer time. In addition remember that more
fluid intake does not make you live longer or better.
There is no advantage to your health to drink excessive
amounts of water and it may dilute your electrolytes
leading to fatigue and dizziness.
Also one of the peptide
hormones which naturally diminish your nighttime urine
production is lower in aging adults. And let’s not
forget if your bladder is prolapsed and prevents it from
emptying well during the day, it can cause not only
sleepless nights but also bladder infections.
With all these reasons to
not be able to sleep at night I may have overwhelmed you
or put you to sleep. It may be a good idea to schedule
an appointment with Central Florida UroGynecology and
have us figure out what is preventing you from getting a
good night’s rest. One thing is for sure, when we get
adequate sleep, we all feel better, even the dog.
Marja Sprock M.D. at Central Florida
UroGynecology in Rockledge is OB/GYN and Female Pelvic
Medicine and Reconstructive Pelvic Surgery
(Urogynecology) board certified and can be reached at
321-806-3929 or check us out at
Florida UroGynecology where high tech and common sense