- The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction - (https://pubmed.ncbi.nlm.nih.gov/30681183/)
- Nocturia - (https://www.urologyhealth.org/urology-a-z/n/nocturia)
- Bladder diary / frequency volume chart - (https://www.ics.org/committees/standardisation/terminologydiscussions/bladderdiary)
- A practical approach to the management of nocturia - (https://pmc.ncbi.nlm.nih.gov/articles/PMC5698733/)
- Pharmacologic management of nocturnal polyuria: a contemporary assessment of efficacy, safety, and progress toward individualized treatment - (https://pmc.ncbi.nlm.nih.gov/articles/PMC7970679/)
- How To Stop Frequent Urination at Night - (https://health.clevelandclinic.org/stop-full-bladder-killing-sleep)
- Nocturia: Causes and Treatments for Frequent Urination - (https://www.sleepfoundation.org/physical-health/nocturia-or-frequent-unrination-night)
- Nocturia: The Complex Role of the Heart, Kidneys, and Bladder - (https://pubmed.ncbi.nlm.nih.gov/31395515/)
- Transition from Childhood Nocturnal Enuresis to Adult Nocturia: A Systematic Review and Meta-Analysis - (https://pmc.ncbi.nlm.nih.gov/articles/PMC8631987/)
- The Effect of Pregnancy on Urinary Symptoms - (https://pmc.ncbi.nlm.nih.gov/articles/PMC10523107)
- Nocturia - (https://www.urologyhealth.org/urology-a-z/n/nocturia)
- Frequent Urination - (https://my.clevelandclinic.org/health/symptoms/15533-frequent-urination)
- A practical approach to the management of nocturia - (https://pubmed.ncbi.nlm.nih.gov/28984060/)
- The economic impact of nocturia - (https://pubmed.ncbi.nlm.nih.gov/24729147/)
Nocturnal Polyuria affects approximately 3% of the elderly population with no gender difference. It can be caused by a disturbance in the hormone vasopressin or antidiuretic hormone (ADH) secretion from the pituitary gland in the brain especially during the night.
Normally vasopressin increases water absorption within the kidneys and a lack of it causes increase in urine volume. In patients with diabetes insipidus there is a general deficiency of the hormone ADH whereas in nocturnal polyuria the hormone level is specifically decreased in the night.
Nocturnal polyuria can also occur due to other causes, like taking medications, consuming caffeine or alcohol or excess intake of water in the evening or night, heart failure and due to sleep apnea. In diabetes mellitus and diabetes insipidus there is polyuria both in the day and night.
In nocturnal polyuria the 24-h urine output or diuresis is normal or only slightly increased but the shift of diuresis from daytime to the night results in disturbance with the quality of sleep and this causes tiredness during the day and decreases not only work efficiency of the person but also makes them prone to diseases.
Download Voiding Diary Form
What is a Voiding Diary?
A frequency volume chart or a voiding diary measures fluid intake and urine output of a person during a 24 hour period. This calculation helps doctors to understand input and output of fluids and the resulting frequency and the volume of urine passed. It normally should be completed over 3 to 5 consecutive days to diagnose the problem.The main columns in a voiding diary should be filled and the time noted. Other information that can be added if symptoms are present is about any urine leakages that may happen due to urgency or otherwise.
Fluid Intake: This is the total amount of fluids consumed (Milliliters or ounces) during a 24 hour period.
Time of Day: Every time you pass urine, mark the time next to the appropriate hour time slot when it occurred.
Toilet Voids or Urine output: This is the amount of urine voided each time during the day or the night. Every time you pass urine measure the amount in a measuring jug and record the volume (in Milliliters or Ounces).
Leakage or wetness: Put a check mark in the wet column each time involuntary urine loss occurs (even if it is a small amount) before you made it to the toilet.
FAQs
1. When should I see a doctor for nocturnal polyuria?
If you wake up more than twice at night regularly to urinate, and it affects your sleep or daily life, it is advised to consult with a Urologist(2✔).
2. Is Nocturnal Polyuria the same as frequent urination?
No, nocturnal polyuria is excessive urine production at night, whereas frequent urination can happen at any time of the day(7✔).
3. Can nocturnal polyuria be a sign of kidney disease?
Yes, kidney disease can affect urine production and cause excessive nighttime urination, but other factors like heart disease or diabetes can also play a role (8✔).
4. Is nocturnal polyuria common in children?
Children can have nocturnal enuresis, which is bedwetting during sleep. It can change into nocturnal polyuria when they become adults however, this condition is not common among children (9✔).
5. Does pregnancy cause nocturnal polyuria?
Yes, pregnant women peeing a lot at night often experience increased urination due to hormonal shifts and pressure on the bladder from the growing baby (10✔).
6. What is the reason that I pee so much at night but not during the day?
It can be due to hormonal imbalance (low ADH levels). However it can occur additionally due to fluid retention, caffeine or alcohol intake, medications, or sleep disorders like sleep apnea. This can lead to polyuria like condition like nocturnal polyuria (11✔).
7. How many times is normal to urinate at night?
It is normal to urinate and wake up once to three times depending on your age (12✔)
Once in the night – Age of 40 to 50 years
Twice in the night - Age – 50 to 70 years
Three times in the night – after 80 years
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