Another Word of the Day Wednesday is upon us. Also, Happy November! Today’s word is NOCTURIA. It means waking up a lot at night in order to pee. Normally, the body produces less urine at night, so you can have some restful, uninterrupted sleep for 6+ hours. But if you’re an older adult, you produce less of the antidiuretic hormone that helps you decrease urine production and retain fluid. The pelvic floor muscles that hold up your bladder and other organs may not be functioning as well as they could, or the muscles may be weaker: this typically happens with age, but pelvic surgeries like prostatectomies can markedly decrease muscle strength. The bladder may also not be able to hold as much volume. For folks aged 60-70, the prevalence of nocturia is between 11% and 50%. For those aged 80+, it rises to between 80% and 90%, with nearly 30% experiencing two or more episodes nightly. (*)
But here’s the issue: older adults already wake up more often at night and have less deep sleep compared to young’uns. Frequent nighttime pee breaks add to the disruption, and poor sleep leads to daytime drowsiness, depressive symptoms, decreased cognitive function, and a reduced feeling of well-being. Nocturia also increases the risk of hip fracture 1.8-fold.(**)
So what’s an older dame or gent to do?! There are some promising results looking at the short-term use of desmopressin to decrease nocturia (***), you can speak to your MD to rule out other possible causes (e.g. heart disease, sleep apnea) — and as always, consider visiting a pelvic physical therapist who can give you an in-depth understanding of how things are working “down there,” and some strategies to manage those nighttime strolls to the loo. (Pro Tip: Elevating the legs on pillows or the edge of a couch and doing ankle pumps in 2-3 hours before bed can really help!)
(*)Weiss JP, Blaivas JG. J Urol. 2000 Jan; 163(1):5-12.
(**) Stewart RB, Moore MT, May FE, Marks RG, Hale WE
J Am Geriatr Soc. 1992 Dec; 40(12):1217-20.
(***) Kang D et al. Int Neurourol J. 2010 Dec; 14(4): 227–231.