What is nocturnal polyuria
Nocturnal polyuria literally means that you wake up at night
(nocturnal) several times (poly) because you have to urinate
("uria").
What causes nocturnal polyuria?
Nocturnal polyuria occurs in both men and women. It becomes more
common as people age.
Nocturnal polyuria is caused by:
- Congestive heart failure -- A condition where
the heart muscle weakens and can not pump blood efficiently
throughout the body. If the heart can not pump efficiently, fluids
can build up in your extremities (eg, legs). Swollen ankles are one
sign of heart failure. During the night, your body absorbs this
excess fluid, changing it into urine, and creating a need for you
to urinate in the middle of the night.
- Hypoalbuminemia -- An abnormally low blood
level of albumin. Normally, albumin is the most plentiful protein
in human blood and the key to the regulation of its osmotic
pressure. Albumin helps blood hold on to its fluidity, so as
albumin levels decrease, fluid eases out of the bloodstream and
body as urine.
- Venous insufficiency -- Venous insufficiency
is a condition in which the flow of blood through the veins is
impaired. When this happens, fluids can build up in your
extremities and lead to the creation of excess urine and the need
to urinate in the middle of the night.
- Excessive fluid intake, especially during the
evening hours (ie, after 7pm). This includes all fluids -- from
water to alcohol and caffeine in particular. Keep in mind that
certain foods contain a lot of water too, such as salads,
vegetables, fruits, rice and pasta.
- Use of long-acting diuretics, which may result
in the need for you to urinate in the middle of the night.
- Sleep apnea -- Sleep apnea is a sleep disorder
in which breathing stops in intervals that may last from 10 seconds
to a minute or longer. Sleep apnea triggers certain hormones in the
heart that promote urine loss.
- Insomnia - trouble sleeping
- No known cause.
How is nocturnal polyuria diagnosed?
To diagnose nocturnal polyuria, your doctor will:
- Take a detailed health history. You will be asked about your
sleeping pattern, urinary problems, medical conditions, and about
the medications you are taking.
- Conduct a physical exam. Your heart and kidneys will be
examined for any problems.
- Ask you to keep a voiding diary. You will be asked to record
each time you urinate, the amount you urinate, and the amount of
fluid you drink to help determine if you have a health
problem.
- Order urinalysis and other screening tests to identify if you
have an infection or other abnormality and to check your kidney
function.
- Order other tests as needed, such as bladder scans,
ultrasounds, sleep studies, urodynamic and endoscopic tests.
What can you do to help resolve nocturnal polyuria?
- Reduce the amount of fluids you consume -- and particularly the
amount of alcohol and caffeine -- and particularly the amount of
fluids consumed in the evening.
- Exercise regularly as a means to increase daytime fluid
excretion -- and overall health. If you have heart problems, talk
with your doctor before beginning any exercise program.
- Consider wearing elastic support (compression) stockings to
help reduce fluid retention and edema (swelling) in your legs.
- Put your feet up after lunch for several hours to also reduce
fluid build up in your legs. Leg elevation needs to be as high as
your heart to be effective.
- Take any diuretic -- for example, furosemide (Lasix®) 10 mg
-- that your doctor may prescribe at tea time (4 to 6 pm). This
will help you pass extra urine in the evening before bedtime.