Nocturia can be troublesome and disruptive to a sense of normalcy. When sleep is interrupted, are impaired: thinking is murky and short term memory becomes disjointed.
Some primary care physicians are quick to prescribe a sleep medication when they briefly hear about sleep disorders, especially if the symptoms are not fully described to them or if recurrent patterns of interrupted sleep are not shared by a patient. Falling asleep initially may not be a problem at all, but staying asleep is another problem altogether!
The first think, as with daytime interruptions to urinate frequently or urgently, keep a log for at least several nights in a row, recording activities during the day, especially the 3-4 hours leading up to bedtime, as well as nighttime interruptions. The bladder diary is still applicable, and a form is available from NAFC as a template to follow.
Once you have a baseline, try for two weeks or more to alter certain behaviors their can affect the need to use the toilet during the night:
• Restrict fluid intake: No fluids the last 3 hours before retiring to bed
• Eliminate alcohol and caffeine, especially the last 3 hours before retiring to bed
• Take a late afternoon rest, lying down for an hour and elevating your legs on a pillow so that heels are higher than your chest, at least 2 hours before retiring
• Just before going to bed, urinate and then double-void, relaxing so as to empty your bladder as much as possible
• If there is any swelling, or edema, in your feet or ankles, wear compression stockings during the day
• During the day, consume fruits and vegetables that have natural diuretic properties. A good example is lemon fruit, believed due to its high vitamin C content, according to Purdue University. Others are watermelon, cantaloupe, pears, and peaches.
If by comparison to your baseline experience, such remedies make little or no difference in your symptoms, make an appointment with your doctor - and possibly ask for a referral to a specialist such as a urologist or urogynecologist if your PCP does not seem able to help you.
There is a variety of medications that might be prescribed and a new one scheduled to come on the market early in 2013 specifically for addressing nocturia.
Others currently on the market include:
• Any one of the anticolinergic medications, prescribed routinely for overactive bladder
• Desmopression, which causes the kidneys to produce less urine
• Furosemide, whose action causes a lower urine production during sleep
• Bumetanide, which helps with the regulation of urine production
Nancy Muller, PhD, MBA
Executive Director, National Association For Continence
Key word: nocturia medications, behavior therapy for nocturia, sleep interruption