Medicines for Getting up at night to pass urine

What it is

Nocturia means waking up during the night one or more times because of the need to pass urine. Occasionally getting up once is common and not necessarily a problem, but waking repeatedly can disturb sleep, cause tiredness, and affect quality of life, and increases the risk of falls in older people. It becomes more common with age. There are several possible reasons, and often more than one contributes. These include: producing more urine at night (for example from drinking a lot in the evening, drinking alcohol or caffeine, or the body's pattern of fluid handling changing with age, or fluid that has gathered in the legs during the day being reabsorbed when lying down); bladder problems (such as an overactive bladder, or, in men, an enlarged prostate causing incomplete emptying); and medical conditions that increase urine production or affect sleep (such as poorly controlled diabetes, heart or kidney conditions, and sleep problems including sleep apnoea). Because the causes vary and are often addressable, identifying what is driving the nocturia is the key to improving it.

How it is treated

Management starts with identifying the likely cause or causes, which guides treatment, and simple measures help many people. A doctor may ask about the pattern (sometimes using a bladder diary that records drinking and urination over a few days), review medicines (some, such as water tablets, can contribute, especially if taken late), and check for underlying conditions (such as diabetes, prostate problems, heart or kidney issues, or sleep apnoea). Practical measures often help: reducing fluid, caffeine and alcohol in the few hours before bed, adjusting the timing of any water tablets (with medical advice), elevating the legs in the evening or wearing compression stockings if leg fluid is a factor, and treating constipation. Where an underlying condition is found — such as an overactive bladder, an enlarged prostate, poorly controlled diabetes, or sleep apnoea — treating it can significantly reduce the nocturia. Managing any bladder condition (for example bladder training or medicines) helps where relevant. In older people, reducing the risk of falls (such as good lighting and a clear path to the toilet) is important. The reassuring message is that nocturia is common and often improves once the underlying cause is identified and addressed, along with simple evening measures.