Night urination can affect the quality of life. It arises due to a variety of problems, for example, enlargement of the prostate gland, congestive heart failure, kidney failure, etc.
Night urination is defined as waking up once or more during the night in order to urinate. This is a common phenomenon that affects the quality of life of much of the population and may affect life expectancy. The percentage of those who suffer from night urination fluctuates with increased age. Various surveys found that the incidence ranges from 16-40 percent among those aged 45-40 and 50-90 percent among those aged 80 years or over.
It is also considered a sleep disorder because it is the cause for daytime sleepiness and fatigue, depression and decreased mental ability. As a result, there may be increased morbidity, increased risk of accidents and increased mortality rate that are mainly due to falls and fractures.
In a healthy person, there are daily periodic changes in the production of urine by the kidneys. Daytime urine output is greater than at night.
By definition, increased nocturnal urine output means more than 20 percent of the total output of urine a day. According to some researchers, the production of more than 0.9 to 1.3 cubic centimeters per minute of urine at night is considered increased nighttime output. Patients who sleep six hours a night and their nocturnal urine output is 324 cc or more will be considered as suffering from increased nocturnal urine output, because they produce over 0.9 cc per minute. Healthy people are not supposed to get up at night to urinate.
The widespread public assumption is that excessive night urination is caused solely due to an enlargement of the prostate gland. But the problem may have several other significant reasons. One is a defect in the “anti -night urination” hormone production. This defect can be congenital or acquired. In many cases, it is part of the aging process, because the hormone production decreases with age. Even drinking fluids or alcohol before bed can affect the production of this hormone.
Another reason is the excessive secretion of salts and water by the body or due to congestive heart failure. Congestive heart failure means your heart can not pump blood effectively. As a result, fluids remain in the body, concentrated mainly in the space between lower limbs cells. These fluids cause edema. Edema can disappear in the morning, because when lying the fluid flows back into blood vessels, the heart and, finally, to the kidneys.
Kidney failure, sleep apnea syndrome or venous insufficiency also can cause blood drainage problems from the lower extremities. As a result, the cumulative fluid in the space between the cells is as in congestive heart failure. While you are lying down at night, the fluid is dripping to the veins in the legs and reaches the kidneys. That produces more urine. Lack of estrogens, i.e. female hormones, causes urinary system dysfunction and frequency in day and night urination. Sleep disorders and urinary bladder storage disorders also increase the need for urinating at night.
The best-known problem associated with it is an enlarged prostate which brings about an obstruction in the bladder’s output. As a result, defects are created causing the need to urinate frequently day and night. A man with the problems should have a short and simple medical examination, which includes a physical examination, completing a questionnaire about his medical condition (illness, surgery and medications he takes) and, of course, filling in a diary documenting his urination output during a 24 hour period.
Recommendations are given to patients to change their lifestyles, such as raising the legs while lying down or using elastic stockings for patients suffering from edema. These measures improve the vein drainage and reduce edema. Another recommendation is to avoid drinking a lot-especially alcohol, tea and coffee-before going to bed. If the patient suffers from sleep apnea syndrome, using a positive pressure mask improves sleep quality and reduces night urination.
Other means of dealing with the problem are the treatment of diseases such as congestive heart failure, diabetes, situations of an overactive bladder or blockage of the bladder by an enlarged prostate.