What's Behind Frequent Urination at Night? Nocturia Causes and More.
Fizyoterapist Nesibe Avşar 
Normally (if excess fluid intake hasn't occurred before bedtime), we don't feel the need to urinate during sleep. Waking up to urinate two or more times at night is called Nocturia.
Factors contributing to Nocturia:
- Excessive consumption of bladder irritants before bedtime (citrus fruits, tea, coffee),
- Decrease in ADH (Anti-diuretic hormone)* production with aging,
- Pregnancy,
- Obesity,
- Neurogenic bladder,
- Chronic constipation,
- Certain medications.
*ADH is a hormone secreted in darkness (nighttime) responsible for maintaining fluid balance in the body.
It promotes water retention in the kidneys and suppresses urine production during sleep. ADH production decreases with age.
*Accumulation of stool in the intestines during sleep can exert pressure on the bladder, triggering the urge to urinate.
Additional factors contributing to Nocturia:
- Excessive fluid intake,
- Obstructive sleep pattern,
- Overactive bladder,
- Urinary tract infection,
- Pressure from a growing uterus/ovarian cyst on the bladder,
- Pelvic organ prolapse,
- Diabetes (irritates the bladder and increases the need for fluid intake).
Recommendations for managing Nocturia:
- Consume fluids regularly during the day, dividing 2.5 liters of water evenly throughout the day.
- Urinate regularly during the day. (Every 3 hours)
- Try to avoid salty and protein-rich meals at dinner.
- Limit fluid intake before bedtime.
- Sleep in a dark environment. (For ADH secretion)
- Use nasal irrigation or nasal dilators if respiratory obstruction increases urine production.
- Avoid constipation.
- Reduce the use of bladder irritants.
- Attempt weight loss if overweight.
For more detailed information, feel free to contact me.
