Nocturia: Waking up at night to go to the toilet

Nocturia: Waking up at night to go to the toilet

What is Nocturia?
This is when you wake up MORE then once a night to go the bathroom. According to the Urology Care Foundation (2023), 1 in 3 adults over the age of 30 experience nocturia. This number increases to 70% in persons over the age of 70 years old.

Why is this a concern?
Nocturia causes sleep disruption which may affect you the following ways:

  • You may not get quality sleep after getting up to pass urine which means you might not function as well through the day
  • You may feel the need to sleep during the day which then affects your sleep quality at night
  • It is also linked with increased falls risk- especially in the older population.

What is a bladder diary, and why is it important?
Your physiotherapist or GP may give you a handout to complete called a Bladder Diary which will give the practitioner lots of information about the type of nocturia it is and how best to address it

What are the types of Nocturia?
There are two different types of nocturia:
Medical and Behavioural.
Medical causes due to underlying medical conditions (such as heart problems, UTIs, diabetes, kidney problems) may show the following outcomes on a bladder diary:

  • The kidneys producing too much urine in a 24hr period not relative to the amount of fluid consumed
  • The kidneys producing too much urine during the night not relative to the amount of fluid consumed
  • Bladder storage concerns-not storing or releasing enough urine

Behaviour causes:

  • Consuming large amounts of fluid too close to bed time
  • Pregnancy
  • Broken sleeping and going to the toilet just because you are awake
  • Drinking alcohol of caffeine too close to bed time

What can a physiotherapist do to help?

  • If it looks like the type of nocturia is most likely a “behavioural” type on the Bladder Diary these are some lifestyle changes your physiotherapist may ask you to make:
    • Don’t restrict your fluid intake! This is a common mistake people make when trying to reduce passing urine at night time. This can cause dehydration which leads to the urine becoming more concentrated. This concentration can upset the bladder and make you need to go to the toilet more regularly
    • Most adults need around 2L of fluid a day to stay hydrated. Instead of restricting your fluid intake- change your daily habits so you drink more fluid in the first ¾ of your day and reduce your intake between dinner and bedtime.
    • Cutting back on your caffeine or alcohol intake in the evenings before bed
    • Listen to your bladder- sometimes you may just be waking up at night (NOT because you need to go to the toilet) and going to the toilet out of habit. See if you can fall asleep without going to the toilet to reduce the amount of times you need to get up during the night (you must make sure there is no medical cause first).

      If you start experiencing nocturia that is not behavioural in nature it is important to see your GP and get investigations to make sure there is no underlying medical cause

If you want more information or assistance with this concern please contact Proactive Physiotherapy on 4053 6222 to book your appointment with our pelvic health physiotherapists.

Urology Care Foundation, Amercia. (2023). What is Nocturia?
Urinary incontinence and Female Urology. (2023). Frequent Urinartion At Night (or Nocturia).