Needing to urinate during the night (nocturia) is more common among older people. It can contribute to sleep problems and to falls, especially if a person is rushing to the bathroom or if the area is not well lit.

Causes

Nocturia may occur in the early stages of many kidney disorders. Nocturia is also common among people with heart failure, liver failure, poorly controlled diabetes mellitus, or diabetes insipidus. A person may have nocturia if the kidneys cannot concentrate urine normally. Frequent urination of very small amounts at night may result when the flow of urine into and through the urethra is obstructed and urine backs up in the bladder. An enlarged prostate is the most common cause of obstruction in older men (see Prostate Disorders: Benign Prostatic Hyperplasia (BPH)). Sometimes, however, the cause of nocturia may simply be drinking a large amount of fluids, especially alcohol or caffeinated beverages (such as coffee or tea), in the late evening.

Bed-wetting (enuresis) is normal in young children. After about age 5 or 6, it may indicate a delay in the maturation of the muscles and nerves of the lower urinary tract, which most often resolves without treatment. If bed-wetting persists, other causes are considered, such as a urinary tract infection, diabetes, inadequate control of the nerves of the bladder, or psychologic causes.

Evaluation and Treatment

The cause of nocturia is often evident from the person's symptoms and the results of the examination. In men, doctors examine the prostate. Testing may be needed, depending on what possible causes are suspected.

Treatment is directed at the underlying disorder. In all people, minimizing intake of fluids, alcohol, and caffeinated beverages during the late evening and voiding immediately before going to bed may help limit nocturia.

Last full review/revision March 2007 by Ralph E. Cutler, MD