“I wake up at 3 to go to the bathroom,” Becky, an acquaintance, told me recently. “Immediately I say to myself, ‘Here we go, I need to go the bathroom really quick and try not to wake too much and try not to think about anything and get right back into bed.’ But of course that doesn’t usually happen. Then I start to have a lot of anxieties—tension I can feel in my body, and a general feeling of stress. My mind starts racing and I’m not able to quiet it enough so that I can fall back to sleep.” Often that’s the end of her night.
The need to void at least once a night is common among seniors. Three-quarters of adults aged 65 and older say having to use the bathroom is the most frequent reason they wake up at night. But nocturia is not just a problem for seniors. Forty percent of younger adults attribute most of their nighttime awakenings to it, as do 58 percent of adults in middle age.
Statistics show that nocturia interferes with getting a good night’s sleep. It’s a risk factor for both insomnia (75% increased risk) and reduced sleep quality (71% increased risk). It’s associated with shorter sleep duration, poorer sleep efficiency, and greater daytime dysfunction as well.
Also, in a telling measure of just how big an impact it has, people with overactive bladders are less likely to benefit from insomnia treatments such as CBT-I (cognitive behavioral therapy for insomnia) and BBTI (brief behavioral treatment of insomnia). Consequently, say the authors of an analysis recently published in the journal Sleep, nocturia should be treated before or during the behavioral treatment of insomnia.
Cut down on nightly bathroom calls by changing what you consume and what you do:
- Keep yourself hydrated during the daytime but avoid drinking fluids after dinner (especially alcohol and beverages containing caffeine).
- Don’t eat foods high in liquid—soup and fruit, for example—for dinner.
- Avoid heavily salted foods later in the day. These foods cause your body to store extra fluid and increase urine production at night.
- If you are on diuretic medications (water pills), take them earlier in the day.
- If your bathroom trips at night are caused by swelling in the ankles and legs, elevate your legs during the daytime and wear compression hose.
- Do pelvic floor exercises. Squeeze the muscles that control the flow of urine and hold for a count of 10. Repeat 4 or 5 times. As your muscle control improves, increase the length of time you hold the muscles and the number of repetitions you do.
- If none of these strategies work, talk with your doctor about the possibility of taking a medication to reduce bladder spasms and the urge to go at night. Desmopressin and imipramine are two medicines that may help.
- Talk to the doctor about the advisability of surgery. Surgical options that relieve the urge to go at night include a device implanted under the skin near the tailbone and procedures for reducing enlarged prostates.