Frequent night time urination or nocturia is a complex problem. It is often caused by multiple factors. The kidneys usually produce most of the body's urine production in the daytime, and much less while you sleep. Thus it is abnormal to wake up more than once to pass urine.
If urinary tract infection and overactive bladder have been excluded (i.e frequent nighttime urination is not accompanied by frequent day time urination), one condition that needs to be considered is nocturnal polyuria. This is a condition where due to hormonal changes, the kidneys produces more urine at night that usual - at least one-third of the total daily urine production.
As the kidneys are producing more urine at night than they should, this causes more frequent filling of the bladder, and thus more frequent night time urination.
This condition can be diagnosed by recording a bladder diary - where the amount of urine produced throughout the day and night is recorded. If the volume of urine passed during sleeping hours exceeds 33% of the total urine production over 24 hours, the diagnosis is made. There are medications that can treat this condition.
It is important to treat nocturia. Chronic disruption of sleep affects daytime vitality, mental performance and quality of life. It also can lead to a higher risk of falls in the elderly, and is associated with a higher risk of death.
