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Frequent Nighttime Urination in Seniors: Is It Normal? Key Tips!

Families with elderly people often find that they often get up in the middle of the night to go to the toilet, maybe 2-3 times a night. The problem of getting up at night troubles many elderly people. Some elderly people dare not drink more water before going to bed because they are afraid of getting up frequently at night.

Many people believe that this is caused by the natural aging of the body, but is the reason behind frequent waking up at night really that simple? What other hazards and risks might we be overlooking?

1 Why do old people get up frequently at night?

    Frequent waking up at night by the elderly is generally divided into two situations. One is that the quality of sleep is indeed poor and they can’t fall asleep; the other is that they are woken up by urination.

    Why are older people more likely to hold in their urine than younger people? The specific reasons are as follows:

    Small bladder output
    Reduced bladder capacity or impaired bladder function, both of which may result in reduced bladder output; patients with overactive bladder and bladder outlet obstruction are more likely to experience reduced urine output.

    Decreased bladder capacity is common in older adults, most likely due to age-related changes in the bladder or detrusor overactivity.

    Increased urination at night
    Increased nocturnal urine output may be due to an increase in nocturnal urination as a proportion of total daily urination (nocturnal polyuria) or an increase in total 24-hour urine output (polyuria). It can also be caused by conditions such as poorly controlled diabetes, benign prostatic hyperplasia, and congestive heart failure.

    sleep disorder
    Insomnia may be caused by obesity, restless legs syndrome, periodic limb movement disorder, obstructive sleep apnea syndrome and other diseases.

    Therefore, any disease that can cause small bladder urination, increased urination at night, and sleep disorders may be the culprit.

    2 What are the dangers of getting up frequently at night?

      Affect sleep
      Frequent waking up at night can seriously trouble some patients, especially those who wake up ≥ 2 times a night. Frequent waking up at night will affect sleep quality to a certain extent.

      reduce quality of life
      Nocturia is one of the most distressing symptoms for elderly men with benign prostatic hyperplasia, and it can cause patients to feel that their quality of life has been significantly reduced.

      Affect daily life and physical health
      Many patients develop nocturia after the age of 50, and it becomes more obvious after the age of 55. Frequent waking up at night can lead to negative effects such as depression and work absence. Patients will also feel that their physical and mental health is impaired. It will also increase the rate of accidental falls and the rate of fractures caused by falls in elderly patients.

      Since getting up frequently at night can cause so many harms, if there is an elderly person in the family who suffers from this situation, they must be prepared in advance. In addition to actively dealing with basic diseases, they must also prevent the elderly from falling accidents.

      3 Precautions for the elderly when getting up at night

        When getting up at night, get up, get out of bed, and walk slowly.
        Choose appropriate shoes and clothing, and pay attention to keeping warm and non-slip.
        Store the debris in your home and the wires on the floor, place a urinal next to the bed, install a bedside lamp or flashlight beside the bed, and keep the passage clear and free of debris.
        Add non-slip mats and handrails to the bathroom to ensure safety as much as possible and prevent falls.

        Despite taking measures to prevent falls, the problem of frequent waking up at night has always troubled the elderly. How to improve the problem of frequent waking up at night?

        4 How to improve the phenomenon of frequent waking up at night

          It is unrealistic to completely eliminate nocturia, but the goal is to reduce the distress of symptoms and reduce the frequency of nocturia.

          First, we must actively treat the underlying disease, including: psychogenic polydipsia (polydipsia, polydipsia, drinking more than 10L of water per day), congestive heart failure or peripheral edema, poorly controlled diabetes, gastroesophageal reflux disease or Coughing at night, etc.

          Secondly, you can also intervene through the following measures:

          Reduce nighttime urination
          ① Reduce total fluid intake, especially those who consume too much, and you can also reduce nighttime intake in a targeted manner. In addition to getting water from their diet, the elderly also need to add an additional 1000-1500mL of water every day.

          However, if you are accompanied by heart and kidney disease, you need to limit the amount of water you drink. If you exercise a lot, before and after taking a bath, or in a high temperature environment, you should increase your water intake appropriately.

          However, if it is an elderly patient whose intake is at a critical level or cannot meet daily needs, there is still no need to limit intake.

          ② Avoid using diuretics at night. If patients use diuretics twice a day due to personal needs, they can advance the evening medication time to around 3 pm under the guidance of a doctor. Also, reduce your nightly intake of diuretic fluids, including coffee and alcohol.

          ③ Reduce the impact of other diseases on nocturia. Taking diabetes as an example, patients with diabetes should avoid nocturnal hyperglycemia as much as possible.

          When blood sugar rises, plasma osmotic pressure will rise, and the brain will issue instructions to make corresponding adjustments, such as drinking more water, producing urine to excrete excess sugar, which will lead to increased water consumption and frequent nocturia.

          Get ready for sleep
          For patients who struggle with waking up at night, using a handheld chamber pot or bedside commode may be helpful.

          In addition, good sleep habits can reduce the number of nighttime urinations, including sleeping in a quiet room with low brightness, a suitable temperature, avoiding using electronic devices before bed, and not taking naps during the day.

          Urinating twice before going to bed may be useful for people who feel that their bladder has not been completely emptied. The specific method is: sit comfortably on the toilet to urinate (including men), lean your upper body slightly forward, and wait 20-30 seconds before urinating again.

          Pelvic floor muscle training
          Pelvic floor muscle training and urinary urge suppression methods (stay still, do not rush to the bathroom, and quickly contract the pelvic floor muscles 3-5 times) are useful for both female and male patients with nocturia.

          Digital rectal examination can assess the functional status of the patient’s sphincter and test whether the exercise can be performed.

          The basic recommended plan is 3 sets of 8-12 slow contractions, each contraction lasting 6-8 seconds, 3-4 times a week, lasting at least 15-20 weeks.

          Treatment measures
          Drug treatment can be given to patients who still have symptoms after initial intervention. However, for patients with nocturia and severe persistent prostate symptoms, if there is bladder outlet obstruction, surgical treatment of prostatic hyperplasia can be performed, which may reduce nocturia to a certain extent.

          Bladder relaxant therapy can be used in women and men without benign prostatic hyperplasia. Bladder relaxant drugs can reduce nocturia by increasing bladder volume and reducing urge to urinate.

          Two main classes of drugs are used: muscarinic antagonists and beta3 agonists, and the choice of initial drug is usually based on the side effects to be avoided.

          However, it should be noted that muscarinic antagonists should be avoided in patients with cognitive impairment (eg, dementia, delirium, confusion), dry mouth, or severe constipation. Beta3 agonists should be used with caution in patients with underlying tachycardia or poorly controlled hypertension.

          Specific drug use still requires professional doctors to provide advice.

          As people age, various body functions will decline accordingly, and they will face more problems. Frequent waking up at night is just one of them. We need to give them enough care. In addition to telling them to have physical examinations on time, we should also pay attention to whether there are any abnormalities. So as not to delay treatment.