What is nocturia?
You know when you are warm and comfortable, curled up under the covers, and you don’t want to get out of bed, but your alarm clock is ringing telling you that it is time to get up and ready for the day ahead…
How much worse is it when it’s the middle of the night, you should be fast asleep and the alarm clock that’s ringing is actually your bladder insisting that you get out of bed to relieve yourself, again. Getting up for the toilet once in the middle of the night is bad enough, but for men with BPH this can be a far more insistent and troublesome problem.
Nocturia is the medical term for needing to urinate excessively during the night, often leading to disrupted sleep. Normally at night we produce much less urine than during the day, though it is far more concentrated.
However, with an enlarged prostate, there is increased pressure on the bladder or the bladder becomes more irritable – this makes the urge to urinate stronger. Additionally, the bladder cannot empty itself as efficiently, meaning that it is not long after going to the toilet that you find yourself having to go again.
What problems can nocturia cause?
Aside from the obvious inconvenience of nocturia, it may take its toll on other aspects of your health. Primarily, people find that having got up to go to the toilet, they struggle to get back to sleep again, only to wake up shortly after to go to the toilet again. This cycle throughout the night leads to loss of sleep and lethargy and tiredness throughout the day.
Sleep deprivation not only leaves you feeling a bit groggy, but it can cause an increase in stress levels, making you feel low in mood and less able to cope with day-to-day pressures. Additionally, being stressed can make it more difficult to get deep and restful sleep.
Prolonged lack of sleep has been found to be linked with further medical conditions, including weight gain, high blood pressure and heart problems.
How can I reduce night-time urination?
There are many methods you can try to help reduce the number of times you need to get up during the night to go to the toilet. Here are some:
1. It makes sense that the more that you drink, the more frequently you will have to go to the toilet, so stop drinking a couple of hours before bedtime, and try to avoid sipping water throughout the night.
2. On the subject of drinking, certain drinks, primarily caffeine and alcohol can irritate the bladder and increase the urge for frequent urination, so try to reduce these types of drinks as much as possible.
3. Fluid has a habit of accumulating in the lower legs, which is then dispersed throughout the body as you lie down, increasing the urge for you to urinate. Elevate legs a couple of hours before bed or wear compression stockings to help to redistribute the fluid in your body before going to bed
4. Go to the toilet just before you go to bed so at least you start the night with an empty bladder. Try the double voiding technique to try to empty your bladder as much as possible. To do this, go to the toilet, then take a short break, for example to brush your teeth, then try to go to the toilet again to squeeze out a few more drops of urine.
5. Saw palmetto is a herb which has a traditional use in the relief of urinary discomfort in men with BPH, specifically nocturia. It is available in licensed herbal products such as A.Vogel’s Prostasan Saw Palmetto Capsules, and used alongside the suggested lifestyle changes gives you the best chance of reducing symptoms.
While these tips will benefit you during the night, there are also many tricks you can try to reduce symptoms during the day.
What can I do to get back to sleep?
If you do have to get up during the night to go to the toilet, all you really want to do is go straight back to sleep. So often, however, this is not the case and you find yourself lying awake staring at the ceiling and willing sleep to fall upon you. Again, there are several methods you can try to help you slip back to sleep:
1. Keep the lights dim when you get up for the toilet. You don’t want it so dark that you trip, but equally, light causes you to waken up, making it harder for you to go back to sleep.
2. Clock watching is just about the best way to keep you awake, so try to resist the temptation to fixate on the time thinking about how long you have stayed awake for.
3. Try to relax your body. Starting at your toes, work through your body, consciously relaxing every muscle. Often by the time you have reached your upper back and shoulders you will be drifting into dreamland.
4. Listen to quiet relaxing music, particularly if you find it hard to block out noises that keep you awake.
5. Many people find herbs are an effective way to help them sleep, particularly as they do not leave you feeling groggy in the morning. Valerian is a herb with a long traditional use as a herbal sleep remedy, and fresh extracts can be found in tinctures such as Dormeasan® Sleep Valerian-Hops oral drops, which can be taken in a small amount of water to help you fall back asleep.
6. Find a technique that works for you and use it every time. This then acts as a signal to your brain and body that you should be asleep, helping you to doze off more easily and quickly.
How is BPH affecting your sleep?
Meet our expert
Having trained as a doctor at the University of Newcastle-on-Tyne, Jen Tan, Medical Director of A.Vogel, has been involved in herbal medicine research over a number of years, coordinating projects both within the UK and internationally.