The definition of nocturia is the complaint that an individual has to wake at night 1 or more times to urinate. This does not include the void just before bedtime or the void when you have awoken for the day. In general, voiding 1-2 times during sleep is considered normal, and usually increases with age. Nocturia only requires treatment if it is bothersome for the individual. There are two main causes of nocturia:

Nocturnal polyuria:
The excessive production of urine during the night

Overactive bladder syndrome:
The bladder does not hold an acceptable volume of urine during the night.
The distinction is important because the two conditions are treated differently. Your physician may have you keep a voiding diary to measure the volume of urine voided.

General recommendations for nocturia include:

• Restrict fluid and food intake at least 4 hours before bedtime
• Avoid caffeine or alcohol, particularly in the afternoon and evening
• If you experience swelling in your lower extremities, periodically elevate your legs above your heart throughout the day to minimize the swelling at the end of the day. Also, compression stockings can minimize swelling.
• If you are taking a diuretic or “water pill”, check with the prescribing physician if you may take the medication in the morning
• If you have a sleeping disorder and you are awakening for reasons other than to urinate this should be addressed separately
• If you have difficulty with getting to the bathroom safely and in a timely fashion during the night you may need a bedside commode
• If the nocturia is bothersome after the above behavior modifications have been adhered to then adding medications to slow down urine production or relax the overactive bladder may be the next step