Many older men get up at night to urinate, and may consider it normal. However, nocturia--the medical term for waking up needing to urinate--can be caused by serious disease. Nocturia is common: British urologist Lucy Abraham and colleagues note that 60 percent of men in their 70s experience this problem.
Prostate Cancer
Nocturia is a common symptom of prostate cancer, according to the National Cancer Institute. Other urinary symptoms of prostate cancer are having trouble starting and stopping urination, and having a weak flow.
Type 2 Diabetes
Type 2 diabetes may be the cause of nocturia in older individuals. According to Japanese urologist Koji Yoshimura and colleagues in their study of more than 6,000 subjects, diabetes is a risk factor for nocturia. In addition, they note that individuals aged 70 and older have a six times greater risk for nocturia than individuals aged 49 or younger.
Benign Prostatic Hyperplasia
Benign prostate hyperplasia--BPH--is a common disorder among many older men that is caused by an enlarged prostate. This oversized prostate can put pressure on the bladder and cause nocturia. In a Dutch study by Luba W. Gourova and colleagues of nearly 3,000 men with nocturia, more than half--58.1 percent--were diagnosed with BPH.
Medications May Cause Nocturia
According to California nephrologists Dean A. Kujubu and Sherif R. Aboseif, some medications may cause nocturia, particularly diuretics and calcium channel blockers. They also noted that excessive consumption of alcohol and caffeinated beverage increase the risk for nocturia.
Obesity and Overweight
A study by Finnish urologist Kari A.O. Tikkinen and colleagues found that being overweight or obese increase the risk for nocturia. Among men aged 70 to 79, those with a body mass index equal to or greater than 30 had nearly five times the risk of having nocturia as same-age men with a body mass index of 25 to 29.9.
Nocturnal Polyuria
Some patients with nocturia produce large amounts of urine, a condition called nocturnal polyuria. According to nephrologists Dean A. Kujubu and Sherif R. Aboseif, most people produce twice as much urine during the day as at night. But for some people, the nighttime urine volume exceeds the daytime volume.
According to urology professor Serge P. Marinkovic at the Southern Illinois School of Medicine, nocturnal polyuria may be caused by a disruption of vasopressin, an antidiuretic hormone produced by the pituitary gland. Alternatively, it could also be caused by sleep apnea, which can increase the level of water excretion due to elevated concentrations of atrial natriuretic peptide, a diuretic hormone that is secreted by the atrium of the heart.
They recommend sleep studies for those who may have obstructive sleep apnea, especially if they have diabetes, hypertension or asthma. They also note that nocturnal polyuria may be caused by congestive heart failure, and individuals with nocturnal polyuria should receive an echocardiogram and comprehensive medical evaluation.
References
- "British Medical Journal"; Managing Nocturia; Serge P. Marinkovic, Lisa M. Gillen and Stuart L. Stanton; May 2004
- "BJU International"; Predictive Factors for Nocturia in Elderly Men: A Cross-Sectional Study in 21 General Practices; Luba W. Gourova, et al.; 2006
- "Urology"; Development and Validation of a Quality-of-Life Measure for Men with Nocturia; Lucy Abraham, et al.; 2004
- "The Permanente Journal"; Evaluation of Nocturia in the Elderly; Dean A. Kujubu, M.D. and Sherif R. Aboseif, M.D.; Winter 2007
- "American Journal of Epidemiology"; Nocturia and Obesity: A Population-based Study in Finland; Tikkinen, et al.; April 2006
