Nocturia: Symptoms, Diagnosis & Treatment

If you wake up more than one time each night to go to the bathroom, you may have nocturia. Sleep disruption from having to urinate during the night can impact your quality of life.

About 1 in 3 adults over the age of 30 experience nocturia. The rate of people affected increases with age. It can be caused by a lifestyle habit or an underlying health problem. Nocturia can be caused by:

• Polyuria: when your body makes too much urine in a 24-hour period 
•  Nocturnal polyuria: when your body makes too much urine during the night 
•  Bladder storage problems: when your bladder doesn't store or release urine well 
• Mixed nocturia: when more than one of these problems are happening

It helps to talk with your health care provider to learn why you make multiple trips to the bathroom at night. You may learn that your nocturia is fairly easy to treat, or you may find it's from something more serious. 

https://www.urologyhealth.org/urology-a-z/n/nocturia

How Does the Urinary Tract Normally Work?

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The "urinary tract" includes the organs in your body that make, store and remove urine. Urine is liquid waste from your body. Urine forms when the kidneys clean your blood. Normally, the kidneys make about 1½ to 2 quarts of urine each day in an adult; less in children. Urine travels from the kidneys to the bladder through the ureters (the tubes that join them). The bladder holds urine until you are ready to empty it.

The brain and the bladder work together to control urinary function. The muscles in the lower part of the pelvis hold the bladder in place. The muscular neck (end) of the bladder stays closed to store urine. The urethra is a tube that carries urine from the bladder, out of the body. It is kept closed with sphincter muscles.

Parts of the bladder control system

Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract. This pushes urine out of the bladder and through the urethra. The sphincter muscles then open and urine is released out of the body.

If you have to get up two or more times each night to go to the bathroom, it’s not normal. This is a clear sign of nocturia. We should be able to sleep for 6 to 8 hours during the night without needing to use the bathroom.

Waking to go to the bathroom obviously affects your quality of sleep, and your quality of life. Most people don’t function well without solid sleep. It makes us grumpy and less productive during the day. Over time, poor sleep can become a severe problem for many of us.

It’s important to remember that nocturia is a sign of something going on in our bodies. It is not a disease in and of itself.

Nocturia can be from a simple habit like drinking too much fluid (especially caffeine or alcohol) before bed. Or it could be from certain medication, illnesses or reduced bladder capacity. The following lifestyle habits are known to cause nocturia in either men or women:

• Drinking too much fluid before bedtime (especially caffeine or alcohol)
• Behavioral patterns (you've trained your body to wake up during the night to use the bathroom, even if you don't necessarily have to go)
• The timing or dose of medicines, such as: diuretic medicine (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D
• Sleep disorders, like insomnia or sleep apnea

Underlying health conditions can cause nocturia. For example:

• Diabetes 
• High blood pressure 
• Heart disease,
• vascular disease or congestive heart failure Bladder obstruction ((stones)), inflammation or other problems that affect bladder capacity (like bladder surgery or fibrosis from radiation)
• Overactive bladder  symptoms
• Prostate obstruction
• Vaginal prolapse
• Menopause Childbirth Pelvic prolapse
• Enlarged prostate (prostatic hyperplasia (BPH)
• Restless leg syndrome
• Edema in the lower limbs, or leg swelling
• Interstitial cystitis 
• Reduced bladder capacity
• Nocturnal polyuria (when your body produces too much urine at night for your bladder to hold)

Often, several of these issues may be going on at once.

You and your health care provider will want to learn the cause of your nocturia. You'll be asked about your symptoms and health history. Your health care provider may also ask you to keep a bladder diary in order to help with a diagnosis. This diary is used to keep track of things like the kind and amount of liquids you drink, trips to bathroom, etc. to track trends over a period of time which can lead to useful treatments.

Some questions your doctor may ask:

• When did your symptoms first start?
• How many times do you need to go to the bathroom each night?
• Is there a large or small amount of urine when you go?
• Has the amount of urine you make changed (increased or decreased)?
• How much caffeine or alcohol do you drink each day? When?
• Do you feel like you're getting enough sleep?
• Has your diet changed recently?
• Do you wake up wet? (Are you leaking?)

If your health care provider needs more information, you may have a:

• Urine cultureandurinalysis check for infection, unwanted blood, and other elements in your urine.
• Blood test: checks the kidney and thyroid, cholesterol levels and the presence of anemia, diabetes or other problems.
• Bladder scan shows how much urine is still in the bladder after you go to the bathroom.
• Cystoscopy: checks for a tumor or other causes of your symptoms by having the doctor insert a narrow tube with a tiny lens inside the bladder.
• Urodynamic testing: checks to see how well your lower urinary tract stores and releases urine.

Lifestyle changes

• Restrict fluid intake at night.
• Drink plenty of fluids during the day (especially water), but limit fluids 2-4 hours before you go to sleep. Be sure to limit alcohol and caffeine (soda, tea and coffee).
• Manage your use of diuretics.
• If you have to take a diuretic, then do so at least 6 hours before you go to sleep. This will help reduce the number of times you urinate during the night. Elevate your legs or use compression socks.
• Some people experience fluid build-up in their legs. When you elevate your legs, it helps to redistribute fluids back into the bloodstream, reducing the need to urinate. Elastic compression stockings help by putting pressure on your legs to prevent fluid build-up.
• Enjoy afternoon naps.
• When you sleep poorly, a nap can be help you feel better during the day. Naps can also allow liquids to be absorbed into the bloodstream. However, be careful not to nap too long or too often. You don't want to disrupt nighttime sleep patterns with naps.

Management

If you experience bed-wetting, there are several products to help keep you and your bed dry. For example, waterproof mattress covers, absorbent briefs and skincare products. Visit our  incontinence website article to learn more about managing leaks with products and devices.

Medicine 

If lifestyle changes alone don't help with your nocturia, some medicines may. Some people try one type, then another, until they find what works best for them. Not everyone benefits from prescription drug options, but it helps to know about them.

• Medicines to help the kidneys produce less urine. For example, Desmopressin (DDAVP®).
• Anticholinergic medicines to treat bladder muscle problems. They relax the bladder if it spasms. These are used to correct overactive bladder. For example, Darifenacin (Enablex®), Oxybutynin (Ditropan®), Tolterodine (Detrol®), Trospium Chloride (Sanctura®), or Solifenacin (VESIcare®).
• Diuretic medicines to regulate urine production and high blood pressure. For example, Bumetanide (Bumex®), Furosemide (Lasix®).

If an underlying illness leads to nocturia, then treating that illness will surely help. It's important to treat diabetes, high blood pressure, congestive heart failure, obstructive sleep apnea, and/or enlarged prostate (BPH). Changing the timing and dose of prescribed medicine may also help.

With long-term lifestyle changes and caring for other health problems, your symptoms should improve. You should be able to sleep well again.

Pay attention to the things that help you sleep through the night. Keep up with these changes to prevent nocturia in the future. Keep in touch with your health care provider to let him/her know if you don't improve over time.

• Do I need to see a specialist?
• If I need a specialist, can you give me a referral?
• Will I need to have tests to find the cause of my nocturia?
• What other problem could be causing my symptoms, and why?
• What treatments do you think are right for me and why?
• What are the pros and cons of each type of treatment?
• After I start treatment, are there problems I should I watch for?
• How soon after treatment will I feel better?
• When should I call you?
• Will I need treatment for the rest of my life? 
  

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Forwarded messages from friends:

Nocturia (Night time urination). Drinking water at night and how it helps.

Noctoria and heart problems are related. It is worth spending two minutes to read the information below.

An American doctor tells us that Nocturia, heart problem and cerebral infarction are related.

The most common symptom of middle-aged and elderly people is nocturia (waking up at night to urinate). Because of nocturnal urine, the elderly are afraid of drinking water before bedtime. They don't know that not drinking water before going to bed, getting up in the middle of the night to pee without drinking water is an important cause of early morning cerebral infarction in middle-aged and elderly people. In fact, nocturia is not a problem of bladder dysfunction. Nocturia is caused by the aging failure of the heart function in the elderly, and the inability of the right heart atrium to suck blood from the lower body.

During the day, we are all in a standing position, The blood will flow down. If the heart is not good, the blood volume of the heart is insufficient, the pressure on the lower body will increase, so middle-aged and elderly people will have lower body edema during the day. When they lie down at night, the pressure on the lower body will be relieved and a lot of water accumulate in the tissues. The water returns to the blood. If there is too much water, the kidneys will work hard to separate out the water and drain it to the bladder, causing nocturia.

Therefore, it usually takes about three or four hours after lying down to sleep to get up and go to the toilet for the first time. After that, the water in the blood continues to increase. So after another 3 hours, they will have to go to the toilet again.

Why is this an important cause of cerebral infarction and myocardial infarction? Because after two or three urinations, the water in the blood is greatly reduced. The body also continue to lose water through breathing. The blood then begins to become thick and sticky, and the heart rate slows down due to the low metabolism of the body during sleep. With thick blood and slow blood flow, the stenosis of the blood vessel is easily blocked... This is why the middle-aged and elderly people almost always have myocardial infarction or cerebral infarction at 5 or 6 in the morning. This situation will lead to death while asleep.

The first thing to tell everyone is that nocturia is not a malfunction of the bladder, but a problem of aging heart. The second thing to tell everyone is that you must drink some warm water before going to bed, and you must drink some warm water after you wake up in the middle of the night to pee. Don't be afraid of nocturia, because not drinking water may take your life.

The third thing is that you must exercise more in normal times to strengthen the function of the heart.

The human body is not a machine. A machine will wear out when used frequently, but the human body will be the opposite. It will become stronger when used frequently.

Do not eat unhealthy food, especially high starch and fried foods.

If you like this article, kindly forward it to your friends.

 

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Self-confidence after middle age is not in the "brain" but in the "feet'

 

Tell everyone: Self-confidence after middle age is not in the "brain" but in the "feet".

"Legs Feet"

Issues that the elderly must pay attention to: 

1. As we get older, our feet and legs must always remain strong.

2. When we get old, we shouldn't worry about our hair turning gray or our skin sagging or wrinkled.

3. Among the signs of "longevity," strong leg muscles are listed as the most important and fundamental muscles, as outlined in the American Journal of Prevention.

4. If you do not move your legs for two weeks, your leg strength will decrease for 10 years.

5. A study by the University of Copenhagen in Denmark found that, regardless of age, within two weeks of "inactivity", the strength of leg muscles will be weakened by one-third, which is equivalent to aging for 20 to 30 years.

6. As our leg muscles weaken, it will take a long time to recover even as we rehab and exercise.

7. Therefore, regular exercise (such as walking) is very important.

8. The weight (load) of the entire body remains on the legs.

9. The foot is a kind of "pillar" that bears the weight of the human body. Interestingly, 50% of a person's body weight is in the bones, and 50% of the bones are in the two legs.

10. The largest and strongest joints and bones in the human body are also in the legs.

11. The "iron triangle" formed by strong bones, strong muscles and flexible joints carries the most important load on the human body.

12. 70% of human activities and energy burning in life are completed by two feet.

13. Did you know? When a man is young, his thighs are strong enough to lift a small car!

14. "Legs and feet" are the center of body movement.

15. The two legs have 50% of the nerves of the human body, 50% of the blood vessels and 50% of the blood flowing through them.

16. This is the large circulatory network that connects the body.

17. When the feet and legs are healthy, the regular blood flow goes on smoothly, so people with muscular legs will definitely have a "strong heart".

18. The "aging" of the human body starts from the feet first, and then develops upwards.

19. As we grow older, the accuracy and speed of the transmission of instructions between the brain and the legs decrease, which is completely different from that of young people.

20. With the passage of time, the calcium of bones will be lost sooner or later, making the elderly more prone to fractures.

21. After the bone fracture of the elderly, it is easy to cause a series of complications, especially fatal diseases, such as cerebral thrombosis.

22. Did you know that 15% of the elderly will die within a year once their thigh is broken!

23. It's never too late to exercise your legs, even after 60 or older.

24. Although our feet and legs will bi gradually age over time, exercising our feet and legs is a lifelong task. . 🤷🏻‍♂. 🧠👂👁️..🥂 

 

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‘Empire of hackers’ uncovered

BEIJING: An investigation report was released on the Central Intelligence Agency (CIA) of the United States, one of the major intelligence agencies of the US federal government, revealing an “empire of hackers” under US manipulation.

Over a long period, the CIA has been secretly orchestrating “peaceful evolution” and “colour revolutions” around the world, continuously conducting espionage activities, said the report by China’s National Computer Virus Emergency Response Centre and internet security company 360.

The rapid development of the internet this century has presented new opportunities for the CIA to conduct its infiltration, subversion and trouble-making activities, the report said.

The report disclosed important details of the weapons the CIA used for cyberattacks and details of specific cybersecurity cases taking place in China and other countries, and revealed the agency’s harmful activities including cyberattacks and espionage.

The report said it was meant to provide references and suggestions for victims of cyberattacks around the world.

The CIA has been involved in overthrowing or attempting to overthrow more than 50 legal governments of other countries, though it only admitted involvement in seven, causing turmoil in relevant countries, the report said.

It said the involvement of some Western countries with the help of the internet can be detected in multiple “colour revolution” cases.

After the “Arab Spring” in West Asia and North Africa, certain large multinational internet enterprises of the United States vigorously engaged in sending an abundance of personnel, material and financial resources to the conflicting sides, drawing over and supporting the opposition parties, and publicly challenging the legal governments of foreign countries that were not in the US interests. Such enterprises were also involved in assisting in the disinformation campaign and fanning the flames of protests among the public, the report said.

The report further cited several measures of such operations, including “The Onion Router (TOR)” technology that enables anonymous communication, developed by a US company with a reportedly US military background. It was provided free of charge to anti-government personnel in countries such as Iran, Tunisia and Egypt to help them evade surveillance.

Also, Google and Twitter developed a special service called “Speak2Tweet” to enable users to communicate when they are disconnected. The technology was used by anti-government forces in Tunisia and Egypt, said the report.

The cyberspace hegemony under US manipulation is shadowing the entire world, with the CIA launching automated, systematic and intelligent attacks worldwide, the report said.

After analysing relevant cases, the technical team found that the reach of such attack weapons has covered almost all internet and Internet of Things assets, making a foreign country susceptible to US control or espionage, the report said, adding that the US is a genuine “empire of hackers.” — Xinhua 

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'Empire of hacking' exposed: China Daily editorial

 

Although the Central Intelligence Agency had acquired exceptional experience in overthrowing governments by triggering "peaceful evolution" or instigating "color revolutions" in other countries before the emergence of the internet, it is the advancement of information and communication technology, in which the US enjoys huge advantages, that has greatly boosted the intelligence agency's capability to accomplish its goals in the new century.

The disintegration of the Soviet Union — the United States established the CIA in 1947 to counter Soviet intelligence wings — transformed the former socialist republics in Eastern and Central Europe, and created a golden opportunity for the CIA to trigger "color revolutions" in the region as well as in the Middle East and Central Asia.

The end of the Cold War gave the CIA the reason to help establish the US' global hegemony by exploiting its advantages in cyberspace to infiltrate, spy on and subvert other countries' governments.

A report "Empire of Hacking: the US Central Intelligence Agency — Part I" jointly published by China's National Computer Virus Emergency Response Center and the 360 Total Security, a Chinese cybersecurity company, on Thursday deserves credit for not only its systematic and professional approach to the ugly role of the CIA, but also its advice to the agency's "victims all around the world" in order to help them better respond to the US' cyberattacks and manipulations.

The report can also be seen as part of China's efforts to help build a community with a shared future in cyberspace, because it regards maintaining silence in the face of the CIA's dirty tricks as being complicit in the US' overall destructive strategy.

The report says that, working with US internet companies, the CIA provides encrypted network communication services, and reconnects service and on-site command communication tools directly for its proxies in targeted countries and regions. For instance, a software called RIOT, developed and promoted jointly by US companies and the CIA, helps the intelligence agency to remote control its pawns triggering demonstrations and riots in other countries, by ensuring they have reliable internet connection and channels of communication that are free from the local government's supervision.

"We lied, we cheated, we stole … we had entire training courses," said Mike Pompeo, former US secretary of state, on the nature of the CIA, an agency he led as director for years. This fact resonates with anyone who reads the NCVERC report.

The US is a country which pledges to help improve cyberspace governance and build a "clean internet" but actually spends all its expertise and high-tech advantages to further sharpen its cyber-espionage and cyber-attack weapons, while claiming to be the largest victim of cyberattacks. 

 

     Related news:

  CIA once again confirms US' title as 'the world's biggest source of chaos': Global Times editorial

China's National Computer Virus Emergency Response Center and cybersecurity company 360 jointly released an investigation report on Thursday, revealing the long-standing use of cyber attacks by the US Central Intelligence Agency (CIA) against other countries. While this is an "eye-opener" for many people, the CIA's obsession and ability to create unrest disturb them significantly.

• Exclusive: New report unveils how CIA schemes color revolutions around the world

  For a long time, the US Central Intelligence Agency (CIA) has plotted "peaceful evolution" and "color revolutions" as well as .

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