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Nocturnal Polyuria: Causes, Treatment, and More – Verywell Health

Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.
Daniel Combs, MD, is board-certified in sleep medicine and pediatrics.
Nocturnal polyuria is a condition that causes an overproduction of urine at night. It is a type of nocturia, a condition in which an individual wakes up at least twice during the night to go to the bathroom. Most people with nocturia are over the age of 60, but it can happen at any age. One in three adults over the age of 30 make at least two trips to the bathroom every night.

This article will discuss the symptoms and causes of nocturnal polyuria and explain how it is diagnosed. It will also explore treatment options and tools to cope.
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The primary symptom of nocturnal polyuria is waking up at least twice each night to urinate. If you are not able to sleep consistently for six to eight hours each night because of a full bladder, talk to your healthcare provider about potential causes.

Some medical conditions cause people to wake up at night to urinate, so it is important to receive a full assessment from a healthcare provider, such as a urologist, to identify the cause of your symptoms. Underlying causes that a provider will look for fall into three categories, which are:
A healthcare provider will review your medical history and perform a physical examination before diagnosing you with nocturnal polyuria. They'll ask about fluid consumption, urinary urgency and frequency, sleep habits, and any medications or supplements you're taking, as they could contribute to nocturnal polyuria.
If the cause of nocturnal polyuria is unclear after the history and physical exam, your provider may request that you keep a journal of your urinary habits to document the timing and volume of each void (each time you urinate). Nocturia is diagnosed if more than one‐third of the 24‐hour urine volume is produced during the night.
Additional testing, like a urinalysis (test to analyze urine), might be considered to ensure no underlying infections or diseases, like diabetes, cancer, or heart disease, are causing nocturnal polyuria. If bladder capacity is thought to be the issue, your provider may recommend a cystoscopy to examine your bladder internally and identify any structural causes for nocturnal polyuria.

In 2017, the Food and Drug Administration (FDA) approved a medication called Noctiva, an internasal spray used approximately 30 minutes before bedtime. It works by increasing the absorption of water by the kidneys, so less urine is produced. Treatment for nocturnal polyuria is usually specific to the underlying cause:
Nocturnal polyuria can be a debilitating problem for many people since it can lead to chronic sleep impairment. However, proper management of this condition can help improve quality of life. In addition to treatments, here are some tools to help cope with nocturnal polyuria:
Nocturnal polyuria is when an individual produces too much urine at night and wakes up at least twice every night to use the bathroom. This condition creates sleep interruptions and can signify a more serious underlying medical condition. It is important to receive a thorough medical examination from a healthcare provider to identify and treat the cause of nocturnal polyuria. If treatment is ineffective, there are other options to manage nocturnal polyuria.

Nocturnal polyuria can be very disruptive to your sleep and impact your overall quality of life. The symptoms may seem harmless (and they might be), but they could also be your body's way of telling you that an underlying problem needs to be addressed. If you're waking at least twice every night to urinate, talk to your healthcare provider to determine the cause of your nightly trips to the bathroom.

National Association for Continence. Nocturia.
Everaert K, Hervé F, Bosch R, et al. International Continence Society consensus on the diagnosis and treatment of nocturia. Neurourology and Urodynamics. 2019; 38: 478-498.
Urology Care Foundation. Nocturia: symptoms, diagnosis & treatment.
Oelke M, De Wachter S, Drake MJ, et al. A practical approach to the management of nocturia. Int J Clin Pract. 2017;71(11):e13027.
US Food & Drug Administration. FDA approves first treatment for frequent urination at night due to overproduction of urine.
By Pamela Assid, DNP, RN
Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.

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