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Urination - excessive at night

Alternative names

Nocturia; Nycturia


This symptom is a frequent need to urinate at night.


It is normal for urine to decrease in amount and become more concentrated at night. Most people can sleep 6 to 8 hours without having to urinate.

Middle aged or older men may normally have to urinate once in the early morning hours.

With nocturia, it is common to awaken one or more times during the night to urinate.

Common Causes

  • Too much fluid intake -- particularly coffee , caffeinated beverages, or alcohol -- before bedtime
  • Benign prostatic hyperplasia
  • Diabetes
  • Chronic or recurrent urinary tract infection
  • Chronic renal failure
  • Congestive heart failure
  • Cystitis, acute ( uncomplicated UTI )
  • Drugs such as diuretics, cardiac glycosides , demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive Vitamin D

Home Care

A voiding diary should be recorded. All fluid intake and output should be monitored and recorded. Record weight at the same time(s) and on the same scale daily.

Call your health care provider if

  • Excessive nighttime urination continues over several days, and is not explained by medications or increase of fluids before bedtime.
  • You are severely bothered by the number of times you must void during the night.

The medical history will be obtained, and a physical examination performed.

Medical history questions documenting the excessive nighttime urination in detail may include:
  • Time pattern
    • How long has this been noticed?
    • How many times does this occur each night?
  • Quality
    • Has there been a change in the volume of urine produced?
    • Are there ever "accidents" or bed wetting ?
    • How much urine is voided each time?
  • Aggravating factors
    • What makes the problem worse?
    • What makes the problem better?
    • How much fluid is consumed in the evening before bedtime?
  • Relieving factors
    • Is there anything that helps relieve the problem?
    • Have you tried fluid restrictions before bedtime?
  • Other
    • What other symptoms are also present? Is there
      • Increased thirst
      • Pain or burning on urination
      • Fever
      • Abdominal pain
      • Back pain
    • What medications are being taken?
    • How much caffeine is consumed each day?
    • Have there been any bladder infections in the past?
    • Is there a family history of diabetes ?
    • Does nocturia interfere with adequate sleep and rest?
    • Do you drink alcoholic beverages and, if so, how much each day?
    • Have there been any changes in the diet?
A physical examination will be performed. Electrolytes and fluids will be monitored over a period of time.

Diagnostic tests that may be performed include:
  • Blood urea nitrogen test
  • Serum creatinine or creatinine clearance test
  • Fluid deprivation test
  • Osmolality test
  • Serum electrolytes
  • Urinalysis
  • Urine concentration test
  • Urine culture

Treatment options vary depending on the cause of frequent nighttime urination. If excessive nighttime urination occurs as a result of diuretic medications, you may be advised to take your medication earlier in the day.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to nocturia, you may want to note that diagnosis in your personal medical record.

Update Date: 11/5/2001

David R. Knowles M.D., Department of Urology, New York-Presbyterian Hospital Columbia Campus, New York, NY. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT