Adult bedwetting and nocturia

What is adult bedwetting and nocturia?

There are two types of nighttime incontinence. Bedwetting, or nocturnal enuresis, is involuntary urination while asleep after the age at which staying dry at night can be expected. This should not be confused with nocturia, which describes frequent urination – in other words, the need wake up one or more times at night to void.

Adult bedwetting (nocturnal enuresis) and nocturia

Frequent urination at night, as well as bedwetting in adults, usually has different causes than similar problems in children. Among adults, bedwetting is known as nocturnal enuresis. Causes can vary – you can find out more about these below – however generally, frequent urination can mean that the body is producing more urine due to changes in certain hormone production, kidney problems, illness, or as a reaction to medication. This can lead to nocturnal enuresis (bedwetting) or the need to go to the bathroom one or several times during night - a condition known as nocturia. It should be noted that among the elderly it is normal to have to get up to urinate once or twice a night.

What causes bedwetting (nocturnal enuresis) and nocturia in adults?

As we grow older, our bodies change. One of these changes is an increased need to go to the bathroom to urinate. So if you are at a stage in life where you find yourself going to the bathroom a couple of times during the night, this is normal. There are several different causes for this. A younger person can hold up to half a liter of urine, but as we age, this is normally reduced by about half as the bladder muscle becomes less elastic. 

Antidiuretic hormone production

Another factor that causes a pressing urge to urinate during the night as we age has to do with a decreased ability to concentrate urine during the night. In turn, this results in large amounts of incomplete urination. Total urine output over a 24-hour period doesn’t necessarily change - however, as we grow older, more urine is produced at night compared to when we’re younger. The amount of water excreted via the kidneys is regulated by an antidiuretic hormone that signals the kidneys to decrease the amount of urine produced. 

Polyuria

Nocturia and adult bedwetting can also happen when the body produces too much urine. Polyuria is excessive or abnormally large production or passage of urine, regardless of the time of day. A healthy adult produces an average of 1-2 liters of urine per 24 hours, depending on how much liquid you drink and eat and how much moisture the body releases. With polyuria, this amount is increased to 2.8 liters or more. Polyuria could be, for example, a symptom of diabetes, however there are other possible causes of this condition. You should always contact your health care provider if you are unsure and in need of advice. 

Prostate problems

The prostate gland often enlarges as men grow older. Because this gland surrounds the urethra, an enlarged prostate can put pressure on the urethra. This prevents the bladder from emptying properly, leading to more frequent urination at night.

Bladder problems

Bladder problems such as urge incontinence where the person feels a sudden need to pass urine can cause nocturnal enuresis and nocturia. An overactive bladder can also cause nocturia.

Heart problems

People who have a heart condition suffer from less efficient circulation and one of the signs of this can be swelling around the lower legs. When the person affected lies down or raises their feet, as we do when sleeping or resting, the fluid collected around the lower legs enters the bloodstream and is removed by the kidneys. The result is an increased need to go to the bathroom at night.

Diabetes

High levels of blood sugar increase thirst. Drinking more than usual leads to an increased need to urinate. High blood sugar levels cause the kidneys to release sugar into the urine which increases the amount of urine and in turn creates a need to urinate more often. 

Other causes of bedwetting and nocturia in adults

Lifestyle-related behavior can affect how much you urinate. For example, drinking large amounts of liquid. Caffeine and alcohol after dinner can also lead to a need to urinate at night.

How can you treat bedwetting and nocturia?

There are several steps you can take to treat the symptoms of nocturia yourself. These include: 
 
Reducing the amount you drink before bedtime
Trying not to drink too much, too late in the evening, without reducing your recommended daily fluid intake, which is 6-8 cups or 2 liters. It’s a case of when you drink rather than how much. 
 
Limiting your caffeine intake
Coffee, tea and other drinks that contain caffeine can irritate the bladder and disrupt your sleep. Trying to limit your intake of these. 

Raising swollen ankles

If you suffer from swollen ankles, try to sit or lie down with your legs raised in the air for about an hour during the day. Wearing support stockings can also help. 

Review your medication

Some medication can lead to increased urine production and nocturia. Ask your healthcare professional if this could be case. Under no circumstances should you stop taking any medication without consulting your doctor. Medicines and conditions connected to nocturia and nocturnal enuresis include:
 
  • Heart and kidney disorders
  • Diabetes
  • Diuretic medicines and sedatives
  • Overactive bladder 
  • Urge urinary incontinence

Reduce the chance of sleep disruption

Are there other factors that are disturbing your sleep? Is your bedroom at a comfortable temperature? Is it too light? Try to reduce the amount of naps you take during the day, if you do this. 

Kegel or pelvic floor exercises

Kegel exercises, also known as pelvic floor exercises, are one of the most effective ways of improving and maintaining bowel and bladder functions. Many people also find bladder training useful.

What specialist treatments are available for nocturia?

Prostate problems
If you are worried you might have prostate problems, talk to your doctor, who will carry out an examination and discuss your treatment options. These range from medication to surgery.
 
Urge incontinence
There are different ways to treat and manage urge incontinence. These depend on the cause of the problem, which cannot always be identified. Treatment options include bladder retraining, pelvic floor muscle training and different types of medication. 

TENA is there for you

Regardless of the cause, severity or frequency of your bedwetting problems, TENA offers incontinence products to help you live your life as normally as possible. Our specially formulated range for night time incontinence includes TENA Intimates Overnight pads and Underwear for even more security. In both our men’s and women’s ranges, you’ll find underwear that protects against moderate-to-heavy bladder leakage. 
If you’re worried about other types of incontinence, please consult a healthcare professional.