Nocturia is the need to wake up during the night to empty your bladder. It can be common in multiple sclerosis particularly if you usually need to use the toilet often during the day (urinary frequency) or if you have difficulty emptying your bladder completely. There are also a number of other possible causes, so it is important that this symptom it is fully investigated.
The sleep disturbance that nocturia causes can affect the quality of your sleep. This can lead to tiredness during the day and contribute to MS fatigue.
What is nocturia?
Nocturia is the need to get up at night to pass urine. Once is usual but getting up twice or more may cause daytime tiredness. People with severe nocturia may get up five or six times during the night.
What causes nocturia?
In MS you are more likely to experience nocturia if you usually need to use the toilet often during the day (urinary frequency) or if you have difficulty emptying your bladder. Urinary tract infections can also increase the need to urinate, including at night. As with the general population, drinking caffeinated drinks or alcohol before bedtime and other poor sleep patterns can result in nocturia. This can also be a result of other health problems such as diabetes, so it is important that this symptom is investigated fully by your health professionals.
How many people have nocturia?
Studies have shown that needing the toilet at night is common in MS and affects around seven out of ten people.
What can I do if I have nocturia?
Talk to a health professional if you find that you are getting up more than once or twice at night to make trips to the toilet, this could be your MS specialist nurse, GP or continence advisor. Many people feel a sense of shame and embarrassment about bladder problems and feel awkward raising them with health professionals. All health professionals should understand that MS has an impact on how the bladder works so don't be shy in raising this.
Reduce the amount you drink before bedtime, ensure that you still drink the recommended daily amount of six to eight cups of fluid, but having your last drink before 8pm can help.
Drink less caffeinated drinks as these can irritate your bladder and change sleep patterns.
Determine if there is anything else that is disturbing your sleep, other MS symptoms such as spasms, anxiety, depression or neuropathic pain may disturb your sleep and you are more likely to need to urinate if you are awake. Side effects of certain medications can also increase urinary frequency. Talk to your health professionals about managing these symptoms and the possibility of substituting any medications which may be causing your nocturia.
How is nocturia treated?
Treatments for bladder frequency including antimuscarinic medications reduce the number of night time visits to the bathroom. A medication called desmopressin may also be used to treat nocturia. This acts by reducing the amount of urine produced by the kidneys for six to eight hours. It is not available for people who are over 65.
- Journal of Neurology 2002:249(8):1010. Summary Relationship between urinary symptoms and disease-related parameters in multiple sclerosis.
- Neurology 2004;63(11 Suppl 5):S12-18. Summary A multimodal approach to managing the symptoms of multiples sclerosis.
- Sleep Medicine 2014;15(1):5-14. Summary Sleep disorders in multiple sclerosis and their relationship to fatigue.
Last updated: 29 September 2015
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