Gotta Go & Go & Go: Nocturia & Black Men
— A new study finds that one in five U.S. men have to get up at least
twice a night to empty their bladders. Known as nocturia, those frequent
overnight trips to the bathroom can be a sign of a health condition,
ranging from a urinary tract infection to diabetes to chronic heart
failure, even a benign enlargement of the prostate.
For some people, the constant sleep disruptions can themselves cause
problems — contributing to depression symptoms or, particularly in
older adults, falls.
How Common Is Nocturia?
Dr. Alayne D. Markland, the lead researcher on
the new study, which appears in the Journal of Urology, found that among
5,300 U.S. men age 20 and up, 21 percent said that in the past month,
they had gotten up at least twice per night to urinate. The study is
based on a government health study of a nationally representative sample
of U.S. adults, and gives a clearer picture of just how common nocturia
is among men.
“Getting up during the night to urinate can be normal,” explained
Dr. Markland. “If you drink a lot of fluids close to bedtime, for
example, don’t be surprised if your bladder wakes you up at night.”
What Causes Nocturia?
Doctors suggest that there are many different causes, but some
factors have been linked to prostate enlargement, a history of prostate
cancer, high blood pressure and depression.
But it’s not entirely clear if all of those problems cause, or result from, nocturia.
With depression, for example, Markland said that poor sleep caused by
nocturia could contribute to depression symptoms. On the other hand,
men with depression may have sleep problems and be more apt to get up to
use the bathroom; in that case, it would not necessarily be a full
bladder triggering the trip to the bathroom.
Nocturia can also be a side effect of some medications, such as
diuretics used to treat high blood pressure. This study did not have
information on men’s medication use.
Why Do African American Men Suffer From This More?
Nocturia was more common among African American men (30 percent)
than those of other races and ethnicities (20 percent). Not
surprisingly, it also increased with age: Just 8 percent of men ages 20
to 34 reported it, compared with 56 percent of men age 75 or older.
The higher rate among African Americans is one of the more interesting findings from the study, said Markland.
The extra risk was not explained by higher rates of medical
conditions among black men, or racial disparities in education or
income. Future studies, Markland said, should try to uncover the reasons
for the higher rate of nocturia among African American men.
What Can I Do To Stop This?
The bottom line for men is that nocturia is something they should bring up to their doctor, according to Markland.
“I think that someone who is having their sleep disrupted with two or
more episodes at night should have it addressed,” she said.
If an underlying medical cause, like diabetes, is to blame, then it’s
important to have that problem treated. In other cases, Markland said,
lifestyle changes may do the trick, such as avoiding caffeine and large
fluid intakes at night, as well as adjusting your sleep habits.
One recent study of 56 older adults with nocturia found that
lifestyle changes, including fluid restriction, limiting any excess
hours in bed, moderate daily exercise and keeping warm while sleeping,
helped more than half of the patients significantly cut down their
overnight trips to the bathroom.
There are also medications available specifically for overactive bladder and nocturia.