EEvery week, general practitioner Hussein Al Zubaidi sees at least one patient who suffers from nocturia, the medical term for having to get up in the middle of the night to urinate. Bladder weakness has long been known as a side effect of aging, and nocturnal urination has also been shown to have an effect. Between 69% and 93% This is often associated with benign prostatic hyperplasia, which is swelling of the prostate gland and surrounding tissue that occurs with age.
“For many men over 60, this means their ability to empty their bladder is reduced,” said Al Zubaidi, lead for lifestyle and physical activity at the Royal College of General Practitioners. To tell. “Standing on the toilet takes more time and generally causes urine to pool, meaning you’re much more likely to wake up in the middle of the night to pee.”
But Al-Zubaidi is beginning to notice a worrying new trend: Many of the patients who come to see him are men or women in their 20s and 30s. Some researchers have discovered the possibility of nocturia. Affects up to 44% of men So what is happening?
One theory is that this is a result of modern lifestyles. “I think it’s mainly due to drinking habits,” Al-Zubaidi said. “People tend not to ‘hydrate’ in the morning because they’re often busy during the day, and that’s what we’re designed for. In the evening I get thirsty and drink more water, but a full bladder in the early morning really wakes me up. ”
These unhealthy drinking habits may be fueled by our preference for streaming platforms and social media. A recent study using data from the US National Health and Nutrition Examination Survey found that 32% of participants over the age of 20 had to wake up to urinate more than once during the night. This risk is almost 50% higher in people who watch videos of various formats for more than 5 hours a day.
“I think if you spend some time to yourself in the evening watching Netflix, you’ll suddenly notice that you’re thirsty, and you’ll be able to react to it and do something about it.” says al-Zubaidi. “But by then it’s a little too late in the day and you’ll probably wake up in the middle of the night needing to pee.”
However, there are many other factors that can cause nocturia. Rebecca Haddad, a doctor at the Rothschild Hospital in Paris who previously specialized in researching nocturia and aging, says smoking, excessive alcohol consumption and physical inactivity all reduce bladder capacity, making it harder to urinate. It states that the need may become more frequent.
“There is a link between daytime and nighttime physical activity and urine production,” she says.
In particular, if you spend long periods of time sitting during the day or staring at a screen in the evening, your body’s circadian rhythm changes, causing a strange phenomenon known as nocturnal polyuria that causes you to produce a normal amount of urine during the day. Possibly, Haddad explains. However, it is loud at night.
The huge hormonal changes throughout life also explain why nocturia becomes more common with age. Haddad points out that while this is often seen as a male condition, it’s a problem for women as well. A major studyThe study, called EpiLUTS, surveyed 30,000 people and found that 69% of men and 76% of women over the age of 40 live with nocturia, a condition that wakes them up at least once during the night. .
“Nocturia is not just a prostate problem,” she says. “Menopause is one of the transition periods that commonly affects its occurrence. Decreasing levels of the hormone estrogen induces anatomical and physiological changes in the bladder, leading to a reduction in functional bladder capacity. Excess urine production at night can also be caused by estrogen depletion.”
Menopause can also disrupt sleep and cause weight gain, and the combination of these factors causes many cases of nocturia. obese people, postmenopausal women People who are prone to a condition called obstructive sleep apnea (OSA) stop and start breathing hundreds of times during sleep, reducing the amount of oxygen that enters the bloodstream.
“The idea is that gaining weight puts a strain on the heart,” Al-Zubaidi says. “And people who have poor quality sleep need their heart to beat faster to keep oxygen circulating in the blood.”
When your heart works harder, it releases a hormone called brain natriuretic peptide, which increases urine production. “Basically, we’re trying to reduce the strain on the heart by removing some of the blood as urine,” Al-Zubaidi said. “A large portion of the population has undiagnosed OSA, and nocturia is one of the nine key symptoms that can be a sign of it. I don’t connect it.”
Because of the connection between the bladder and other body systems, nocturia can also be a sign of chronic conditions such as high blood pressure, type 2 diabetes, and kidney damage.
Professor Marcus Drake, a specialist in neurourology at Imperial College London, said: “Chronic kidney disease is a problem because the kidneys have a reduced ability to produce concentrated urine, and when there’s too much water, they can’t urinate.” There is a possibility that it will happen.”
But Drake says there’s no need to worry too much unless there’s no obvious behavioral cause and the problem suddenly becomes severe. “It’s even more concerning if you’re constantly feeling thirsty and have additional unexplained symptoms, such as unsteady walking or excessive snoring.”
At the same time, having to get up in the middle of the night to go to the bathroom is not ideal for your health. We’re increasingly finding out that sleep deprivation can have all sorts of negative effects, not only on energy levels, but also on blood sugar stability and long-term cognition.
“Regular spikes in blood sugar levels make it easier to maintain weight, contributing to obesity,” Al-Zubaidi says. “We also know that even one night of sleep deprivation causes certain proteins to build up in the brain, which can lead to dementia later in life.”
The best advice for preventing nocturia would be to focus on scheduling most of your fluid intake early in the day. In particular, Al-Zubaidi advises not to drink more than 330ml of water within three hours of going to bed. This is the same amount as a typical can of soft drink or a large glass.
“At least a quarter of your daily water intake should be consumed during the first hour to two hours after sleep, when your body really needs hydration,” he says. “And if you’re exercising, make sure you hydrate on the fly. We call this the golden hour, but if you can do it within an hour of your activity, It’s much better than going for a run and him catching up three or four hours later.”
If you have to wake up during the night, try to go back to sleep as soon as possible. It may be tempting to check your phone’s notifications or scroll through social media, but the light from your screen can affect your sleep hormone levels and make it harder to nod off again.
“When you go out for a while, try not to turn on the lights,” says Al Zubaidi. “Since you woke up in the middle of the night, your eyes need to adjust to the darkness. Then, try to get back to bed as soon as possible. A final tip is to learn the important things your body uses to fall asleep. One of the signals is a drop in body temperature, so just changing your pillow or removing your duvet when you get back to bed increases your chances of getting sleepy again.”
5 other reasons why you wake up regularly during the night
1 overheating During sleep, core body temperature should drop by 1 to 2 degrees Celsius, a pattern common to all mammals. However, overheating the body can be caused by eating a large meal near bedtime or consuming alcohol or caffeine in the evening, as digestion increases metabolic rate, leading to deep sleep. can be difficult to reach. It’s also possible that your duvet is too thick.
2 stress A stressful day can mean that a complex network in your body known as the hypothalamic-pituitary-adrenal axis, which connects the brain and various glands, is still active even when you’re trying to fall asleep. There is a gender. This means cortisol, the main stress hormone, is much higher than your body expects in the early morning. This can disrupt your natural sleep cycle.
3 Sleep apnea syndrome Obstructive sleep apnea, which causes people to temporarily stop breathing, is estimated to affect 1.5 million people in the UK and is more common in overweight people. The resulting lack of oxygen activates survival reflexes, causing enough arousal to begin breathing again and interrupting the sleep cycle. As a result, people with this condition tend to start their mornings feeling tired.
Four heartburn When you lie in bed for hours, food and stomach acid flow into your esophagus, and this acidity builds up slowly throughout the night, causing you to wake up with a burning sensation and discomfort. This can be caused by smoking, eating a large meal before bed, eating spicy, acidic, or high-fat foods, and drinking excessive amounts of alcohol or carbonated drinks.
Five restless legs syndrome This surprisingly common disease affects between 5 and 10 per cent of adults in the UK and can have a variety of causes, from genetic predisposition to low iron levels in the brain. Some antidepressants and antihistamines can make symptoms worse. Patients usually experience a tingling or pulling sensation in their legs, and symptoms are more severe at night. The best treatment is considered to be daily exercise, a regular sleep schedule, stretching the leg muscles before bed, and taking a hot bath.
