Why do diabetics often urinate at night

Having to urinate repeatedly at night can be an alarm signal


Going to the bathroom two or more times a night and having to interrupt your sleep is not just an annoying phenomenon of old age. The common disease nocturia can also be an alarm signal.

Waking up every night because the bladder requires going to the toilet is a widespread ailment - and a dangerous one at the same time: On the one hand, the consequences of regularly interrupting night sleep to urinate, technically called nocturia, are underestimated. On the other hand, going to the toilet at night is often an alarm signal that indicates an illness that requires treatment. "Nocturia is often wrongly dismissed in the population as an unavoidable symptom of old age, primarily of men, although the individual causes need to be clarified," explains Prof. Dr. Kurt Miller, President of the German Society for Urology eV (DGU) Volksleiden will also be the subject of the 68th DGU Congress from September 28 to October 1, 2016 in Leipzig.

In fact, nocturia is the most common cause of sleep disorders, which in turn poses risks to the health and life expectancy of those affected. Contrary to popular belief, men and women are equally affected. There are no reliable current figures on the frequency, but according to older studies, more than 60 percent of all people aged 70 and over suffer from nocturia that requires treatment, which drives those affected to urinate twice or more per night. While advanced age is a major contributor to nocturia, it does not prevent younger people from it. In the age group of 20 to 40 year olds, around every fifth to sixth person is affected - women more often than men.

“Nocturia is not a chronic disease in its own right, but a symptom of other physical disorders. Different causes can be considered for the urge to urinate at night, which are initially to be found in the area of ​​urine production and in the system of storage and drainage of urine, "explains Prof. Dr. Stephan Roth, Director of the Clinic for Urology and Pediatric Urology at the University Hospital Wuppertal Many nocturia patients have nocturnal polyuria and excrete more than the usual 24-hour urine volume at night, which should be up to 20 percent for younger people and 65 to 33 percent for other patients A reduced capacity of the urinary bladder was found, which necessitates the frequent emptying of smaller amounts. Especially in the elderly, several factors often coincide which can be the cause of nocturia: These include the decreased ability to hold urine, increased residual urine volume, changes in the urinary expelling muscle detrusor vesicae, low concentration of antidiuretics human hormones (ADH), chronic lower urinary tract infections, overactive bladder and, in men, an enlarged prostate.

"In the case of polyuria, it is necessary to clarify the causes of the increased nocturnal urine production," continues Prof. Roth. Heart failure, for which an excess of tissue fluid would be an indication, as well as diabetes, increased systolic blood pressure or disorders of the Kidney function, like medication, can affect urine production.

Snoring, which affects more than half of all men, and nocturnal pauses in breathing (sleep apnea) are closely linked to nocturia, which is even considered a key symptom of obstructive sleep apnea syndrome. If this dangerous sleep disorder is effectively treated, the urge to urinate at night will also improve. Another risk factor for nocturia is obesity.

The consequences of nocturia can be serious: sleep disorders often lead to daytime sleepiness, poor concentration, reduced mental performance and headaches. In some cases, depression can result. Danish researchers found that nocturia can reduce labor productivity by up to 24 percent. Older people in particular have an increased risk of falls and broken bones. For patients with heart disease, concomitant nocturia is assumed to have an increased risk of mortality.

"In view of the high level of suffering, possible complications and the sometimes serious causal diseases, the need for a thorough medical diagnosis of nocturia becomes clear", sums up DGU President Prof. Dr. Kurt Miller.

Source: German Society for Urology e.V.