Peeing at night, sleeping during the day

Q. I’m a 76-year-old woman and have to take a long nap every day because I’m urinating at night. I know a lot of my contemporaries have the same problem. I’m curious to know how widespread this is.

First, don’t presume that the nightly bathroom trips are insignificant. See a doctor to determine the cause. Solutions to your problem exist, but they depend upon a diagnosis.

You’re suffering from a very common problem called “nocturia,” the need to urinate at night. Some people with severe nocturia get up as many as six times a night to go to the bathroom. The International Continence Society defines nocturia as two or more voids at night.

Nocturia is more common among seniors than younger people. In a survey by the National Sleep Foundation, about two-thirds of the adults (55 to 84 years old) polled reported an urge to go to the bathroom at least several nights a week.

There are a variety of reasons for nocturia in older people.

First, we produce less of a hormone that helps us retain fluid. Because of this decreased capacity, seniors produce more urine at night. Second, the bladder, a muscular sac, loses its capacity to hold urine. Third, we have more health problems that can affect the bladder.

Both men and women get nocturia. Many men suffer from nocturia because of benign prostatic hyperplasia (BPH), also known as enlarged prostate. The prostate is a walnut-sized organ that surrounds the tube (urethra) that carries urine from the bladder and out of your body.

BPH is common in men 50 and older.

An enlarged prostate may squeeze the urethra, making it hard to urinate. It may cause dribbling after you urinate or a frequent urge to urinate, especially at night.

Pelvic organ displacement, menopause and childbirth can cause nocturia in many women.

The pelvic floor is a network of muscles, ligaments and other tissues that hold up the pelvic organs: the vagina, rectum, uterus and bladder. When this hammock-like network weakens, the organs can slip out of place, creating disorders.

A woman reaches menopause when a year has passed since her last period. Like many of the changes in a woman’s body throughout her lifetime, menopause is caused by changes in hormone levels. Menopause can make it difficult to hold urine.

Other medical conditions cause nocturia. These include infection, tumors, heart disease, high blood pressure, liver failure, diabetes and sleep apnea.

Sleep apnea is much more common in older adults and men. Apnea is Greek for “without breath.” People with sleep apnea stop breathing for as long as 30 seconds at a time. These interruptions can happen hundreds of times a night. The breathing cessations may wake you.

Some people overproduce urine at night. This is called “nocturnal polyuria.” It can cause nocturia, too.

Other causes of nocturia that are not medical conditions are drinking caffeine, alcohol or too much liquid close to bedtime. In addition, diuretic medications can contribute to the problem.

Fred Cicetti is a freelance writer who specializes in health. He has been writing professionally since 1963. Before he began freelancing, he was a reporter and columnist for three daily newspapers in New Jersey. If you would like to ask a question, write to fred@healthygeezer.com.