II. Definitions

  1. Nocturia
    1. Frequent Urination at night (more than once)

III. Mechanism

  1. Urine Volumes are typically reduced at night via diurnal rhythm
  2. Nocturia occurs when urine formed exceeds Bladder capacity
    1. Decreased Bladder capacity
    2. Decreased renal concentrating function
    3. High Sodium excretion or other solute diuresis

IV. Causes

  1. All causes of Polyuria also cause Nocturia
    1. Diabetes Mellitus
    2. Diabetes Insipidus
    3. Primary Polydipsia (e.g. water Intoxication)
  2. Decreased Bladder capacity (may be due to inflammation or irritability)
    1. Urinary Tract Infection
    2. Bladder Tumor
    3. Urinary tract stone
  3. Edematous state fluid redistributes at night into dependent positions and then intravascularly mobilized
    1. Congestive Heart Failure
    2. Nephrotic Syndrome
    3. Hepatic Cirrhosis with Ascites
    4. Venous Insufficiency
  4. Bladder outflow obstruction
    1. Benign Prostatic Hyperplasia
    2. Urethral stricture
    3. Urinary tract stone
    4. Pelvic tumor
  5. Other causes
    1. Sleep Apnea

V. Management

  1. Identify and treat underlying causes
    1. Benign Prostatic Hyperplasia
    2. Diabetes Mellitus
    3. Diabetes Insipidus
    4. Overactive Bladder
    5. Obstructive Sleep Apnea
  2. Employ simple strategies
    1. Dose Loop Diuretics earlier in the day
    2. Redistribute edema during the daytime (e.g. compression socks, leg elevation)
  3. Medications (not recommended)
    1. Low dose Desmopressin (Noctiva)
      1. Expensive, marginal efficacy, risk of Hyponatremia (requires Sodium monitoring)

VI. References

  1. (2018) Presc Lett 25(5): 27
  2. Coe in Wilson (1991) Harrison's Internal Medicine, 12th ed, McGraw Hill, p. 275

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Ontology: Nocturia (C0028734)

Definition (MSHCZE) Časté močení v noci, mnohdy spojené s menším močením během dne. Např. jeden z příznaků srdečního selhávání. (cit. Velký lékařský slovník online, 2012 http://lekarske.slovniky.cz/ )
Definition (NCI) Frequent episodes of urination during the night.
Definition (MSH) Frequent URINATION at night that interrupts sleep. It is often associated with outflow obstruction, DIABETES MELLITUS, or bladder inflammation (CYSTITIS).
Concepts Disease or Syndrome (T047)
MSH D053158
ICD9 788.43
ICD10 R35.1
SnomedCT 207178007, 6408001, 139394000, 158475006
English NOCTURIA, [D]Nocturia (context-dependent category), Nycturia, Nocturia, [D]Nocturia, urinary frequency more than once at night (nocturia), urinary frequency more than once at night, nocturia, urinary frequency more than once at night (symptom), Nocturnal frequency, Nocturia [Disease/Finding], nocturnal frequency, Nocturia (finding), Finding of nocturia, [D]Nocturia (situation), Nocturia - finding, Finding of nocturia (finding), nycturia
Portuguese NOCTURIA, Nictúria, Noctúria
Spanish NICTURIA, Micción nocturna, Nicturia, [D]nocturia (categoría dependiente del contexto), Nocturia (hallazgo), Nocturia, [D]nocturia (situación), nicturia, [D]nocturia, nicturia (hallazgo)
Dutch nycturie, nachtelijk frequentere urinelozingen, nachtelijke mictie
French Fréquence nocturne, Nocturie, Nycturie, NYCTURIE
German naechtliche Haeufigkeit, Nykturie, Nocturia, NYKTURIE
Italian Pollachiuria notturna, Nocturia, Nicturia
Russian НИКТУРИЯ, ПОЛИУРИЯ НОЧНАЯ, NIKTURIIA, POLIURIIA NOCHNAIA
Swedish Nokturi
Japanese ヤカンヒンニョウ, 頻尿, 夜間頻尿, 夜間頻尿症
Finnish Yövirtsaisuus
Czech Častá nokturie, Nokturie, Nykturie, nykturie, nokturie
Polish Nykturia, Nokturia, Częstomocz nocny, Oddawanie moczu w nocy, Moczenie nocne
Hungarian Nycturia, Éjszakai gyakori vizelés, nocturia
Norwegian Nokturi, Økt urinutskilling om natten