What is Nocturia and Nocturnal Enuresis (adult bed-wetting) and how to treat it?

Frequent urination at night, as well as bed-wetting in adults, usually have different causes to when these conditions occur in children.  

Changes to the amount of urine we produce and the timing of urine production are caused by changes in the production of certain hormones, kidney problems, certain illnesses, or due to the direct or indirect effects of certain medicines. Changes in urine production can lead to waking during the night to pass urine (‘Nocturia’) or bed-wetting (‘Nocturnal Enuresis’). In older adults, it is considered by many to be normal to have to get up to pass urine once or twice a night. 

What is Nocturia?

Nocturia is a term used by medical professionals when people have to wake during the night to empty their bladder. It is normal to wake up around once in the night for both adults and children. However, if you are experiencing more frequent bathroom visits, you may be experiencing Nocturia Enuresis. Nighttime incontinence can be difficult to manage, however you don’t have to struggle in silence. We have a great guide on coping with night-time incontinence, so you can get a restful night’s sleep. 

Among men, Nocturia is usually related to an enlarged prostate. Overactive muscles of the bladder, or underlying health conditions, can however cause frequent urination at night regardless of age and sex. Remember that excessive fluid intake, especially fluids with caffeine, can affect the number of toilet visits. 

Enuresis is a word that describes involuntary urination. Enuresis often occurs in children after the age when they should be able to control their bladder. The medical term for bed-wetting is ‘Nocturnal Enuresis’, and this describes involuntary urination while asleep.  

Involuntary urination in adults is also more commonly known as urinary incontinence.  

Read on to learn more about the causes of Nocturnal Enuresis and ways to stop it. 

As we grow older, our bodies change, and we naturally need to go to the toilet more often than before. Having to go once or twice during the night is, in other words, normal. A younger person can hold up to half a litre of urine, but as we age, this is normally reduced by about half as the bladder muscle becomes less elastic. There are several different causes for this including the following: 

• Hormonal Changes: Another reason for a more pressing urge to urinate as we age has to do with hormonal changes that lower the concentration of the urine. The total amount of urine doesn´t necessarily change, but often more is produced at night.  
• Lifestyle Factors: There are also lifestyle-related behaviours that can affect how much you urinate, like drinking large amounts of liquid. Caffeine and alcohol after dinner can also lead to a need to urinate at night. If you’re after some more helpful advice on what foods and drinks to avoid, take a look at our article on foods to avoid with an overactive bladder.
• Insufficient Production of ADH (Antidiuretic Hormone): Another factor may be insufficient production of ADH, the antidiuretic hormone which signals the kidneys to decrease the amount of urine produced. The body normally overproduces ADH to avoid Nocturia but when your body does not produce the appropriate amount of this hormone at night, it leads to high urine production and a frequent need to visit the toilet. 
• Overactive Bladder: An overactive bladder, also referred to as an "irritable bladder", is described as a series of problems connected to the urgency to urinate and at times difficult to suppress. 
• Other Causes: These could include a smaller than usual bladder capacity, overactive bladder, the effect of bladder irritants such as alcohol and caffeine, and a side effect of certain medications.

Firstly, it's sensible to check that bed-wetting is not being caused by medications being taken. Read the information that came with any medicines you’re taking, and consult a pharmacist. Sometimes, a simple change in when you take your medicine can help reduce symptoms.  

Some medicines prescribed for the following conditions can cause nocturia and nocturnal enuresis: 

• Heart and kidney disorders 
• Diabetes
• Diuretic medicines and sedatives

Once you have spoken to a medical professional, these tips below could manage and help with bed-wetting at night, so you can have a peaceful sleep: 

1. Limiting Alcohol and Caffeine Intake 

High alcohol and caffeine intake can also cause or worsen nocturnal enuresis, and can be easily avoided, so limiting intake of these substances and drinking more fluids may help. 

2. Keeping a Bladder Diary

When searching for Nocturia treatments to help cure bed-wetting, it is important to keep track of how often bed-wetting occurs, the ratio of dry nights to wet nights and your diet (especially fluids). You can do this by keeping a bladder diary, this will help you keep track of how often you have to use the toilet, how much you’ve urinated and which and how many fluids you consume during the day.  

When you are ready to see a doctor, they will carry out a physical examination, a neurological evaluation and a urinalysis and urine culture to determine the contents of the urine. This may lead to further tests. 

3. Using Night-Time Incontinence Products 

Depending on the severity of the bed-wetting, there are a range of TENA pants available for moderate to heavy bladder leakage for both men and women. 

Our specially formulated night-time products, from TENA Women Mini Night pads with triple protection to TENA Discreet Maxi NIGHT for even more security, ensure that you’re protected all night long. 

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