Hypertension, old age up nighttime urination

After age 60, people are more likely to have to get up at least twice in the middle of the night to urinate - called nocturia - if they also have high blood pressure and take diuretics, a study shows. And the older people get, the more likely they are to have this problem.

Although doctors often tell people with nocturia to avoid coffee and nighttime fluids, in the current study neither appeared to increase the risk of nocturia in older adults.

"We are very used to giving advice about caffeine intake to deal with bladder problems," said study author Dr. Theodore M. Johnson II. "While it is true that caffeine causes an overproduction of urine and may also be a bladder irritant, this advice may be less important in nocturia," he noted.

Johnson, who is based at the Birmingham/Atlanta Department of Veterans Affairs Geriatric Research Education and Clinical Center, added that nocturia is a "symptom," not a condition, which may result from low bladder capacity, too much urine production at night, or a sleep disturbance.

In the Journal of the American Geriatrics Society, Johnson and his team note that nocturia can significantly disrupt older adults' sleep, and doubles their risk of falling.

To investigate what factors are associated with nocturia, the researchers asked 1,632 people aged 60 and older to estimate the number of times they usually urinate after going to sleep at night. People were followed for several years; anyone who said they urinated at least twice after bed was diagnosed with nocturia.

Nearly one-third of the people who participated in the study were diagnosed with nocturia, and a handful (1 percent) said they had to get up at least six times every night to urinate.

Examining all variables, Johnson and his colleagues found that having hypertension, taking diuretics, and increased age were associated with a higher risk of nocturia.

Johnson explained that previous research has often linked hypertension and older age to nocturia. In terms of diuretics, he noted that it's difficult to say if they are a cause or symptom of the problem.

Although this research does not offer much insight for how to treat nocturia, further studies may, Johnson noted. And in the meantime, older adults need to make sure that when they get up to urinate, they do so safely.

"People who go to the bathroom frequently at night should identify a clear path to the bathroom and maybe use some low level lighting to help guide the nighttime journey," he said.

SOURCE: Journal of the American Geriatrics Society, June 2005