Although the need to go to the bathroom in the middle of the night can happen to people of all ages, the urge seems to become more frequent as we get older. For some, it is simply a matter caused by drinking fluids late in the day or just before bedtime, consuming caffeinated beverages and pregnancy. And while being awakened in the middle of the night by the need to hit the “head” can prevent someone from getting much-needed sleep, many people may also experience the urge to go whenever they are roused from sleep. In fact, a close friend of mine once remarked that “her kidneys are the first to wake up in the morning,” even before her eyes are open.
Meanwhile, doctors note that Nocturia (the need to urinate 2 or more times during the night) may also be the overproduction of urine (nocturnal polyuria) as well as a side effect of various medical conditions including urinary tract infections, enlarged prostate, diabetes prolapsed bladders and sphincter control problems. Other serious (but less common) causes have been attributed to the liver and/or kidney failure, as well as congestive heart failure.
Although the seriousness of specific causes of nocturia need to be addressed by one’s healthcare provider, it may now be possible to help adults (only) alleviate symptoms caused by nocturnal polyuria with the use of a newly approved nasal spray, Noctiva (desmopressin acetate), taken ½ hour before bedtime each night in order to increase the ability of kidneys to absorb more water, thus reducing the amount of urine produced.
According to Hylton V. Joffe, M.D., M.M.Sc., director of the Division of Bone, Reproductive, and Urologic Products in the FDA’s Center for Drug Evaluation and Research, the effectiveness of the nasal spray was proven during two 3-month, randomized, placebo-controlled trials in 1,045 patients 50 years of age and older with nocturia due to nocturnal polyuria.
In the end, it was found that those using Noctiva were able to reduce their trips to the bathroom by half as compared to a control group using a placebo. The most common side effects of Noctiva during the trials were nasal discomfort, cold symptoms, nasal congestion, sneezing, high or increased blood pressure, back pain, nosebleeds, bronchitis, and dizziness.
Noctiva is not to be used by children, expectant mothers, or patients with congenital heart failure. It should also be noted that the nasal spray could cause low sodium levels in the blood (hyponatremia). Severe hyponatremia can be life-threatening if it is not promptly diagnosed and treated, leading to seizures, coma, respiratory arrest or death.
Note: People with nocturia who experience symptoms such as bloody or pink-colored urine, urinary retention, difficult or painful urination, burning with urination, or fever during their nightly bouts with nocturia should call 911 for immediate medical attention.