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A man in bed with one eye closed and the other eye open looking at a clock with full bladders all around in

The Problem of Nocturia

Bladder cancer causes dysfunction along the entire urinary tract. Unfortunately, those resulting and frequent trips to the bathroom — often to void just a small amount of fluid — don’t go away at night.

What is nocturia?

‘Nocturia’ describes frequent nighttime urination. It’s a problem for those diagnosed with bladder cancer, as well as for others with different medical conditions, for a few reasons.

About that frequent nighttime trip…

We’re meant to go to bed at night and stay there until we awaken. But for people with nocturia, this seems utterly impossible. For people who struggle with bladder cancer, this territory can be far too familiar and frustrating.

There are several reasons why getting up several times during the night can wreak havoc on someone who has bladder cancer.

  1. Your body needs at least 7 consecutive hours of sleep (which include all the sleep stage and cycles necessary for complete rest) in order to fight cancer. Fragmented sleep (in which you awaken frequently, for whatever reason) can create immune system dysregulation which might actually encourage tumor growth.1
  2. Broken sleep only exacerbates cancer-related daytime fatigue, leading to the need for naps or the problem of cognitive fog caused by poor nighttime sleep. It’s a vicious cycle: poor sleep at night leads to the need for naps during the day, which may make it harder to fall asleep at night… you get the picture.
  3. If having bladder cancer isn’t already a big enough dilemma, its emotional consequences — depression and anxiety, as well as a loss of confidence in one’s own body—can be amplified when you’re not getting enough sleep.2
  4. For those with bladder cancer who are less steady on their feet, more trips to the bathroom mean more opportunities for a bad fall. 3
  5. Urgent and frequent urination at night can result in incontinence that makes it hard to share a bed with a loved one or travel without fear of leakage. This can be a life-altering problem preventing you from living a normal life. Anxiety about this, by itself, might lead to sleeplessness.

Be aware of hidden sleep apnea

Sometimes the frequent urination that is a hallmark of bladder cancer may divert attention away from another problem which may exist simultaneously: obstructive sleep apnea (OSA).

Incontinence and frequent awakenings are two aspects of OSA which may go unresolved if they aren’t looked into.4

People with OSA are frequently awakened after periods when they cannot breathe properly; the brain releases stress hormones to signal them to awaken and take a breath. These stress hormones also stimulate activity in the bladder, leaving one with the feeling they need to urinate (sounds familiar?) when they may not actually need to.

Pertinent risk factors for OSA include carrying extra weight, specific facial structures which contribute to airway blockage (such as an overlarge tongue or tonsils), and large neck circumference.

When in doubt, check it out

As with any other undesirable symptom, you are best advised to share your concerns with your doctor. Poor sleep, by itself, can be reason enough to warrant a closer look, if only to rule out hidden sleep disorders which could complicate your cancer treatment and recovery.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Tumor Growth Promoted by Circadian Rhythm Disruptions. GEN. Published May 1, 2019. Accessed May 14, 2019.
  • Anxiety, Fear, and Depression. American Cancer Society. Last revised May 24, 2016. Accessed May 14, 2019.
  • Kim SY, Bang W, Kim MS, Park B, Kim JH, Choi HG. Nocturia Is Associated with Slipping and Falling. PLoS One. 2017;12(1):e0169690. Published 2017 Jan 6. doi:10.1371/journal.pone.0169690
  • Raheem OA, Orosco RK, Davidson TM, Lakin C. Clinical predictors of nocturia in the sleep apnea population. Urol Ann. 2014;6(1):31–35. doi:10.4103/0974-7796.127019
  • Comments

  • Dick
    3 months ago

    I ended up with bed wetting when I finished my bladder cancer treatment. This is what my cancer doctor prescribed for me to take and it works good with no night time problems. It is safe to use as it is what doctors prescribe for bed wetting children. It is Desmopressin Acet Tabs 0.1 mg. Taken before going to bed and I have been using it for approx 7 years with no side effects.
    Hope this helps someone

  • TK Sellman moderator author
    3 months ago

    Thanks for sharing your solution, Dick, others might be able to ask their doctor about this option and whether it’s right for them. It’s especially nice to hear you’ve had no side effects!

  • Mac Howard moderator
    4 months ago

    TK, Now I have a name for my symptoms. Thank you. I have gotten up all through the night for years and have been on an apnea machine for over a decade. Bladder cancer only increased the frequent urination. All of this does lead to a cycle of constant fatigue.

    Thank you for the information.
    Mac (site moderator)

  • TK Sellman moderator author
    4 months ago

    All those nighttime interruptions are going to cost something, right? Glad to hear you’re using PAP (I do, too), it does help so much. I’m happy to help anyone dealing with constant fatigue, as it has been part of my reality, too, and it’s no way to live well. Hope you are well and bladder cancer is controlled and in the past for you! Tamara

  • shortecapone
    9 months ago

    I was waking up 4-5 times a night and then going to work for 12-13 hour day for almost a year. When I finally got a diagnosis and went through about 4 of 6 chemotherapy treatments, my bladder function returned to normal.

  • TK Sellman moderator author
    4 months ago

    That is a relief! I’m so glad you made it through, and hope you remain cancer free!

  • volsrider
    9 months ago

    I would love to sleep more than 2 hours at a time. Seems my urination urges seem to have a schedule. Thanks for the article.

  • TK Sellman moderator author
    4 months ago

    I cannot resist suggesting you get checked out for sleep apnea. Those nighttime visits, if on a schedule as you describe, might be happening during certain stages of sleep at night, which cycle over a period of 1.5 to 2 hours (especially later in the night). If you get a sleep study, you might uncover your culprit right there. Best to you,

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