Nocturia causing fragmented sleep! :(

Hi, I am a healthy 22y/o male and for the last 2 years or so I've had on and off problems with frequent awakenings at night.

I am growing increasingly desperate, therefore the long text, thank you so much for reading!

Before I go to bed, I tend to stay away from screens, do some meditation and stretching to de-stress. I always feel ready to hit the sack and fall asleep without problems. I take 500µg melatonin 2 hrs before bed. But recently, I've had the same pattern of fragmented sleep almost every night: I wake up pretty much every 1-2 hours. If I go 3 hours without waking up, thats a success for me... Everytime I wake up I go to urinate, now it's hard to tell if this is habitual, or if I actually need to urinate. Sometimes I urinate normal amounts, sometimes hardly anything. But whenever I awake in bed, I feel a slight pressure in my bladder region to go urinate. Obviously this is really having an impact on my sleep quality, although most of the time I can fall asleep again quickly. Another important thing to note: my urination patterns during the day are normal, I go probably every 2-3 hours and am regularly hydrated. So the problem is really only at night.

I've been to a urologist: prostate is maybe on the larger side, but not too large and I should be too young (22) for BPH?? Wasn't checked for prostatitis, but I don't have any symptoms of inflammation or infection in that region; no burning sensations etc. My urine sample was tested for glucose and I assume other things: nothing unusual.

There are some possible causes I am thinking of, maybe someone could comment on this:

• Defect in ADH (Vasopressin/anti-diuretic hormone) secretion

  -> diabetes insipidus?

  --> but I highly doubt i have diabetes insipidus, I drink normal amounts, experience normal thirst and again, urinate normally during the day

• Some kind of asymptomatic urinary infection?

  --> however, my urine sample was tested (I assume also for infections) and was fine

• Maybe some kind of hypersensitivity to caffeine?

  --> I only drink a cup of green tea first thing in the morning, so shouldn't affect my sleep but will try and cut this out for now.

• Overactive bladder?

  --> my urologist said I have "strong" bladder muscles. Maybe my bladder is too tense? Should I try and train my bladder, by trying to go less frequently during the day, in the hope this will then be applied at night? Or could that make it worse by strengthening my bladder even more?

• STRESS

  --> I think this is the most likely. I tend to overthink things and can easily get stressed. I don't have anxiety and often feel relaxed before bed, but maybe I am subconsciously stressed? I know cortisol greatly impacts sleep and read that cortisol can inhibit deep sleep and also ADH secretion from the hypothalamus (?) I notice that when I'm on vacation or generally in a more relaxed setting, I tend to sleep better, maybe only waking up once or twice a night instead of, say, four times. So my best bet is that some kind of stress is causing this and maybe the fact that I urinate when I wake up is because you usually only wake up at night to go to the bathroom, hence my brain has made some sort of association between waking up and urinating. I don't think I have some sort of disease like Cushing syndrome, because I don't show symptoms of chronically elevated cortisol.

Anyway, if anyone has some experience with this, any ideas, anything would be greatly appreciated! It's kind of tough to go visit a doctor right now (COVID).

THANKS!

1 like, 5 replies