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Nighttime vs. Adult Daytime Incontinence
Same Problem, Different Causes
By Lisa A. Goldstein
Some people have incontinence during the day, while others experience it at night – and some experience loss of bladder control both day and night. No matter when it occurs it's still the same problem, but there are some significant differences between daytime and nighttime incontinence both in their cause and treatment.
"The causes are as different as night and day," says Dr. Michael Lutz, assistant clinical professor of urology at Wayne State University School of Medicine in Detroit, Mich.
The most common forms of daytime incontinence are stress incontinence, urge incontinence or a combination of both. Stress incontinence occurs when the muscle controlling urine flow is too weak and releases urine during coughing, sneezing, laughing, lifting or exercising, says Jean Wyman, director of the Center for Gerontological Nursing at the University of Minnesota. Those who experience urge incontinence have a strong, sudden sensation of needing to empty their bladder.
Daytime incontinence also may result from medical procedures, decreased mobility or a urinary tract infection. In addition, the lack of estrogen associated with menopause has been linked to stress incontinence, Wyman says. Men who have enlarged prostates or who have had prostate surgery are also at risk for urge incontinence, she says.
Nighttime incontinence, on the other hand, is usually associated with an overactive bladder and occurs during sleep. This condition is called nocturnal enuresis. "During the nighttime, people may have a poor sleep pattern that is the primary cause of frequency," Dr. Lutz says. In addition, he says, when the legs are elevated at night, any fluid they have retained may work back into circulation and be eliminated as urine.
Also, men with prostate problems may have nighttime incontinence because they are unable to completely empty their bladder, necessitating more trips to the bathroom.
