Why do I need to get up during the night to wee? Is this normal?

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It can be normal to wake up once or even twice during the night to wee, especially as we get older.

One in three adults over 30 makes at least two trips to the bathroom every night.

Waking up from sleep to urinate on a regular basis is called nocturia. It’s one of the most commonly reported bothersome urinary symptoms (others include urgency and poor stream).

So what causes nocturia, and how can it affect wellbeing?

A range of causes

Nocturia can be caused by a variety of medical conditions, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an overactive bladder, or gastrointestinal issues. Other causes include pregnancy, medications and consumption of alcohol or caffeine before bed.

While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or insomnia, can also cause nocturia.

When we sleep, an antidiuretic hormone is released that slows down the rate at which our kidneys produce urine. If we lie awake at night, less of this hormone is released, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.

Stress, anxiety and watching television late into the night are common causes of insomnia.

A person with their hands in front of their pelvic area in a bathroom.
Sometimes we need to get up late at night to pee.
Christian Moro

Effects of nocturia on daily functioning

The recommended amount of sleep for adults is between seven and nine hours per night. The more times you have to get up in the night to go to the bathroom, the more this impacts sleep quantity and quality.

Decreased sleep can result in increased tiredness during the day, poor concentration, forgetfulness, changes in mood and impaired work performance.

If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.

In more severe cases, nocturia has been compared to having a similar impact on quality of life as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.

Nocturia not only upsets sleep, but also increases the risk of falls from moving around in the dark to go to the bathroom.

Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.

Can you have a ‘small bladder’?

It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is smaller relative to your other organs.

If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.

If you find you are going to the bathroom quite a lot during the day and evening (more than eight times in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.

If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.

There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.

A happy and healthy bladder

Here are some tips to maintain a happy and healthy bladder, and reduce the risk you’ll be up at night:

Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow, Medical Program, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Stretching for 50+ – by Dr. Karl Knopf

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Knopf explores in this book the two-way relationship between aging and stretching (i.e., each can have a large impact on the other). Thinking about stretching in those terms is an important reframe for going into any stretching program. We’d say “after the age of 50”, but honestly, at any age. But this book is written with over-50s in mind, as the title goes.

    There’s an extensive encyclopedic section on stretches per body part, which is exactly as you might expect from any book of this kind. There is also a flexibility self-assessment, so that progress can be measured easily, and so that the reader knows where might need more improvement.

    Perhaps this book’s greatest strength is the section on specialized programs based on things ranging from working to improve symptoms of any chronic conditions you may have (or at least working around them, if outright improvement is not possible by stretching), to your recreational activities of importance to you—so, what kinds of flexibilities will be important to you, and also, what kinds of injury you are most likely to need to avoid.

    Bottom line: if you’re 50 and would like to do more stretching and less aging, then this book can help with that.

    Click here to check out Stretching for 50+, and extend your healthspan!

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  • Parents are increasingly saying their child is ‘dysregulated’. What does that actually mean?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Welcome aboard the roller coaster of parenthood, where emotions run wild, tantrums reign supreme and love flows deep.

    As children reach toddlerhood and beyond, parents adapt to manage their child’s big emotions and meltdowns. Parenting terminology has adapted too, with more parents describing their child as “dysregulated”.

    But what does this actually mean?

    ShUStudio/Shutterstock

    More than an emotion

    Emotional dysregulation refers to challenges a child faces in recognising and expressing emotions, and managing emotional reactions in social settings.

    This may involve either suppressing emotions or displaying exaggerated and intense emotional responses that get in the way of the child doing what they want or need to do.

    Dysregulation” is more than just feeling an emotion. An emotion is a signal, or cue, that can give us important insights to ourselves and our preferences, desires and goals.

    An emotionally dysregulated brain is overwhelmed and overloaded (often, with distressing emotions like frustration, disappointment and fear) and is ready to fight, flight or freeze.

    Developing emotional regulation

    Emotion regulation is a skill that develops across childhood and is influenced by factors such as the child’s temperament and the emotional environment in which they are raised.

    In the stage of emotional development where emotion regulation is a primary goal (around 3–5 years old), children begin exploring their surroundings and asserting their desires more actively.

    Child sits next to her parent's bed
    A child’s temperament and upbringing affect how they regulate emotions. bluedog studio/Shutterstock

    It’s typical for them to experience emotional dysregulation when their initiatives are thwarted or criticised, leading to occasional tantrums or outbursts.

    A typically developing child will see these types of outbursts reduce as their cognitive abilities become more sophisticated, usually around the age they start school.

    Express, don’t suppress

    Expressing emotions in childhood is crucial for social and emotional development. It involves the ability to convey feelings verbally and through facial expressions and body language.

    When children struggle with emotional expression, it can manifest in various ways, such as difficulty in being understood, flat facial expressions even in emotionally charged situations, challenges in forming close relationships, and indecisiveness.

    Several factors, including anxiety, attention-deficit hyperactivity disorder (ADHD), autism, giftedness, rigidity and both mild and significant trauma experiences, can contribute to these issues.

    Common mistakes parents can make is dismissing emotions, or distracting children away from how they feel.

    These strategies don’t work and increase feelings of overwhelm. In the long term, they fail to equip children with the skills to identify, express and communicate their emotions, making them vulnerable to future emotional difficulties.

    We need to help children move compassionately towards their difficulties, rather than away from them. Parents need to do this for themselves too.

    Caregiving and skill modelling

    Parents are responsible for creating an emotional climate that facilitates the development of emotion regulation skills.

    Parents’ own modelling of emotion regulation when they feel distressed. The way they respond to the expression of emotions in their children, contributes to how children understand and regulate their own emotions.

    Children are hardwired to be attuned to their caregivers’ emotions, moods, and coping as this is integral to their survival. In fact, their biggest threat to a child is their caregiver not being OK.

    Unsafe, unpredictable, or chaotic home environments rarely give children exposure to healthy emotion expression and regulation. Children who go through maltreatment have a harder time controlling their emotions, needing more brainpower for tasks that involve managing feelings. This struggle could lead to more problems with emotions later on, like feeling anxious and hypervigilant to potential threats.

    Recognising and addressing these challenges early on is essential for supporting children’s emotional wellbeing and development.

    A dysregulated brain and body

    When kids enter “fight or flight” mode, they often struggle to cope or listen to reason. When children experience acute stress, they may respond instinctively without pausing to consider strategies or logic.

    If your child is in fight mode, you might observe behaviours such as crying , clenching fists or jaw, kicking, punching, biting, swearing, spitting or screaming.

    In flight mode, they may appear restless, have darting eyes, exhibit excessive fidgeting, breathe rapidly, or try to run away.

    A shut-down response may look like fainting or a panic attack.

    When a child feels threatened, their brain’s frontal lobe, responsible for rational thinking and problem-solving, essentially goes offline.

    The amygdala, shown here in red, triggers survival mode. pikovit/Shutterstock

    This happens when the amygdala, the brain’s alarm system, sends out a false alarm, triggering the survival instinct.

    In this state, a child may not be able to access higher functions like reasoning or decision-making.

    While our instinct might be to immediately fix the problem, staying present with our child during these moments is more effective. It’s about providing support and understanding until they feel safe enough to engage their higher brain functions again.

    Reframe your thinking so you see your child as having a problem – not being the problem.

    Tips for parents

    Take turns discussing the highs and lows of the day at meal times. This is a chance for you to be curious, acknowledge and label feelings, and model that you, too, experience a range of emotions that require you to put into practice skills to cope and has shown evidence in numerous physical, social-emotional, academic and behavioural benefits.

    Family dinner
    Talk about your day over dinner. Monkey Business Images/Shutterstock

    Spending even small amounts (five minutes a day!) of quality one-on-one time with your child is an investment in your child’s emotional wellbeing. Let them pick the activity, do your best to follow their lead, and try to notice and comment on the things they do well, like creative ideas, persevering when things are difficult, and being gentle or kind.

    Take a tip from parents of children with neurodiversity: learn about your unique child. Approaching your child’s emotions, temperament, and behaviours with curiosity can help you to help them develop emotion regulation skills.

    When to get help

    If emotion dysregulation is a persistent issue that is getting in the way of your child feeling happy, calm, or confident – or interfering with learning or important relationships with family members or peers – talk to their GP about engaging with a mental health professional.

    Many families have found parenting programs helpful in creating a climate where emotions can be safely expressed and shared.

    Remember, you can’t pour from an empty cup. Parenting requires you to be your best self and tend to your needs first to see your child flourish.

    Cher McGillivray, Assistant Professor Psychology Department, Bond University and Shawna Mastro Campbell, Assistant Professor Psychology, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Military Secrets (Ssh!)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Can you keep a secret?

    When actor Christopher Lee was asked about his time as a British special forces operative, he would look furtively around, and ask “can you keep a secret?” Upon getting a yes, he would reply:

    “So can I”

    We can’t, though! We just can’t help sharing cool, useful information that changes people’s lives. Never is that more critical than now, as the end of January has been called the most depressing time of year, according to Dr. Cliff Arnall at the University of Cardiff. It doesn’t have to be all doom and gloom, though:

    Today we’re going to share a trick… It’s called the “secret of eternal happiness” (yes, we know… we didn’t come up with the name!) and is taught to soldiers to fend off the worst kinds of despair.

    The soldiers would be ordered to take a moment to reflect on the sheer helplessness of their situation, the ridiculous impossibility of the odds against them, all and any physical pain they might suffer, the weakness of their faltering body… and just when everything feels as bad is it can possibly feel, they’re told to say out loud—as sadly as possible—this single word:

    “Boop”

    It all but guarantees to result in cracking a smile, no matter the situation.

    Now this knowledge is yours too! Keep it secret! Or don’t. Sharing is caring.

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  • When Bad Joints Stop You From Exercising (5 Things To Change)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The first trick to exercising with bad joints is to have better joints.

    Now, this doesn’t necessarily mean you can take a supplement and magically your joint problems will be cured, but there are adjustable lifestyle factors that can and will make things relatively better or worse.

    We say “and will”, because you don’t get a choice in that part. Everything we do, every little choice in our day, makes our health a little better or a little worse in some aspect(s). But we do get a choice between “relatively better” and “relatively worse”.

    With that in mind, do check out:

    Ok, you have bad joints though; what next?

    Let’s assume you’re doing your best with the above, and/or have simply decided not to, which is your call. You know your circumstances best. Either way, your joints are still not in sufficiently good condition to be able to exercise the way you’d like.

    First, the obvious: enjoy low-impact exercises

    For example:

    • Swimming
    • Yoga (much more appropriate here than the commonly-paired “and tai chi”)*
    • Isometric exercises (i.e. exercise without movement, e.g. squeezing things, or stationary stability exercises)

    *This is not to say that tai chi is bad. But if your problem is specifically your knees, there are many movements in most forms of tai chi that require putting the majority of one’s weight on one bent leg, which means the knee of that leg is going to suffer. If your knees are fine, then this won’t be an issue and it will simply continue strengthening your knees without discomfort. But they have to be fine first.

    See also: Exercising With Osteoporosis

    Second: support your joints through a full range of motion

    If you have bad joints, you probably know that there’s an unfortunate paradox whereby you get to choose between:

    1. Exercise, and inflame your joints
    2. Rest, and your joints seize up

    This is the way to get around that damaging dilemma.

    Moving your joints through a full range of motion regularly is critical for their maintenance, so do that in a way that isn’t straining them:

    If it’s your shoulders, for example, you can do (slow, gentle!) backstroke or front-crawl or butterfly motions while standing in the comfort of your living room.

    If it’s your knees, then supported squats can do you a world of good. That means, squat in front of a table or other stable object, with your fingertips (or as much of your hands as you need) on it, to take a portion of your weight (it can be a large portion; that’s fine too!) while you go through the full range of motion of the squat. Repeat.

    And so forth for other joints.

    See also: The Most Underrated Hip Mobility Exercise (Not Stretching)

    Third: work up slowly, and stop early

    You can do exercises that involve impact, and if you live a fairly normal life, you’ll probably have to (walking is an impact exercise). You can also enjoy cycling (low-impact, but not so low-impact as we discussed in the last section) and work up to running if you want to.

    However…

    While building up your joints’ mobility and strength, it is generally a good idea to stop before you think you need to.

    This means that it’s important to do those exercises in a way that you can stop early. For example, an exercise bike or a treadmill can be a lot of use here, so that you don’t find you need to stop for the day while miles from your house.

    If you get such a device, it doesn’t even have to be fancy and/or expensive. This writer got herself an inexpensive exercise bike like this one, and it’s perfectly adequate.

    Fourth: prioritize recovery, even if it doesn’t feel like you need it

    Everyone should do this anyway, but if your joints are bad, it goes double:

    Overdone It? How To Speed Up Recovery After Exercise (According To Actual Science)

    Fifth: get professional help

    Physiotherapists are great for this. Find one, and take their advice for your specific body and your specific circumstances and goals.

    Take care!

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  • What will aged care look like for the next generation? More of the same but higher out-of-pocket costs

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Aged care financing is a vexed problem for the Australian government. It is already underfunded for the quality the community expects, and costs will increase dramatically. There are also significant concerns about the complexity of the system.

    In 2021–22 the federal government spent A$25 billion on aged services for around 1.2 million people aged 65 and over. Around 60% went to residential care (190,000 people) and one-third to home care (one million people).

    The final report from the government’s Aged Care Taskforce, which has been reviewing funding options, estimates the number of people who will need services is likely to grow to more than two million over the next 20 years. Costs are therefore likely to more than double.

    The taskforce has considered what aged care services are reasonable and necessary and made recommendations to the government about how they can be paid for. This includes getting aged care users to pay for more of their care.

    But rather than recommending an alternative financing arrangement that will safeguard Australians’ aged care services into the future, the taskforce largely recommends tidying up existing arrangements and keeping the status quo.

    No Medicare-style levy

    The taskforce rejected the aged care royal commission’s recommendation to introduce a levy to meet aged care cost increases. A 1% levy, similar to the Medicare levy, could have raised around $8 billion a year.

    The taskforce failed to consider the mix of taxation, personal contributions and social insurance which are commonly used to fund aged care systems internationally. The Japanese system, for example, is financed by long-term insurance paid by those aged 40 and over, plus general taxation and a small copayment.

    Instead, the taskforce puts forward a simple, pragmatic argument that older people are becoming wealthier through superannuation, there is a cost of living crisis for younger people and therefore older people should be required to pay more of their aged care costs.

    Separating care from other services

    In deciding what older people should pay more for, the taskforce divided services into care, everyday living and accommodation.

    The taskforce thought the most important services were clinical services (including nursing and allied health) and these should be the main responsibility of government funding. Personal care, including showering and dressing were seen as a middle tier that is likely to attract some co-payment, despite these services often being necessary to maintain independence.

    The task force recommended the costs for everyday living (such as food and utilities) and accommodation expenses (such as rent) should increasingly be a personal responsibility.

    Aged care resident eats dinner from a tray
    Aged care users will pay more of their share for cooking and cleaning.
    Lizelle Lotter/Shutterstock

    Making the system fairer

    The taskforce thought it was unfair people in residential care were making substantial contributions for their everyday living expenses (about 25%) and those receiving home care weren’t (about 5%). This is, in part, because home care has always had a muddled set of rules about user co-payments.

    But the taskforce provided no analysis of accommodation costs (such as utilities and maintenance) people meet at home compared with residential care.

    To address the inefficiencies of upfront daily fees for packages, the taskforce recommends means testing co-payments for home care packages and basing them on the actual level of service users receive for everyday support (for food, cleaning, and so on) and to a lesser extent for support to maintain independence.

    It is unclear whether clinical and personal care costs and user contributions will be treated the same for residential and home care.

    Making residential aged care sustainable

    The taskforce was concerned residential care operators were losing $4 per resident day on “hotel” (accommodation services) and everyday living costs.

    The taskforce recommends means tested user contributions for room services and everyday living costs be increased.

    It also recommends that wealthier older people be given more choice by allowing them to pay more (per resident day) for better amenities. This would allow providers to fully meet the cost of these services.

    Effectively, this means daily living charges for residents are too low and inflexible and that fees would go up, although the taskforce was clear that low-income residents should be protected.

    Moving from buying to renting rooms

    Currently older people who need residential care have a choice of making a refundable up-front payment for their room or to pay rent to offset the loans providers take out to build facilities. Providers raise capital to build aged care facilities through equity or loan financing.

    However, the taskforce did not consider the overall efficiency of the private capital market for financing aged care or alternative solutions.

    Instead, it recommended capital contributions be streamlined and simplified by phasing out up-front payments and focusing on rental contributions. This echoes the royal commission, which found rent to be a more efficient and less risky method of financing capital for aged care in private capital markets.

    It’s likely that in a decade or so, once the new home care arrangements are in place, there will be proportionally fewer older people in residential aged care. Those who do go are likely to be more disabled and have greater care needs. And those with more money will pay more for their accommodation and everyday living arrangements. But they may have more choice too.

    Although the federal government has ruled out an aged care levy and changes to assets test on the family home, it has yet to respond to the majority of the recommendations. But given the aged care minister chaired the taskforce, it’s likely to provide a good indication of current thinking.The Conversation

    Hal Swerissen, Emeritus Professor, La Trobe University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Cross That Bridge – by Samuel J. Lucas

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Books of this genre usually have several chapters of fluff before getting to the point. You know the sort:

    1. Let me tell you about some cherry-picked celebrity stories that overlook survivorship bias
    2. Let me tell you my life story, the bad parts
    3. My life story continued, the good parts now
    4. What this book can do for you, an imaginative pep talk that keeps circling back to me

    …then there will be two or three chapters of the actual advertised content, and then a closing chapter that’s another pep talk.

    This book, in contrast, throws that out of the window. Instead, Lucas provides a ground-up structure… within which, he makes a point of giving value in each section:

    • exercises
    • summaries
    • actionable advice

    For those who like outlines, lists, and overviews (as we do!), this is perfect. There are also plenty of exercises to do, so for those who like exercises, this book will be great too!

    Caveat: occasionally, the book’s actionable advices are direct but unclear, for example:

    • Use the potential and power of tea, to solve problems

    Context: there was no context. This was a bullet-pointed item, with no explanation. It was not a callback to anything earlier; this is the first (and only) reference to tea.

    However! The book as a whole is a treasure trove of genuine tips, tools, and voice-of-experience wisdom. Occasional comments may leave you scratching your head, but if you take value from the rest, then the book was already more than worth its while.

    Get Your Copy of Cross That Bridge on Amazon Today!

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