If you suffer from nocturia (nocturnal polyuria; excessive urination during the night), you probably have a few questions you’d like answered about this uncomfortable topic and disorder.
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Tips to Stop Nocturia or Frequent Peeing at Night
in the middle of the night can certainly be bothersome—and interfere with a good night’s sleep! The amount of urine in the body should become more concentrated at night, but with nocturia, you may feel the need to wake up and frequently urinate during the night. So, what can you do to stop peeing in the middle of the night? Let’s first take a closer look at the causes of nocturia and who is primarily affected by this condition:
Who Is Affected by Nocturia?
Nocturia, or excessive urination at night, is a problem that is common in the over-65 crowd, primarily due to the aging bladder and urethra. As you get older, the body produces fewer diuretic hormones, which can contribute to frequent urination at night.
This condition occurs in both men and women, but it is generally more of an issue with women. Weakness of the bladder sphincter muscle due to menopause, pregnancy, or previous surgery can allow urine to escape the urethra from pressure.
Nocturia Causes
Everything from lifestyle changes to medical conditions can cause nocturia. Common causes include:
1. Urinary Tract Infection (UTI) is an infection in any part of the urinary tract — kidneys, ureters, urinary bladder and urethra, but mostly it occurs in urinary bladder and urethra. The symptoms include painful or burning urination, frequent urination or constant urge to urinate and urgency to pass urine.
2. Benign Prostatic Hyperplasia (BPH) is an enlarged prostate gland which is a common condition in elderly men. Its common symptoms are frequent urination, nocturia, urgency to urinate, difficulty in initiating urination, weak urine stream and dribbling at the end of urination.
3. Inflamed prostate gland (prostatitis) causes pain or burning sensation during urination, nocturia, urgency to urinate, difficulty in initiating urine, dribbling urine, pain in groin, abdomen, blood in urine, pain in penis or testes.
4. Fourth is diabetes.
5. It can arise from an overactive bladder. In this condition, the bladder muscles start to contract involuntarily even with a small amount of urine in the bladder. It mainly causes symptoms like sudden urge to urinate, frequent urine, nocturia and involuntary urine passage immediately after an urge for urination is felt.
6. Tumors in the bladder or pelvic area and bladder prolapse can also lead to nocturia.
7. Other than this, it can happen in case of anxiety, obstructive sleep apnea (a serious sleep disorder in which breathing stops momentarily and then starts occurring several times during sleep), during pregnancy and from use of certain medicines (e.g. diuretics which are the drugs that increases urine flow). It can also be a symptom in case of heart or liver failure and some neurological disorders.
These neurological disorders include Parkinson’s disease which is a nervous system disorder that affects part of the brain that controls body movements. It begins with tremor in one hand and causes stiffness, slow movement, impaired posture and balance. It can lead to several complications one of which is bladder problems. Second such disorder is multiple sclerosis, an autoimmune disease in which there is damage to the myelin sheath of nerve cells in the brain and spinal cord.
Next neurological disorder is Alzheimer’s disease, a progressive neurological disorder in which the brain cells gradually die that leads to memory loss, difficulty in thinking, reasoning and social skills. Last is compression of the spinal cord.
8. Elderly persons are more at risk. Though nocturia can affect persons of any age group, it is common in elderly people. As a person ages, production of hormone that concentrates urine is reduced, so he/ she is unable to hold urine until the morning.
9. In some cases, the urge to urinate at night does not wake a person, if a person wakes there is need to pass urine. This can arise in case a person has restless leg syndrome, depression, chronic pain that disturbs sleep.
Allopathic treatment for nocturia
Treating the underlying cause typically comes first. For example, if patient have sleep apnea or has prostate is enlarged, patient may need to treat that condition.
Advise your patient certain lifestyle changes, regardless of what’s causing his/her nocturia.
Lifestyle changes for nocturia include:
- Restricting fluids in the evening (especially caffeinated beverages).
- Taking diuretic medication in the morning or at least six hours before bedtime.
- Taking afternoon naps. Naps allow our bloodstream to absorb liquid, meaning patient will need to use the bathroom after a nap. This could reduce patient’s trips to the bathroom at night.
- Elevating legs while patient is sitting at home. This helps with fluid distribution.
- Pelvic floor physical therapy to strengthen patient’s pelvic floor muscles.
- Wearing compression stockings, which also helps with fluid distribution.
Allopathic medications include:
- Anticholinergics: These medications reduce symptoms of overactive bladder. Up to 40% of patients find success with anticholinergics. Examples of this type of medication include mirabegron, darifenacin, oxybutynin and tolterodine.
- Diuretics: Medication like bumetanide and furosemide assist in regulating how much pee your patient produce.
- Desmopressin: Helps kidneys produce less pee.
You should always talk to your patients about the side effects of these medicines.
Homeopathic treatment for Nocturia
Lycopodium
Urgent want to urinate, with too frequent emission, large quantities of pale urine. Frequent micturition by night, with scanty and rare discharges by day. Sometimes dark urine with diminished discharge. Greasy pellicle on the urine. Involuntary micturition. Hematuria (Bloody urine), painless. Thickening of bladder with irritable urethra.
Foamy urine. Urine deep colored, with yellow or reddish sediment or clear transparent urine, having a heavy, red, crystallized sediment. In typhus fever, where the patient is in a very low state, and cannot retain the urine. A very severe pain is felt in the back every time before urinating; causing patient to cry out; retention of urine; patients will get into position to urinate, accompanied by the characteristic pain in the back, which ceases when the urine flows.
Turbid, milky urine, with an offensive purulent sediment; dull pressure in region of bladder and abdomen; disposition to calculi; cystitis. Hematuria from gravel or chronic catarrh. Renal calculus and gravel. Itching in urethra during and after emission of urine. Burning in urethra and glans.
Phosphoric Acid
Urgent want to urinate, with scanty emission of urine. Frequent and profuse emission of aqueous urine, which immediately deposits a thick and white cloud. Urine like milk, with sanguineous and gelatinous coagulum. Fetid urine. Flow of urine with spasmodic pains in loins.
Urgent and irresistible desire to urinate. Anguish and uneasiness before urinating. Nocturnal enuresis and pass a great deal. Children’s bed wetting. Burning pain in urethra during and after emission of urine; cutting before. Creeping in urethra when not urinating. Spasmodic (painful) constriction of bladder (without urging).
Merc Solubus
Urine acrid; turbid; too frequent; complaints while passing, and after, day and night, sometimes with abortive efforts, or with scanty emission. The stream of urine is excessively small. Irresistible, sudden desire to urinate. Frequent and copious emission of urine, as in diabetes, with great emaciation. Involuntary emission of urine.
Urgent want to urinate, with incontinence of urine. The quantity of urine emitted is greater than the quantity of fluid drunk. Bed wetting. Emission of urine drop by drop. Urine as if mixed with flour or chalk, or of the color of blood, offensive, turbid urine, with sediment. Sanguineous, pungent, or sour-smelling urine.
Emission of hard mucus, or of flocks, and white threads during or after the emission of urine. Discharge of blood from urethra. Incisive and contractive pains in renal region, at night. Pulsation, incisive pains, burning and shooting in urethra, even when not urinating. Inflammation of orifice of urethra, and discharge of thick, yellowish, or serous, whitish matter. Thick greenish (or yellow) discharge from urethra, more at night, (gonorrhea) with phimosis; chancroids. 
Baryta Carbonica
Frequent inclination to urinate, with abundant emission. Urgent inclination to urinate; it can hardly be retained. During urination, burning in urethra. excessive irritation of bladder at night. Urgency to urinate at night. They have an urgent desire to urinate and are unable to retain it, if the bladder is not emptied immediately. It is one of the most suitable medicines for frequent urination in old age. It is a very beneficial medicine for prostate issues.
Cantharis
Retention of urine, with cramp-like pains in the bladder. Urgent and ineffectual efforts to urinate, with painful emission, drop by drop. Difficult emission of urine, in a weak and scattered stream. Increased secretion of urine. Urine, pale yellow, or of a deep red color. Flow of sanguineous mucus from the bladder. Emission of blood, drop by drop. Purulent urine. Incisive pains in the front part of the urethra, during the emission of urine, and afterwards. Sharp, tearing, and incisive pains, successive pulling and pulsations in the urinary organs. Burning, stinging and tearing in the kidneys. Pressing pain in the kidneys, extending to the bladder; along the ureters; relieved by pressing upon the glans. Inflammation and ulceration of the kidneys, of the bladder, and of the urethra. Exceedingly painful sensibility of the region of the bladder on its being touched.
Causticum
Involuntary when coughing, sneezing. Expelled very slowly, and sometimes retained. Involuntary during first sleep at night; also, from slightest excitement. Retention after surgical operations. Loss of sensibility on passing urine.
Sarsaparilla
Urine scanty, slimy, flaky, sandy, bloody. Gravel. Renal colic. Severe pain at conclusion of urination. Urine dribbles while sitting. Bladder distended and tender. Child screams before and while passing urine. Sand on diaper. Renal colic and dysuria in infants. Pain from right kidney downward. Tenesmus of bladder; urine passes in thin, feeble stream. Pain at meatus.
Equisetum
Severe, dull pain and feeling of fullness in bladder, not relieved by urinating. Frequent urging with severe pain at the close of urination. Urine flows only drop by drop. Sharp, burning, cutting pain in urethra while urinating.
Thuja Occidentalis
Urethra swollen inflamed. Urinary stream split and small. Sensation of trickling after urinating. Severe cutting after. Frequent micturition accompanying pains. Desire sudden and urgent, but cannot be controlled. Paralysis sphincter vesicae.
Borax
Ineffectual urgency to urinate, with incisive pains in the urethra, and swelling in the lumbar region. Urgent inclination to urinate. Frequent emission of urine even in the night. Hot urine. Acrid fetor of urine. Soreness in the urethra after micturition, and esp. on being touched, even when not making water.
Calcarea Carbonica
Tenesmus of the bladder. Too frequent emission of urine, even in the night. Wetting the bed. Deep-colored urine, without sediment. Urine red like blood, or a brownish red, of an acrid, pungent, and fetid smell, with white and mealy sediment. Passing of blood. Flow of blood from the urethra. Abundant discharge of mucus with the urine. Polypus of the bladder. Burning in the urethra, when making water, and at other times.
Natural Remedies for Nocturia
Since nocturia is typically a symptom of another condition (i.e. a urinary tract infection); try treating the condition first to help stop frequent urination at night. A few tips include:
- Modify your diet: If you have a poor diet, try eating less sugar and refined carbohydrates. Replace these with whole fruits, vegetables, whole grains, legumes, lean proteins and healthy fats. Avoid excessive alcohol intake, smoking, artificial sweeteners and food additives. Try to limit your caffeine intake during the day to help stop frequent urination at night.
- Drink water and cranberry juice: If you suffer from bladder irritation or a urinary tract infection, drink lots of fresh spring water. You can also add one to two glasses of fresh, unsweetened cranberry juice to your daily fluid intake to help clear out your system. Cranberry juice can also help reduce bladder wall irritation and prevent bacteria from infiltrating the bladder and urethral mucous membranes.
- Exercise: Regular physical activity, including pelvic floor exercises, can help prevent weight gain and constipation. It can also help prevent urinary tract infections by improving muscle tone within the bladder outlet.
P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
For proper consultation and treatment, please visit our clinic.
None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.
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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.
Senior research officer at Dnepropetrovsk state medical academy Ukraine.
Location: Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.
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