Nocturia – An Excessive Frequency of Nighttime Urination


Nocturia, aka excessive night urination frequency, is the subject of this article. Night urination frequency management is crucial because it causes short naps, weakness, and fatigue during the day. A variety of factors may harm your quality of life. How often you use the restroom at night might not be on your radar, but it should be. Getting up constantly to use the restroom might be annoying and draining. If it occurs frequently enough, it can make you feel drowsy and less able to concentrate throughout the day.

Nocturia is a medical ailment that occurs when you wake up in the middle of the night to urinate. High fluid consumption, sleep issues, and bladder blockages can all contribute. Some actions, such as limiting fluid intake and using drugs that lessen the symptoms of an overactive bladder, are included in the treatment of nocturia.


The body’s antidiuretic hormone (ADH) production instructs your kidneys on how much water to store. It’s your body’s way of keeping the water level in your blood in check so you can continue operating correctly.

ADH levels rise at night while you sleep to prevent you from waking up to use the restroom. Because ADH levels decline with age, elderly people are more likely to need to urinate at night.

Those who do not experience nocturia can typically go the entire night—six to eight hours of sleep—without going to the bathroom. You’re probably still within the typical range if you have to get up once during the night to urinate. More than once, it could be a sign of an issue that will make you feel worn out.

Dr. Danella stated that drinking too much before bed, especially diuretic drinks like alcohol or caffeine, can cause you to wake up several times at night. Certain medical disorders may make you regularly urinate when you should be sleeping.

Urological infections, interstitial cystitis, bladder and prostate cancers, bladder prolapses, and sphincter control issues are a few of these illnesses. Additionally, those who suffer from heart disease, liver problems, or poorly controlled diabetes are more likely to experience nocturia.

Dr. John Danella, a urologist at Geisinger, defined nocturia as the frequent need to urinate at night. As you age and if you have certain medical conditions, it happens more frequently.

The meaning of nocturia.

You may wake up in the middle of the night to urinate if you have nocturia. You can think of this as having a nocturnal urinary frequency or the need to urinate more frequently at night. As people age, this illness grows more prevalent and affects both men and women, sometimes for different reasons. Most people typically wake up once a night to go to the bathroom, but urinating more frequently could indicate a problem. Nocturia can occur independently or be connected to frequent urination during the day. It’s critical to distinguish polyuria (urinating too much volume) from nocturia, which is excessive nighttime urination frequency.

Nocturia vs. Polyuria

Nocturia and Polyuria

Nocturia is a typical aging symptom that significantly impacts overall health and quality of life. A side effect of nocturia is deteriorating sleep, leading to increased daytime sleepiness and decreased energy and activity. Injuries from falls, for example, are more common in accidents for seniors who experience nocturia both during the day and at night. Nocturnal polyuria, decreased bladder capacity, or a combination of the two causes nocturia. Numerous conditions, including diabetes insipidus, diabetes mellitus, congestive heart failure, and sleep apnea, can result in nocturnal polyuria. 24-hour diuresis is normal or slightly enhanced in people with nocturnal polyuria syndrome (NPS), but there is a change in diuresis from day to night. A vasopressin system malfunction causes NPS when there is no nocturnal increase in plasma vasopressin or, in some cases, no measurable hormone levels throughout the 24-hour period. With no gender differences, the estimated frequency of NPS in an aged population is around 3%. Severe sleep disturbances are present in NPS, partially due to the need to urinate. Still, there are also more difficulties falling asleep following nocturnal awakenings and more morning lethargy. Avoiding excessive fluid consumption, using diuretics in the afternoon rather than the morning, and taking desmopressin orally at bedtime are possible treatments for NPS.

Excessive nighttime urination frequency (nocturia)

You may urinate in small amounts or more frequently if you have a nocturnal urinary frequency. The total amount of urine produced is not elevated. This is usually due to an inability of the bladder to empty (this is why it fills up faster) or the bladder’s inability to fill before developing the urge to urinate (low bladder volume). This can also occur due to difficulty sleeping—you may wake up for one reason but then go to the bathroom while awake, making you think you woke up because you had to urinate.

The causes of an inability to fully empty your bladder can include the following:

The causes of an inability of the bladder to fill can include:

  • Bladder overactivity (bladder spasms).
  • Bladder infection or recurrent urinary tract infection.
  • Bladder inflammation (swelling).
  • Interstitial cystitis (pain in the bladder).
  • Bladder malignancy.
  • Obstructive sleep apnea.

An excessive amount of urine (polyuria)

Those with nocturnal polyuria only produce a large urine volume at night. Their daytime pee output is either standard or decreased. Daytime fluid retention, which frequently accumulates in the feet or legs, is typically to blame for this. Gravity no longer retains the fluid in your legs after you are asleep. Your kidneys can filter it, so urine is created when it re-enters your veins.

Among the potential causes of nocturnal polyuria are:

  • Congestive heart failure.
  • Lower extremities edema (swelling of the legs).
  • Sleep disturbances include obstructive sleep apnea (breathing is interrupted or stopped often during sleep).
  • Diuretics (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D are some of the medications that fall under this category.
  • Drinking too much liquid, especially coffee, caffeinated drinks, or alcohol, before going to bed.
  • Consuming a diet heavy on salt.

Causes of nocturia.

Frequent urination at night is a widespread issue. Ailments affecting the urinary tract at any point may cause nocturia, frequent urination at night. The urinary tract incorporates the kidneys, ureters, bladder, and urethra.

causes of nocturiacauses of excessive nighttime urination frequency

Numerous issues and circumstances may be associated with frequent urination at night, such as:

  • Contamination, illness, wound, or even chemical irritation of the bladder
  • Diseases that boost urine fabrication
  • Changes of metabolism in muscular tissues, nerves, or connecting tissues impacting bladder performance
  • Particular cancer medications
  • Prescriptions
  • Drinks (alcoholic and non-alcoholic) that enhance urine creation

Depending on what is triggering your nocturia, you may encounter other urinary complications, such as:

  • Soreness and/or burning or tenderness during urination
  • A robust urge to pee
  • Trouble urinating
  • Deficit of bladder self-control
  • Bizarre urine color

The significant causes of nocturia are:

  • Congestive heart failure.
  • Edema or lymphedema of the lower limbs (swollen legs).
  • Sleeping ailments, such as sleep apnea.
  • Particular medications, comprising diuretics, cardiac glycosides, tetracycline, lithium-containing medications, Penthrox, Dilantin, propoxyphene (opioid pain reliever used to treat mild to moderate pain), and excessive consumption of vitamin D.
  • Intake of excessive fluids before bedtimes, such as coffee, tea, caffeinated brews, or alcohol.
  • High sodium diet.

Signs and symptoms of excessive nighttime urination frequency.

You should typically be able to sleep for six to eight hours at a time without getting up to use the restroom. Nocturia causes people to get up multiple times throughout the night to urinate. This may interfere with a person’s regular sleep cycle.

Nocturia symptoms are:

  • Need more than one nighttime urinal awakening.
  • Excessive amount and frequency of urination (if polyuria is present).
  • Even after waking up, you’re still tired and sleepy. This happens as a result of frequent urination disrupting your sleep pattern.

Can nocturia be treated?

Consult your healthcare practitioner if you believe you may have nocturia. To treat the issue, he or she might suggest that you see a urologist.

The underlying reason is typically the focus of treatment. You might be recommended to a pulmonologist or sleep specialist if sleep apnea is suspected. If the prostate enlargement is to blame, treatment options could include medication or surgery.

How to stop nocturia

Regardless of the reason, nocturia may be treated with the following:

Interventions for nocturia treatment:

  • Limit fluid intake in the evening (especially coffee, caffeinated beverages, and alcohol).
  • Taking diuretics over time (take them mid-to-late afternoon, six hours before bedtime).
  • snooze in the afternoon.
  • Raise your legs (this helps prevent fluid accumulation).
  • Put on compression socks (this also helps prevent fluid accumulation).

Medications for nocturia:

  • Anticholinergic drugs can reduce the symptoms of an overactive bladder).
  • Furosemide (Lasix®) and bumetanide (Bumex®) (diuretics that assist in regulating urine production).
  • DDAVP (desmopressin) (helps the kidneys produce less urine).

Natural treatment for nocturia.

As described below, some supplements may be helpful depending on the etiology of nocturia, whereas others that are advocated for this use may not. See the links for information about dose and ConsumerLab’s Top Picks among marketed items.

To guarantee that the proper reason for your issue is determined, you must speak with your doctor if you frequently urinate at night. Diabetes mellitus or diabetes insipidus, heart failure, kidney disease, chronic pain, low levels of albumin (which maintains fluid in your blood vessels), chronic venous insufficiency, obstructive sleep apnea, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, and depression are additional conditions that have been linked to nocturia. Proper treatment for some diseases, such as sleep apnea, can lessen overnight urine. These factors can also cause nocturia, some medications, such as diuretics used to treat high blood pressure, and dietary habits (such as excessive fluid intake, alcohol use, or caffeine consumption). Weiss (2012), Rev Urol, and Kujubu (2009), Geriatric Nephrology Curriculum

Although not all studies have shown a correlation, and it is unclear how statins may induce this effect, it has been reported that nocturia and other lower urinary tract symptoms (LUTS) are caused by cholesterol-lowering statin medicines in specific individuals. An analysis of data from the FDA Adverse Event Reporting System (FAERS) between 2004 and 2011 showed that nocturia was reported 57% more often with statins than with other drugs. The FAERS can find patterns but not prove cause and effect. Reports also increased over the first 12 weeks of use, suggesting a potential link. There were also more reports of increased midday urination. Mevacor, Crestor, Zocor, Pravachol, and Lipitor. Livalo and Lescol did not seem to carry a higher risk (Fujimoto, Int J Clin Pharmacol Ther 2014).

Dietary supplements for nocturia treatment.

Nocturia can have a variety of causes, and in some circumstances, some supplements may be beneficial. For instance, beta-sitosterol, pygeum bark, pine bark extract (Pycnogenol), lycopene, and cranberry tend to help men with BPH and other prostate disorders minimize nightly urination. On the other hand, despite Saw Palmetto’s frequent promotion for reducing BPH symptoms, including nocturia, several studies indicate it is ineffective. Melatonin, cranberries, D-mannose, and AZO Bladder Control with Go Less may help women with nocturia from illnesses like hyperactive bladders or UTIs. Probiotics and vitamin D supplements are not known to be helpful. Supplemental glycine appears helpful for nocturia brought on by an overactive bladder, prostate inflammation, or other disorders in both men and women. Valerian’s assistance seemed doubtful.

Supplements for men’s nocturia

Most (but not all) studies have demonstrated that beta-sitosterol can reduce urologic symptoms in men with BPH. It is a popular component of prostate supplements.

Men with BPH may experience less nightly urination thanks to pygeum bark, an element that is frequently used in prostate supplements.

The standardized pine bark extract Pycnogenol seems to help with BPH symptoms like waking up at night to go to the bathroom more than standard management alone or some BPH medications (dutasteride and/or finasteride). It should be taken with standard BPH management, which includes staying hydrated, exercising, going to the bathroom often, avoiding long periods of sitting, and drugs that stop urine flow.

Men with HIV-positive BPH may experience fewer prostate symptoms, such as the need to urinate at night, by taking a whole-tomato dietary supplement containing lycopene.

Cranberry powders and extracts may help men with nonbacterial prostatitis or BPH and men who are getting treatment for prostate cancer with lower urinary tract symptoms (LUTS), like having to go to the bathroom more often, more urgently, and more often at night.

Saw palmetto is frequently recommended for treating BPH symptoms, such as frequent urination throughout the day and at night; however, the evidence supporting this claim is inconsistent, and several trials have failed to demonstrate any advantage over a placebo.

Supplements for treating women’s nocturia

In postmenopausal women, melatonin administration may somewhat reduce the number of episodes of midnight urination by roughly one per night. However, the amount of urine passed does not seem to be affected.

A product called AZO Bladder Control with Go Less, which includes a “unique blend” of soy germ extract and pumpkin seed extract (Go Less®), may modestly reduce the frequency and urgency of women’s nightly (and daytime) urination. There hasn’t been any proof of a benefit for guys.

Cranberry powder supplementation does not seem to lessen the requirement for nighttime urination in women with hyperactive bladders. However, cranberry juice (or perhaps cranberry pills) may help lower the risk of recurring UTIs in women, a common cause of nocturia.

Supplementing with D-mannose, like cranberry juice, may help women have less nocturia and recurring UTIs.

There is no solid evidence that supplementing with vitamin D reduces overnight urine in women with overactive bladders, even though low vitamin D levels have been associated with an increased risk of the disorder.

Probiotics may help prevent UTIs and the nocturia they cause, but there isn’t enough data to say for sure.

Supplements for both men and women to treat nocturia

If you have an overactive bladder, chronic prostatitis, bladder pain syndrome, or interstitial cystitis, taking glycine may help you sleep better at night. Although it doesn’t appear to impact daytime urination frequency.

People with overactive bladders and urine incontinence (142 men and women) took 840 mg (two capsules) of the supplement Urox (by Seipel Group) once a day for eight weeks. Compared to a placebo (color-matched cellulose), Urox cut down on overnight urination by about one episode each night. Urge symptoms subsided, and daytime urination decreased. Flatulence, urinary tract infections, and episodes of diarrhea were among the reported side effects, although two instances of diarrhea and one report of a UTI were in the placebo group. The manufacturer of Urox partially funded and carried out this study (Schoendorfer, BMC Complement Altern Med 2018). Horsetail stem, Japanese evergreen spicebush root, and unspecified volumes of pure extracts of Crataeva nurvala stem bark make up the unique mixture known as Urox.

Valerian is frequently taken as a sleep aid, and some people do so, hoping to get a better night’s sleep and fewer urination wake-up calls. The evidence for valerian as a sleep aid is conflicting, with the majority of higher-quality studies demonstrating no benefit (although it may enhance sleep in certain people), and it doesn’t appear that any studies have been done to demonstrate that valerian decreases overnight urination.

Acupuncture treatment for nocturia.

Acupuncture and Chinese Herbs for Nocturia

A form of nerve stimulation technology, acupuncture is a Traditional Chinese Medicine (TCM) technique. In medical settings, acupuncture and moxibustion can stimulate the percutaneous posterior tibial nerve and change the tone of the sacral nerve. This has an electrical nerve effect and is therefore therapeutic. Currently, acupuncture is frequently used to treat nocturia. Many clinical studies have demonstrated that acupuncture can relieve patients’ lower urinary tract symptoms and bladder function while reducing the frequency and volume of nocturia. The meta-analysis of acupuncture in the treatment of nocturia is still largely unpopulated despite certain studies on the treatments for nocturia using moxibustion and acupuncture. To thoroughly assess the clinical effectiveness of acupuncture and moxibustion in the treatment of nocturia, we will use all pertinent randomized controlled trials (RCTs) data for meta-analysis.

Homeopathic treatment for nocturia.

homeopathic treatmentHomeopathic remedies can be used to treat the issue of frequent urination effectively. The natural treatments for frequent urination are chosen based on each person’s unique symptoms. The amount of urine, color, related offensiveness, and symptom duration is written down when recommending the best medication. Additionally, the presence or absence of pain or a burning sensation during or after urination is considered. Additionally noted are the physical and mental constitutional symptoms. The best treatment for the patient to stop frequent urination is given only after thoroughly evaluating the symptoms.

  1. Equisetum Hyemale: For Significant Urine Amounts

One of the best natural treatments for treating frequent urination is Equisetum hyemale. The primary symptom requiring its use is a persistent urge to urinate and, when urinating, a lot of urine. This ailment may bother you the most at night. Most of the urine passed is clear. Equisetum hyemale is the best treatment for sudden, intolerable urges to micturate or urinate. The urge to urinate might be nearly constant for some people. The person may urinate frequently and feel intense discomfort when passing urine or right after. The accompanying symptoms include bladder pain, discomfort, and persistent pee that persists even after urinating. Additionally, Equisetum Hyemale is the best treatment for kids who frequently wet their beds at night.

  1. Cantharis and Merc Cor: For Persistent Urinary Insufficiency (Tenesmus) with Burning

When there is a continual desire to urinate, but the urge is nearly ineffective since it returns shortly after urinating and the individual is not pleased, the natural medications Cantharis and Merc Cor are the finest options. The most noticeable side effects of utilizing both treatments include burning in the urethra and a persistent urge to urinate. The burning duration in the urethra is a reason to select one of these treatments. Burning occurs while taking Cantharis before, during, and after urinating. Merc Cor is utilized when the urge to urinate is marked by urethral burning. Blood in the pee and heated urine are two additional typical side effects of these medications. Additionally, the urine is sparse or is passed drop by drop.

  1. Lycopodium: The Finest Natural Treatment for Frequent Nighttime Urination Lycopodium is the best natural remedy for frequent nighttime urination. The Lycopodium user frequently wakes up at night to urinate. The amount of pee evacuated may be small or substantial, but night aggravation is noticeable. Lycopodium is also the best treatment for cystitis, bladder calculi, or an enlarged prostate that causes nighttime urination. When using Lycopodium for frequent nighttime urination, the urine may be clear, frothy, milky, pale, dark, or any combination thereof. Back pain that worsens before urinating is one distinguishing aspect of frequent urination. The craving for sweets, hot beverages, and warm food is a significant constitutional symptom. Frequent urination may also be linked to gastric symptoms such as abdominal gas, burping, and constipation.
  2. Urinary Tract Infection-Related Frequent Urination (UTI)

The natural remedies with the highest success rates for frequent urination due to UTI include cantharis, apis mellifica, merc cor, and sarsaparilla. The most typical side effects of employing these medicines include frequent urination and a urethral burning feeling. The best treatment for persistent urethral burning that occurs before, during, and after urination is cantharis. When there is a continual need to urinate and burning in the urethra when passing the last drops, Apis mellifica is the best natural cure. Merc Cor is a helpful medication for urethral burning that occurs before passing urine and is associated with a frequent need to urinate. For frequent urination with burning in the urethra after urine, sarsaparilla is a very effective therapy.

  1. Frequent Nighttime Urination

Most problematically, frequent urination occurs at night since it interferes with sleep. Top natural therapies for frequent nighttime urination include Lycopodium, Mercurius Solubilis, and Kreosote. When the urge to urinate is strong at night, lycopodium is the best treatment. Before utilizing Lycopodium, back pain may be present. Mercurius solubilis is a beneficial medication for nighttime urination, and increased thirst is desirable. Kreosotum is the best treatment if the urge to urinate is frequent at night and the urine is foul.

  1. Constant Urination in Cases of Enlarged Prostate

Herbal remedies, Lycopodium, Staphysagria, and Sabal Serrulata, are beneficial for treating frequent urination by an enlarged prostate. The most popular medication for treating cases of frequent urination in prostate situations is Sabal Serrulata. It can be used when a person experiences frequent urges to urinate that could be uncomfortable. Sabal serrulata is also necessary in cases of enlarged prostates where frequent nighttime urination is aggravated. Lycopodium is the treatment for frequent nighttime urination due to an enlarged prostate. It is utilized in prostate situations where frequent urination is accompanied by back pain before urinating. Homeopathic natural medicine When there is persistent pressure in the bladder and an intense burning sensation when passing urine, Staphysagria is particularly helpful.

Natural treatment for excessive nighttime urination frequency in Philadelphia.

If you or someone you love suffers from excessive nighttime urination frequency and prefers holistic nocturia treatment, the Philadelphia Holistic Clinic is the right place. Based on customer reviews and national media reports, our holistic center is #1 in service quality and success rate. Dr. Victor Tsan gathered the best holistic providers practicing in the clinic in the area. We use traditional Chinese acupuncture provided by Dr. Da Wei Hu Lac, who has an extensive educational background in China. Dr. Tsan is one of the best homeopathic practitioners alive worldwide, with 45+ years of academic and clinical experience. He is also a Reiki master trained in India. Victor Tsan, MD, is also a hypnotist, trained in London’s best hospital under the supervision of Johnathan Royle.  To schedule an initial holistic evaluation appointment and discuss your best treatment options with Dr. Tsan, contact Philadelphia Holistic Clinic at (267) 403-3085 or use our secure online application.