Nocturia - Want to stop frequent urination at night?

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What is Nocturia?

Nocturia is a condition in which you wake up during the night because you have to urinate. As we get older, more and more people suffer from Nocturia. Some study shows, about 60% in the 50s and 80% in the 60s or older are awake more than once during the night.

According to the Western medicine, the causes can include high fluid intake, sleep disorders, bladder obstruction, and decreased function of internal organs. Still, about one-third is due to 'overactive bladder,' which is caused by autonomic nerves disturbed so that the contractile function of the bladder occurs.

Nocturia is also seen among women in the early perimenopausal stage. There might be an association between decreasing estradiol levels and disturbance of autonomic nervous system.

Most of the Nocturia is also "Nocturnal polyuria”. If one-third of the daily urine volume is present at bedtime, it becomes Nocturnal polyuria.

Usually, the amount of urine at night decreases compared to the daytime, but with aging, the amount of "antidiuretic hormone" that reduces the amount of urine at night decreases, and the kidneys' function that concentrate urine declines. As a result, the amount of urine produced in the middle of the night increases.

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Treatment

Treatment of Nocturia by Western medicine includes certain activities, such as restricting fluids or medications that reduce symptoms of overactive bladder. However, there are side effects of using drugs, such as stomatitis and constipation.

Case Treatment by Acupuncture

Clinical manifestations: Nocturia, frequent-pale urination, feeling cold, cold lower back and knees, lower backache, dizziness, tinnitus, exhaustion, nocturnal enuresis in children, incontinence in old people, Impotence, low libido in men, menstrual disorders in women.

Tongue: Pale & Wet. Pulse: Deep-Weak.

Diagnosis: Kidney-Yang deficiency  Treatment principle: Tonify and warm Kidney-Yang, strengthen the Governing Vessel.

Acupuncture Points: BL-23 腎兪, BL-20 脾兪, S.I.-3 後渓 with BL-62 申脈, Du-4 Mingmen 命門(with moxa), Du-20 百会, Ren-6 気海, Ren-4 関元, KI-3 太谿. All with reinforcing method.

self-treatment

If the cause of Nocturia is overactive bladder, there is a way to improve it safely at home.

1) “Rubbing the back of the leg" exercise

All you have to do is rubbing the back of your leg, include the back of the calf, knee, and thigh, where the nerves related to the bladder concentrate, and also, bladder meridian runs there according to the traditional Chinese medicine. Please massage slowly and gently for a few minute with your both hands, tennis ball, or massage roller. We recommend to do it after taking a hot bath, hot shower, and after your skin is dry.

By rubbing your back of the leg, you can reset your autonomic nervous system. There are reports among our patients who have improved Nocturia with the massage. One of the patients who were showing menopause symptoms, used to wake up twice for urination during the night, but now she only wakes up once after practicing this exercise.

If you are spending time in the same posture - sitting or standing - during the day, the body's water will accumulate in the lower limbs due to gravity. Furthermore, as you age, the ability to circulate blood declines, causing water in your legs to leak from your blood vessels and accumulate in your calves. This leads to Nocturia as well as "swelling feet" at night. Some people call the calf the ”second bladder” because the water they ingest during the day accumulates in the calf. By rubbing your calf, it is possible that you can decrease the water accumulation. Additionally, elevating the legs and wearing compression stockings will greatly help prevent fluid accumulation.

2) Warm the bedding before going to bed. It is said that the temperature of the bedding that leads to a good night's sleep is a little lower than your body temperature. Warm your bedding with a Futon dryer or a heated mattress pad. The Futon dryer warms and dries mattress and comforter by forcing warm air through it.

3) Take foot bath, hot bath or hot shower before go to bed. You can improve blood flow by soaking your feet in a foot bath with hot water (109.4F (43C)). Or, use Foot Spa Bath Massager. In the bathtub, make sure to massage your scalp, feet and back of calves to improve blood circulation.

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*This care method works only for Nocturia caused by the overactive bladder. If it doesn't work, you need to suspect a serious illness, such as angiopathy, heart disease, diabetes, or visceral dysfunction. Please consult your physician.

Reference:

Nocturia

“40代から急増する夜間頻尿 第二の膀胱ふくらはぎが原因かも”

“夜間頻尿の原因「過活動膀胱」防ぐための「骨盤底さすり」“

Maciocia, Giovanni, The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs, Second Edition