After a long day of work, lying in bed and attempting to sleep, you suddenly feel the need to urinate, causes the accumulated drowsiness to disappear. Your sleep is interrupted, and it is difficult to fall asleep again. It would be challenging to get a good night’s sleep, let alone maintain energy the following day, as the cycle would go on and on.
What is nocturnal polyuria?
Many patients are hesitant to use the restroom at night: I have a habit of drinking water before going to bed, and I use the restroom when I drink water and intend to urinate; is this normal? Is urinating at night a disease?
Under normal conditions, as long as you only need to urinate three times per night and your night time urine output is less than 1/3 to 1/4 (300 to 400 ml) of your daily urine output, it is a physiological phenomenon and there is no need to be concerned.
Nocturnal polyuria is defined as frequently waking to urinate for more than two days and more than three times per day, with urine output exceeding that of the daily (more than 300-400 ml). If this condition is interfering with your sleep, you should seek medical attention.
TCM perspective on nocturnal polyuria
Chinese medicine attributes frequent night time urination to the kidney and bladder, and the onset is closely linked to the spleen and sanjiao. Urine storage and excretion all depend on the warm nourishment and vaporisation of the kidney Yang Qi because the kidney is a water reservoir, governs water, and controls the opening and closing of the urethra and anus while the bladder is the organ in charge of body fluid. The kidney works in conjunction with the bladder. Frequent urination is caused by the lower body being cold and the kidneys being unable to store urine, according to the “Tips for The Cure,” whereas the “Su Wen: the Essentials and Fundamentals of Diagnostic Palpation” stated that incontinence of urine is caused by the bladder’s inability to shut and store urine. As can be seen, the kidneys and bladder are inextricably linked to nocturnal polyuria.
Along with the kidneys, the spleen’s ability to transport and transform fluid, the bladder, and the sanjiao all play a role in the production and excretion of urine. The spleen governs transportation and transformation, absorbing and metabolising water taken in by the body before sending nutrients to nourish the entire body’s organs. Excess water and waste are then sent to the lungs, kidneys, and bladder where they are metabolised into sweat and urine through the process of vaporisation and expelled from the body.
1. Kidney Yang deficiency
Kidney yang is the foundation of the human body’s yang, and kidney yang deficiency causes the kidney to lose the ability to control the opening and closing of the urethra. When yin qi dominates the night, the kidney is unable to store urine, and the urethra opens more frequently than it closes, resulting in nocturnal polyuria.
2. Spleen weakness
The spleen regulates transportation; spleen deficiency results in disruptions of transportation at night, obstructs the body’s metabolism in transporting body fluid, and causes excretion problems that results in frequent urination at night.
3. Bladder malfunction
Coldness in the lower body and kidney yang deficiency affect the ability of the bladder to store urine, obstructing the vaporisation process and increasing nocturnal polyuria.
Methods for reducing nocturnal frequent urination
1. Maintain your warmth in the air conditioning room
The physiological processes of the body are easily affected by cold and low temperatures, and prolonged exposure in an air-conditioned environment weakens our yang qi. As a result, some of the body parts that are more susceptible to cold, such as the lower limbs, abdomen, and waist, should be covered with clothing.
2. Reduce your water intake before bed
Less water should be consumed 2-4 hours prior to bedtime for patients with nocturnal polyuria. Even if the mouth is dry after getting up in the middle of the night to urinate, it is advised to rinse your mouth out rather than drinking water.
3. Establish the routine of urinating before bed
It is highly advised to use the restroom prior to bed, whether or not you intend to urinate, in order to properly empty your bladder and lessen night – time urination.
4. Dietary interventions
Avoid raw and cold foods that cause increased urination at night. Patients with nocturnal polyuria should avoid eating winter melon, cucumber, cabbage, white radish, sponge gourd, banana, pear, and other diuretic foods, as well as coffee, tea, and alcoholic beverages.
5. Consume more warm, dark foods.
For the health of your spleen and kidneys, consume more warm, dark foods. According to Chinese medicine’s theory of the five elements and five colours, “black colour food is associated with the kidneys.” Eat more black foods like black sesame, black beans, mulberries, black-boned chicken, and black dates if you want to supplement kidney essence.Lotus seeds, chestnuts, gorgon fruit, pork belly, and raspberries are among the foods that warm the spleen and kidneys. Vegetables to consider include chives, Chinese yam, and mushrooms.
5. Increase your lifting and training of the pelvic floor muscles
Both men and women who are elderly will experience a decline in physiological function, relaxation of the pelvic floor muscles, atrophy of the bladder muscles, and decreased elasticity due to a reduction in bladder capacity. Even a slight intention to urinate will result in a strong urinary response, and nocturnal polyuria is a common occurrence.
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