Are you suffering from a urinary tract infection? And the symptoms are getting worse at night? Is it making your night sleepless? Do you have to go for urination again and again?
This is really a troublesome condition. So, what may be the cause of the worsening of symptoms at night? And what can we do to deal with this irritating situation?
Let’s have a discussion of this issue in this article. Urinary tract infection is a very common condition, especially for women.
It usually presents with increased frequency of urination, urgency, burning sensation during urination, lower abdominal pain, fever, etc.
In many patients, these symptoms increase at night. Many patients say that their increased fever, urgency, the frequency of voiding, etc. make the night dreadful. And this nighttime presentation is also found more among women.
It does not occur in every patient, but it is not very uncommon.
Why the symptoms of UTI worsen at night?
It is really a debated topic.
Why this is happening, why not in every patient, and what are the stimulating factors?
All of these questions are still confusing to doctors. But there are few explanations about the mechanism of this issue.
Doctors explain it from various angles. We are going to discuss those in brief.
1. Lack of distraction of mind at night:
You will easily understand that we have less work to do at night.
In the daytime, we have to take care of a lot of personal, familial, and professional responsibilities.
We also have to think of many other topics even if we are ill. So our brain gets busy with those.
You probably know that our micturition reflex is not only an autonomic reflex, but it also has a psychogenic part, too.
That means, though the urge to urinate is initiated by stimulation from the bladder, it may be affected by your wish.
When you have a urinary tract infection, there is an irritation of the bladder wall which continuously sends an autonomic response.
Though, the bladder is not full. When you are busy, this autonomic reflex is reduced by an inhibitory signal from the brain.
At night, your brain is less busy. So, it continuously receives the stimuli from the bladder and you feel frequent urge to urinate.
Sometimes the urge becomes so frequent that you may have to pass a sleepless night.
2. Decreased cortisol secretion:
Our body produces a lot of hormones that regulate different systems of our body.
Corticosteroids or cortisol are a group of hormones produced by the adrenal gland which has a powerful effect on the various system of the body.
The most important effect of cortisol is that it suppresses the immune system and reduces inflammatory reaction.
It reduces your fever, pain, etc by inhibiting white blood cells and other inflammatory mediators.
The secretion of cortisol has a diurnal variation.
It is secreted more in the morning and reduces at night. So, at night, the white blood cells and other inflammatory mediators get a chance to work strongly.
To make it simple, your body fights against infections more vigorously at night.
So you may suffer from increased fever, abdominal pain, restlessness, etc at night.
All of these are signs of the battle which take place between your immune system and the bacteria.
This happens not only in urinary tract infection but also during other diseases especially infections.
3. The release of pro-inflammatory cytokines at night:
The cytokines are chemical mediators secreted by white blood cells. They regulate the immune system of the body by different biochemical pathways. Pro-inflammatory cytokines are produced more at night.
During illness like UTI, the pro-inflammatory cytokines are produced more which causes fatigue, tiredness, dizziness, etc. And all of these create a feeling of increased illness in you.
4. Collection of concentrated urine:
Have you ever noticed that your urine production is lower at night? Just think a little, you have to pass urine several times a day but only once or twice at night.
This is a normal phenomenon. Our body secretes ADH ( antidiuretic hormone) at night which reduces urine production at night. But the fact is, though the urine volume is lower, the concentration is higher. And this concentrated urine stays longer in the urinary bladder.
The bacteria multiply rapidly in this concentrated urine.
Now, the concentrated urine cause more irritation of the bladder wall and urinary tract. So, there is increased frequency and burning sensation during micturition.
Many patients complain of UTI symptoms only at night.
Probably this is the explanation of their problem. They have a mild infection. And they only notice the symptoms at night when the urine is more concentrated.
5. Bladder contraction:
This is also related to bacterial load in the urine.
High bacterial load irritates the bladder muscle which may cause frequent contraction of the bladder.
It leads to the development of spasmodic pain. As the urine is more concentrated at night, the pain occurs more at night.
You may note that all patients do not get this kind of worsening at night. Because our body and its immune system differ from person to person. So, the presentation of the disease also differs.
Most of the patients do not feel the difference between day and night. But some patients, in whom the described mechanisms predominate, suffer from nighttime symptoms.
And also note that the mechanisms described above are just some explanations and hypotheses from doctors & scientists.
We still need further research to be confirmed.
How to get rid of these tiresome UTI symptoms?
So what can you do when you are going through a restless, sleepless night? It is really a bad situation.
First of all, you must contact your doctor for proper diagnosis and treatment. Because it may not even be a UTI.
There are some conditions that may mimic UTI. However, it may not be possible for you to find a doctor at midnight.
We are going to discuss some ways which may give you some relief. Let’s have a look.
1. Warm sponging or hot water bottle:
Place a hot water bag or bottle on your lower abdomen or in between the thighs.
It will help you to reduce bladder spasm and lower abdominal pain. Be careful, don’t use too hot water, and don’t sleep keeping in on your tummy. It may burn your skin.
If you have a commercially available warm water bag, that’s good. If you don’t have one, no worry. Take a hot water bottle and wrap it with clothes. Check the temperature whether it is tolerable to the skin. You can use it.
or you can have a nice hot water bag with it’s clothe wrap by ordering from amazon check out its price here.
2. Phenazopyridine:
It is an excellent drug to reduce the symptoms of urinary tract infection rapidly. I say it’s the best way to deal with UTI symptoms at night.
It will not cure the UTI as it can’t kill the bacteria. But it will reduce your burning sensation, frequency, urgency, abdominal pain, etc.
It is a Category-B drug. That means it can be used even when you are pregnant.
You will find it as a tablet form by different names like Pyridium, Azo, Urisept, etc.
The usual dose for an adult is 200mg tablet thrice daily. Don’t continue it for more than two days unless advised by your doctor.
More about phenazopyridine is in the how to get rid of UTI fast article.
As we said earlier phenazopyridine is sold under many commercial names with AZO and URISEPT being the most famous ones, AZO being the most wildly used and trusted around the world.you check it’s price on Amazon.
3. Lemon juice:
It is a very cheap and easily available remedy for burning sensation. Lemon contains citric acid which helps to regulate the acidity of urine and reduce dysuria.
You can take lemon in any form either as juice or with food. It is effective just like commercially available citrate drugs. But lemon juice is much safer and cheaper than those.
for more information about this subject please visit the UTI home remedies article.
4. Cranberry juice:
Cranberry extract, tablet, and juice are being used traditionally for treating UTI. Though recent studies did not find strong evidence regarding its efficacy, it is helpful in treating UTI. Especially when used along with antibiotics, it helps to reduce symptoms fast.
5. Urine alkalinizing drugs:
There are some drugs like Citra-K, Urikal, etc which contain Citric acid and potassium citrate. You will find those as syrup or solution.
Just mix two teaspoonful syrup in one glass of water and take it.
It reduces the acidity of urine and thus reduces burning sensation during urination. You will get immediate relief from dysuria.
However, these drugs are more effective when UTI and kidney stone coincide.
And long term use of these agents without the supervision of a doctor is not recommended.
6. Anti-spasmodic drugs:
One of the causes of your lower abdominal pain and frequency is the bladder spasm.
So, an anti-spasmodic drug will help you. You can take Tiemonium methylsulfate is a good choice to reduce bladder spasm and pain. You may take a 50 mg tablet three times daily.
7. Herbal tea:
If you like herbal medicines, there are some options for you. You can take peppermint tea which may help you. It boosts the immune system and increases the antibacterial activity of the body.
the peppermint tea for UTI article discusses this subject with more details. Chamomile tea is another herbal tea. These teas are not able to cure you directly. But they will reduce your restlessness and promote good sleep.
8. Apple cider vinegar:
You might have heard about the use of apple cider vinegar to cure UTI. But a recent study denied that claim.
It can’t cure UTI, but it may help to reduce symptoms and prevent further infection.
But don’t use it as a bath. Because it actually can’t reach the urinary tract via the vagina. You can drink it with water or fruit salad. A good option is to mix with cranberry juice. Hope you will get some benefit.
for more information about this subject please read the apple cider vinegar for UTI article.
9. Avoid coffee, alcohol, and spicy foods:
You might have the habit of taking excessive coffee, alcohol, or spicy foods. Please avoid those during this illness.
Because these foods have an irritating effect on the bladder and may worsen your frequency of urination.
Now, please be advised that these home remedies are not an alternative to antibiotic therapy. Don’t forget that, UTI is caused by bacteria and the substances described above can’t kill them.
These are just to reduce your suffering temporarily during the night. Don’t ignore your disease if the symptoms are alleviated. Because long term UTI without antibiotics may reach your kidneys and make the situation complicated.
So, always visit your doctor for proper treatment. So, that’s the end of the article.
Don’t forget to give your feedback if this was helpful to you. Thanks for reading. Have a nice day.