Nighttime Potty

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Many patients I see have difficulty sleeping because they have to go to the bathroom multiple times during the night. Men are often told it has to do with their prostate being enlarged while women are often told they have a distended or prolapsed bladder.

While these problems may cause people to urinate more frequently in daytime or nighttime, the dysfunction of the Autonomic Nervous System is the most common cause of frequent nighttime urination.

This is why most of the medicines prescribed for frequent urination because of prostate or anatomical bladder problems have their effect by changing how the Autonomic Nervous System functions.

The Autonomic Nervous System is our brain’s master control mechanism for running our body. The Autonomic Nervous System controls all organ function (bladder, intestines, heart, etc.), regulates most hormones, and it controls inflammation and other aspects of our immune system.

When the Autonomic Nervous System quits functioning correctly people begin experiencing problems such as frequent urination, heartburn or constipation, and headaches.

One of the most difficult jobs your Autonomic Nervous System performs is regulating the proper pressure of blood upwards into the upper half of the body when you are in the upright position. The two main branches of the Autonomic Nervous System have to control the changes in pressure in both the lower extremities and up in the head.

If your Autonomics are not functioning correctly, gravity will prevent you from getting enough oxygen and blood pressure up into your head and this results in a lightheaded or dizzy sensation when you stand up quickly. This poor response to gravity when there is a change in position is called orthostatic intolerance.

Orthostatic intolerance may also cause unexplained anxiety or neck pain and tightness when you are sitting or standing still. Other abnormal orthostatic responses when someone stands up include erratic elevations in blood pressure (white coat syndrome), excessive increase in heart rate (tachycardia/POTS), decreases in heart rate (bradycardia), or decreases in blood pressure (hypotension).

Our brain temporarily compensates for the symptoms of low brain blood pressure involved in orthostatic dysfunction by directing us to get up and walk around, to fidget our muscles such as foot tapping or being hyperactive, by sitting with our leg crossed underneath us, or by compelling us to exercise. We also get the same temporary boost by eating carbs or sugar, drinking liquids, or by smoking nicotine. All of those things can help us get through our day when we are impaired by low brain blood pressure.

But there is a price to pay at the end of the day that interferes with our ability to sleep through the night. Low pressure in the brain triggers an increase of thirst during the day. Drinking more liquids temporarily improves blood pressure in the brain. But this low pressure also prevents your kidneys from making as much urine as normal during the day.

The consequence of drinking more than normal, plus urinating less than normal, results in an excessive amount of water collecting in the lower half of your body while you are in the upright position (sitting, standing, or walking around) throughout the day.

At night when you lay flat to sleep the excessive fluid that was abnormally collecting in the lower half of your body shifts to the upper portion of your body just as a half full bottle of water will when tipped on its side. Suddenly your kidneys are presented with an excessive amount of fluid that needs to be filtered and turned into urine.


Understanding the mechanics behind numerous nighttime bathroom trips and how they are a response to Autonomic Nervous System dysfunction may help you work towards sleeping through the night.

First, you need to know that Autonomic dysfunction is capable of improvement. The old way of thinking in the field of Autonomics was that once damaged or broken, our Autonomics could be stabilized but that they probably would never recover. My medical discovery is that our Autonomics are indeed capable of improvement or repair, and the tools I use to accomplish this in my patients may be surprisingly simple for many people.

Second, you need to understand that lowering your inflammation is the key to your cells and systems functioning again. A low inflammatory environment is created by reproducing the natural environment our cells enjoyed before omega-6 vegetable oils (soybean oil, soy oil, safflower oil, grapeseed oil, etc.) and margarines were added to our foods, and before modern medicines, surgeries, pollution, and chemicals altered our intestinal bacterial flora. I commonly prescribe dietary shifts for my patients such as eliminating omega-6 oils from foods, maintaining a healthy balance of intestinal bacterial by consuming the prebiotic fiber inulin, and discontinuing all probiotics.

Third, there are additional nutritional steps to improve Autonomic function that are found in giving the brain and nervous system the critical core nutrients they require by supplementing with both omega-3 fatty acids in fish oil, and with two tablespoons per day of omega-9 found in authentic domestic (California Olive Council certified) extra virgin olive.

Fourth, know that inflammation is not just about what we eat but also how we cook it. Cooking methods can make a substantial difference in our levels of inflammation. When foods are cooked hot and quickly they make abnormal molecules called advanced glycation end products (AGE’s) that contribute to inflammation and our premature aging. I cook slowly and at low temperatures with crock pots and by sous-vide (water bath) methods to cut down my exposure to AGE’s.

And fifth, some people over the age of 40 need more anti-inflammatory measures and I may prescribe Vagus nerve stimulation (tVNS) for my patients. Thanks to decades of work by Dr. Kevin J. Tracey, M.D. we now understand how the Vagus nerve in the Autonomic Nervous System suppresses inflammation. Stimulating the Vagus nerve helps regulate and reduce harmful inflammatory cytokines. This stimulation is a form of non-invasive bioelectrical medicine that some of my patients use every day to helps to lower their inflammation.

Vagal nerve stimulation is a doctor-prescribed medical treatment and it should not be initiated on one’s own or by a medical professional who does not understand exactly what they are doing to the patient. Failure to perform tVNS correctly, and the use of some frequencies, may result in permanent damage to the Vagal nerve. Vagal nerve stimulation should never be done while pregnant.

I have been testing and treating the Autonomic Nervous System for 12 years and I have developed a treatment program called “The Nemechek Protocol™ for Autonomic Recovery” (Patent Pending) that is specifically designed to reduce multiple sources of inflammation and restore the body’s natural brain repair mechanism.

I believe that the key to restoring our natural inflammation control mechanisms is through a reduction of inflammation throughout the brain and body by using every scientific, nutritional, and bioelectric tool available.

I am an internal medicine physician (D.O.) from UCLA and my Internal Medicine and Autonomic practice is in the Phoenix, Arizona area. For additional information, go to

This post is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, and it does not create any patient-physician relationship.

© 2018. Nemechek Consultative Medicine, Inc. All Rights Reserved.

Patrick Nemechek, D.O.

Patrick Nemechek, D.O.

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