Effect Of Nocturia Research Articles

Effect of nocturia in patients with different severity of obstructive sleep apnea on polysomnography: A retrospective observational study

ObjectiveObstructive sleep apnea (OSA) is one of the etiologies of nocturia. We analyzed polysomnography (PSG) results to determine correlated factors related to nocturia in OSA patients with different severity. MethodsPatients with suspected OSA were examined using PSG. They were divided into two groups based on the presence of nocturia. Nocturia was defined as a patient who needed to void at least once. Apnea–hypopnea index (AHI) was employed to classify patients according to degrees of severity: AHI<5 events/h, 5 events/h≤AHI<15 events/h, 15 events/h≤AHI<30 events/h, and AHI≥30 events/h, defined as normal, mild OSA, moderate OSA, and severe OSA, respectively. Demographic variables, PSG parameters, International Prostate Symptom Scores (IPSSs), and quality of life scores due to urinary symptoms were analyzed. ResultsIn total 140 patients, 114 patients had OSA (48 had mild OSA; 34 had moderate OSA; and 32 had severe OSA) and 107 patients had nocturia. The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients. With the increasing severity of OSA, more correlated factors related to nocturia were determined. In mild OSA patients, nocturia related to increased age (p=0.025), minimum arterial blood oxygenation saturation (p=0.046), and decreased AHI of non-rapid eye movement (p=0.047), AHI of total sleep time (p=0.010), and desaturation index (p=0.012). In moderate OSA patients, nocturia related to increased age (p<0.001), awake time (p=0.025), stage 1 sleep (p=0.033), and sleep latency (p=0.033), and decreased height (p=0.044), weight (p=0.025), and sleep efficiency (p=0.003). In severe OSA patients, nocturia related to increased weight (p=0.011), body mass index (p=0.009), awake time (p=0.008), stage 1 sleep (p=0.040), arousal number (p=0.030), arousal index (p=0.013), periodic limb movement number (p=0.013), and periodic limb movement index (p=0.004), and decreased baseline arterial blood oxygenation saturation (p=0.046). ConclusionOur study revealed that there were more correlated factors related to nocturia with increasing severity of OSA. This study helps in clinical education and treatment for OSA patients with different severity.

The Effect of Nocturia on Sleep Quality in Patients with Benign Prostatic Obstruction and Their Female Partners

The Effect of Nocturia on Sleep Quality in Patients with Benign Prostatic Obstruction and Their Female Partners

Effect of Nocturia on Quality of Life among Clients with Benign Prostatic Hyperplasia.

Effect of Nocturia on Quality of Life among Clients with Benign Prostatic Hyperplasia.

Sleep quality matters more to community-dwelling individuals than nocturia frequency

Objective: The objective of this study is to identify variables that describe nocturia-related bother in a sample of community-dwelling individuals. Materials and methods: Community-dwelling individuals age 40 years and older who woke to pass urine at night completed an online questionnaire. Participants were asked (i) their top three concerns in relation to nocturia, (ii) to agree or disagree with a list of statements related to bother, and (iii) to complete the Nocturia Impact Diary items. Fisher exact test and the Mann–Whitney U test were used to assess whether differences in nocturia-related bother existed when comparing participants stratified by nocturia severity. Results: Moderate to extreme nocturia-related bother was described by 56% of the 202 respondents and by 68% of individuals with nocturia two or more times per night. Effects of nocturia, specifically sleep disruption and impact on daytime function, were the most cited concerns. Low nocturia-related health literacy was evident. The sample was younger (83% age &lt;70 years), predominantly female (74%) and nocturia treatment naïve (95%). Conclusion: The study highlights the potential to evaluate patient care based on change in sleep and daytime function rather than solely on nocturia frequency. A suite of patient-reported outcome measures adjunctive to clinical data may have utility in quantifying meaningful change to patients after treatment for nocturia. Level of evidence: Not applicable for this multicentre audit.

Current guidelines and treatment paradigms for nocturnal polyuria: A "NEW" disease state for US physicians, patients and payers.

Nocturia is one of the most bothersome symptoms encountered in urology, and its prevalence rises with age. Causes include both urological and non-urological aetiologies, often in combination. The effects of nocturia on a patient's quality of life can be detrimental. The initial approach to managing this condition includes appropriately classifying nocturia based on the results of a 24-hour bladder diary. Broadly, the categories under which nocturia can be classified include: low nocturnal or global bladder capacity, nocturnal polyuria, global polyuria and mixed.Based on the type of nocturia and possible underlying causes, clinicians can appropriately discuss with patients the treatment plans that may include a combination of behavioural, pharmacologic, and invasive therapy. The available literature on the management of nocturia was reviewed. Findings were incorporated into a practice-based approach for its workup and treatment.

The Degree of Bother of Nocturea on Quality Of Life in a Group from Al-Diwaniya Population.

Nocturia is common and disrupts sleep. Traditionally,one nightly episode has been regarded as clinically meaningless.To evaluate the bothersome effect of nocturia on health related quality of life (HRQoL) in a group from Al-Diwaniya population. Patients and methods: In 2006–2008,a survey was made on a random sample of 600 patients aged 18–79 yr who were identified from Al-Diwaniya teaching hospital,proportion was 62% males and 38% were females).bother from nocturia on QoL were examined in relation to self-reported nocturia frequency (using the American Urological Association Symptom Score). Bother from nocturia was assessed on a four-point scale (none,small,moderate,major). Degree of bother increased with nocturia frequency (p &lt; 0.01). The most commonly cited degree of bother for those with one,two,and three nightly voids was no bother,small bother,and moderate bother,respectively. At least two voids per night are bothersome and associated with impaired HRQoL. The majority of people report having bothered when the number of nocturia episodes is two and moderate or major bother when the number is three or more. One void per night does not identify subjects with interference from nocturia and,thus,is not a suitable criterion for clinically relevant nocturia.

Effect of nocturia on next-day sedentary activity in adults with type 2 diabetes

PurposeNocturia, a common cause of disturbed sleep quality and next-day fatigue, may contribute to difficulty with diabetes self-management. The purpose of this study was to examine the effect nocturia has on next-day subjectively measured mental and physical energy and objectively measured physical activity. MethodsThis secondary analysis utilized sleep diaries over one week which measured nocturia frequency and other sleep quality indicators (wake after sleep onset, sleep quality and sleep duration) along with next-day reports of mental and physical energy. Next-day physical activity was measured with the BodyMedia Sensewear armband. ResultsSleep quality and sleep duration were associated with next-day physical and mental energy. Nocturia frequency (≥2 times per night) was associated with increased next-day sedentary activity. ConclusionThese results suggest that nocturia could negatively affect next-day physical activity in people with diabetes.

The burden of nocturia among middle-aged and older women.

To examine the prevalence, predictors, and effects of nocturia in women and evaluate overlaps with established urinary tract disorders. This was a cross-sectional analysis of 2,016 women, aged 40 years and older, recruited from Kaiser Permanente Northern California from 2008 to 2012. Nocturia and other urinary symptoms were assessed using structured interviewer-administered questionnaires. Nocturia was defined as patient-reported nocturnal voiding of two or more times per night over a typical week. Thirty-four percent (n=692) reported nocturia, and 40% of women with nocturia reported no other urinary tract symptom. Women with nocturia were older (mean age 58 compared with 55 years) (odds ratio [OR] per 5-year increase 1.21, 95% confidence interval [CI] 1.12-1.31), more likely black (45%) (OR 1.75, 95% CI 1.30-2.35) or Latina (37%) (OR 1.36, 95% CI 1.02-1.83) compared with non-Latina white (30%), have worse depression (mean Hospital Anxiety and Depression Scale score 3.8 compared with 2.8) (OR per 1-point increase in Hospital Anxiety and Depression Scale score 1.08, 95% CI 1.04-1.12), and worse mobility (mean Timed Up-and-Go 11.3 compared with 10 seconds) (OR per 5-second increase in Timed Up-and-Go 1.29, 95% CI 1.05-1.58). Nocturia occurred more among women with hysterectomy (53% compared with 33%) (OR 1.78, 95% CI 1.08-2.94), hot flushes (38% compared with 32%) (OR 1.49, 95% CI 1.19-1.87), and vaginal estrogen use (42% compared with 34%) (OR 1.50, 95% CI 1.04-2.18). Nocturia is common in women and not necessarily attributable to other urinary tract disorders. Factors not linked to bladder function may contribute to nocturia risk, underlining the need for multiorgan prevention and treatment strategies. II.

Factors associated with the night-time index fall in an older hip fracture population

PurposeWe examined factors associated with the night-time index fall in a population-based sample of hip fracture patients with a specific focus on the effect of nocturia and visits to the bathroom with falling at night. Material and methodsThe study population comprised 849 (69%) hip fracture patients aged 65 years and over. Data were collected by means of interviews. Age- and gender-adjusted and multivariate logistic regression analyses were used. ResultsOf these patients, 122 (14%) had fallen between midnight and 06:00. Of the night-time fallers, compared to the daytime fallers, 38% vs 9% had fallen on the way to the bathroom. Of these, 95% reported nocturia at least once. After adjusting for age and gender, age at least 90 years, taking 4–10 or more than 10 medications, reporting any nocturia or nocturia more than three times, fall on the way to the bathroom, non-independent mobility level and use of any walking aid were significantly associated with falling at night. In the multivariate analysis, having fallen on the way to the bathroom (OR 4.45; 95% CI 2.65–7.46), reporting nocturia more than three times (OR 2.44; 95% CI 1.15–5.16) and having non-independent mobility level (OR 1.84; 95% CI 1.08–3.11) remained significantly associated with falling in the night-time. ConclusionsFalling on the way to the bathroom, severe nocturia and mobility impairment were independently associated with night-time falls in older hip fracture patients. The findings offer insights into understanding night-time falls and into preventing of falls and fractures in the oldest and frailest older population.

Evaluation and management of patients with nocturia

Nocturia, or awakening one or more times to void at night, becomes clinically significant with two or more voids a night. In the past, nocturia has typically been viewed as a symptom of benign prostatic hyperplasia and/or overactive bladder syndrome. However, newer evidence supports that this is no longer just a symptom but a medical condition that warrants further workup and treatment given its effect on quality of life. The negative effects of nocturia include sleep fragmentation, decreased productivity at work, and increased risk of falls and fractures. A workup to find the underlying cause of nocturia will help guide treatment, which may include pharmacologic agents.

Efficacy and Safety of Low Dose Desmopressin Orally Disintegrating Tablet in Women with Nocturia: Results of a Multicenter, Randomized, Double-Blind, Placebo Controlled, Parallel Group Study

Previous studies suggest a lower dose of desmopressin orally disintegrating tablet may be effective in females compared to males with nocturia. We confirm the efficacy and safety of 25 μg desmopressin orally disintegrating tablet compared to placebo in female patients. In this 3-month, randomized, double-blind, parallel group study 25 μg desmopressin once daily was compared to placebo in women with nocturia (2 or more nocturnal voids). The co-primary efficacy end points were change from baseline in mean number of nocturnal voids and proportion of patients achieving at least a 33% reduction from baseline in the mean number of nocturnal voids (33% responders). The full analysis set comprised 261 patients (age range 19 to 87 years). Desmopressin significantly reduced the mean number of nocturnal voids and increased the odds of a 33% or greater response compared to placebo during 3 months, assessed by longitudinal analysis (-0.22, p = 0.028 and OR 1.85, p = 0.006, respectively). Desmopressin increased the mean time to first nocturnal void by 49 minutes compared to placebo at 3 months (p = 0.003). The response to desmopressin was seen by week 1 of treatment and was sustained throughout the trial. Significant increases in health related quality of life and sleep quality were observed compared to placebo. Desmopressin was well tolerated. Serum sodium levels remained greater than 125 mmol/L throughout the trial and 3 transient decreases to less than 130 mmol/L were recorded. At a dose of 25 μg, desmopressin orally disintegrating tablet is an effective and well tolerated treatment for women with nocturia. Treatment provides rapid and sustained improvement in nocturia and quality of life.

Associations Between Improvements in Lower Urinary Tract Symptoms and Sleep Disturbance Over Time in the CAMUS Trial

We recently reported an association between the bother and severity of lower urinary tract symptoms secondary to benign prostatic hyperplasia and the severity of sleep disturbance. However, few studies have examined whether alterations in the severity of urinary symptoms influence the degree of sleep problems over time. The severity of lower urinary tract symptoms in men enrolled in CAMUS (Complementary and Alternative Medicine for Urological Symptoms), a clinical trial of saw palmetto (Serenoa repens), was evaluated using AUASI (American Urological Association symptom index) and quality of life scores. Sleep disturbance was evaluated by the Jenkins sleep scale at 0, 24, 48 and 72 weeks. Statistical analyses were used to assess the relationship(s) between changes in lower urinary tract symptoms and sleep disturbance. The baseline characteristics of the 339 men (172 placebo arm and 167 saw palmetto arm) enrolled in the CAMUS trial with assessment of sleep disturbance and urinary symptoms were similar. There were no differences between improvements in the severity of sleep disturbance or urinary symptoms between the 2 experimental arms. Combined analyses of the entire cohort revealed significant associations (p <0.001) between the AUASI score and sleep disturbance severity with time. Multivariate analyses demonstrated that improvements in lower urinary tract symptoms other than nocturia were the most significant predictors of improvements in sleep disturbance. Specific analyses adjusting for other baseline characteristics demonstrated that a 3-point improvement in AUASI score was associated with a 0.73-point improvement in the Jenkins sleep scale with time. Improvements in lower urinary tract symptoms correlate with changes in sleeping abilities with time in men with benign prostatic hyperplasia. While nocturia is significantly associated with sleep disturbance, other changes in overall lower urinary tract symptoms are better predictors of changes in sleep dysfunction.

Sleep Analysis of Patients With Nocturia and Benign Prostatic Obstruction

To analyze the timing of nocturia during sleep and its effect on sleep quality using the polysomnography (PSG) findings from patients with benign prostatic obstruction. From August 2009 to August 2010, 20 patients diagnosed with benign prostatic obstruction were enrolled in the present study. The sleep evaluation was performed by PSG. The Epworth index was used to evaluate the sleepiness of the patients. The effect of nocturia on sleep quality is evaluated by sleep efficacy, total sleep time, and rapid eye movement sleep duration, calculated from the hypnograms derived from the polysomnograms. The mean age, total International Prostate Symptom Score, nocturia frequency on International Prostate Symptom Score, and frequency of nocturia recorded during PSG was 60.4 ± 8.5 years (range 44-74), 19.3 ± 4.9 (range 10-28), 3.5 ± 1.05 (range 2-5), and 1.35 ± 1.2 (range 0-4), respectively. In 6 patients (30%), the Epworth sleepiness score was pathologic (score >8). Nocturia correlated positively with increased daytime sleepiness, however it did not correlate with sleep efficacy or total sleep time. These parameters were affected by the apnea-hypopnea index, the major determinant of obstructive sleep apnea. Of the 20 patients, 14 (70%) experienced nocturia during PSG, and in these patients, we recorded 23 nocturia episodes that mostly occurred in the superficial sleep stage (16 [70%] of 23). Only 7 nocturia episodes (30%) occurred in the deep sleep stage. The sleep quality of patients with deep sleep nocturia did not differ from that of patients with superficial sleep nocturia. The results of our study have shown that nocturia predominantly occurs during the superficial sleep or rapid eye movement stage and is related to increased daytime sleepiness in patients with benign prostatic obstruction. The timing and frequency of nocturia had no significant affect on sleep quality; however, the presence of obstructive sleep apnea negatively interfered with these parameters.

UP-1.26: The role of alpha 1(A) Adrenoceptor antagonist tamsulosin for the treatment of patients with lower urinary tract symptoms in women: the effect of nocturia and sleep quality

UP-1.26: The role of alpha 1(A) Adrenoceptor antagonist tamsulosin for the treatment of patients with lower urinary tract symptoms in women: the effect of nocturia and sleep quality

The effect of nocturia on sleep

Sleep plays a vital role in physical and mental functioning. It is increasingly recognized that disturbed sleep is a highly prevalent and chronic condition that merits greater awareness due to the wide-ranging and serious repercussions associated with it. Nocturia is one of the causes of sleep disturbance and has been shown to impair functioning, quality of life, health and productivity, with those experiencing two or more voids per night reporting significant 'bother'. Nocturia warrants full consideration as a significant target for intervention, aiming to reduce the burden of disturbed sleep on individuals, families and society. Currently, however, a definitive evaluation of the most relevant sleep endpoints in nocturia therapy is lacking. One endpoint often used is the duration of the initial sleep period, which when evaluated in combination with the number of voiding episodes per night, might be an indication of the severity of sleep disruption in patients with nocturia.

Exploring older peoples' experiences of nocturia: A poorly recognised urinary condition that limits participation

Purpose. This study sought to understand the experience of living and coping with nocturia, from the perspective of community-living older men and women.Method. Individual semi-structured interviews were undertaken with 32 older people with self-reported nocturia of twice nightly or more.Results. Four key characteristics of nocturia were identified. Nocturia was described as simultaneously debilitating, frustrating, distressing and puzzling. It impacted on sleep patterns and quality, personal relationships and increased the fear of falling among older people when rising to use the toilet at night. Previously unrecognised variability and unpredictability in the condition were highlighted features. Nocturia was not prioritised for health intervention. There were gender differences in initial help-seeking however once prostate disease was eliminated, self-management strategies to cope with the effects of nocturia were the norm.Conclusions. This study indicates that nocturia has a widespread and profound influence on older people's quality of life and participation, despite being regarded as a relatively benign condition by both older people and health professionals. Several features of the condition, which have the potential for great impact, are poorly recognised in particular its variability and unpredictability.

Content Validation of Symptom-Specific Nocturia Quality-of-Life Instrument Developed in Men: Issues Expressed by Women, as Well as Men

Nocturia, waking at night to void, is a common symptom in both men and women. The nocturia quality-of-life instrument, International Consultation on Incontinence Modular Questionnaire-Nocturia Quality of Life (ICIQ-Nqol), is the only current available, validated, symptom-specific tool for patients with nocturia. Because the ICIQ-Nqol was developed exclusively in men, the validity of its use in women is unknown. Qualitative analyses of patient transcripts from the Atlanta (7 men and 17 women) and Piedmont (20 men and 23 women) groups at 5 sites (Florida, Georgia, Washington State, North Carolina, and Maryland) were used to assess the content validity of the ICIQ-Nqol. The Atlanta participants underwent 1:1 semistructured interviews emphasizing Kleinman's Explanatory Model. The Piedmont subjects participated in 6 focus groups and used a developed guide. Content review of the transcripts was used to derive items and themes. A total of 48 items and 13 thematic areas from the Atlanta and 64 items and 12 thematic areas from the Piedmont groups were derived from the transcripts using qualitative analysis. The ICIQ-Nqol before final item consolidation covered every thematic area generated by the Atlanta and Piedmont groups. The Piedmont and Atlanta participant pool generated only 2 themes-"fear of falling at night" and "nocturia makes me feel old"-that were not present in the final 12-item ICIQ-Nqol. The ICIQ-Nqol appears to have strong content validity for the experiences of both men and women with nocturia. Supplementing the ICIQ-Nqol with questions about a fear of falling and the effect of nocturia on age self-concept might provide more complete information about the effect of nocturia on the quality of life of older adults.

The Effect of Nocturia on Health-related Quality of Life and Medical Outcomes Study Sleep Score in Female

The Effect of Nocturia on Health-related Quality of Life and Medical Outcomes Study Sleep Score in Female

Importancia de la nocturia y su impacto en la calidad del sueño y en la calidad de vida en el paciente con hiperplasia benigna de próstate

IntroductionNocturia is the main cause of insomnia or sleep interruption in adult men, which has a negative impact on daily activities, quality of life (QoL) and quality of sleep (QoS).The assessment of nocturia and its impact on QoL and QoS in patients suffering from benign prostatic hyperplasia (BPH) has been poor in terms of clinical research, moreover there is a lack of specific methods to assess this impact. Objetives: The objectives of BPH treatment should include the improvement of patient’s QoL by controlling both diurnal and nocturnal symptoms. In order to assess how nocturia affects QoL and also QoS, some specific tools, such as N-QoL questionnaire or the number of Hours of Undisturbed Sleep (HUS), have been recently developed. Therefore, it would be interesting to assess how nocturia reduction due to LUTS/BPH treatment can impact on some objective parameters such as HUS and also how nocturia reduction improves QoS and QoL. This assessment should be developed during the application of pharmacological treatments in clinical practice by means of these specific tools.With the aim of tackling nocturia as an urologic problem in patients with LUTS/BPH, as well as knowing the physiology of sleep and the effect of nocturia on the sleep and QoL, a meeting of expert urologists, that gathered about fifty specialists of all around Spain, was held in Madrid. This article presents the main ideas and concepts exposed in this meeting. ConclusionsNocturia is a symptom with a high prevalence in older patients with STUI/BPH. The PreNoc study has showed a Nocturia prevalence in Spain of 83% in patients ??60 years old diagnosed of BPH. Nocturia is the most bothersome symptom in patients with STUI/BPH.

The effect of nocturia on health-related quality of life

The effect of nocturia on health-related quality of life