To evaluate lifestyle modification achieved through a structured self-check sheet-based behavioral therapy program and its association with changes in nighttime frequency in patients with nocturia.

We analyzed 218 patients from 14 institutions aged ≥40 years who completed a 4-week behavioral therapy program. Eight lifestyle habits were assessed before the intervention, and behavioral change was defined as executing a behavioral item on ≥14 of 28 days. Outcomes included (1) the association between the number of behavioral items successfully adopted and the change in nighttime frequency, (2) the association between adoption of each behavioral item and (3) changes in estimated salt intake.

Greater reductions in nighttime frequency were associated with a higher number of behavioral items adopted, with the greatest reduction observed in those who adopted four to five items (–1.1 episodes), and showed significant differences among groups ( P = .03). In multivariable regression, positive changes in nighttime frequency (indicating greater improvement) were independently associated with regular mealtimes (β = 0.739, P = .030) and evening exercise (β = 0.328, P = .028). Salt intake significantly decreased only in patients who newly adopted salt-reduction behavior (9.4 → 8.6 g/day, P = .01).

Behavioral therapy using a simple, time-efficient self-check sheet is associated with improvement in nighttime frequency with a minimal burden on patients. Greater adherence is associated with greater improvement, and specific behaviors, particularly regular mealtimes and evening exercise, show independent associations with symptom improvement.