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Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences - 05/11/19

Doi : 10.1016/j.urology.2019.07.005 
Donald L. Bliwise a, , Adrian Wagg b, Peter K. Sand c
a Sleep Center, Emory University School of Medicine, Atlanta, GA 
b University of Alberta, Edmonton, Alberta, Canada 
c NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Chicago, IL 

Address correspondence to: Donald L. Bliwise, Ph.D., Sleep Center, Emory University School of Medicine, 12 Executive Park Drive, Room 435, Atlanta, GA 30329.Sleep CenterEmory University School of Medicine12 Executive Park Drive, Room 435AtlantaGA30329

Abstract

Nocturia is a bothersome, multifactorial condition with many underlying causes and contributing factors. Nocturnal polyuria (NP; overproduction of urine at night) is a frequent component. The prevalence of nocturia increases with age; specific estimates of prevalence are influenced by frequency thresholds used to define it. There is a tendency toward higher prevalence in young women than young men, which is reversed in later life.

The association between frequency of nocturnal voiding and sleep disruption is well-documented. Nocturia correlates strongly with shorter sleep during the first part (2-4 hours) of the night, during which the first nocturnal void often occurs. A short time to first void after sleep onset (often referred to as “first uninterrupted sleep period”) is associated with increased daytime dysfunction and decreased sleep quality and/or sleep efficiency.

Adverse health consequences related to nocturia include poor sleep, depression, reduced quality of life, and increased risk of morbidity, mortality, falls, and fractures; studies have been able to establish a causal role for nocturia in only some of these.

The potential impact of nocturia on health increases with age. By age 80, 80% of people will rise at least once per night to void. Despite its associated bother, nocturia is often accepted as a natural consequence of aging and many people do not seek help. Women, in particular, may be reluctant to report nocturia.

This article reviews the prevalence of nocturia, possible impact on sleep, mortality and morbidity, and falls, and its importance in the elderly/frail population and women.

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 Declarations of Interest: Donald L Bliwise is a consultant for Ferring, Merck, Jazz, Eisai, and Respicardia. Adrian Wagg reports research grants, speaker honoraria, or consultancy from Astellas Pharma, Pfizer Corp, Essity Health & Hygiene AB, and Pierre Fabre Medicaments. Peter K Sand is a consultant for Allergan, Astellas, Amphora, Ferring, Outpost Medical, Urovant, Valencia, and Velicept, and reports honoraria from Allergan, Astellas, Ferring, and Avadel, and reports research grants from Allergan, Boston Scientific, Cook Medical, and Valencia.
 Financial Disclosure: Donald L Bliwise, Adrian Wagg, and Peter K Sand received honoraria from IQVIA for their participation in a roundtable meeting supported by a grant from Ferring Pharmaceuticals. Presentations and discussions were developed solely by the participants, without grantor input. The meeting chair, Jeffrey P. Weiss, determined the agenda and attendees. Donald L. Bliwise, Adrian Wagg, and Peter K. Sand developed the presentations and led the discussions upon which this article is based, provided critical review and revisions to the outline and manuscript drafts, provided final approval of the version to be published, and are accountable for the integrity of the content and for addressing questions.
 Disclosure Statement: This paper is part of a Supplement funded by a grant from Ferring Pharmaceuticals.


© 2019  Pubblicato da Elsevier Masson SAS.
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Vol 133 - N° S

P. 3-13 - novembre 2019 Ritorno al numero
Articolo precedente Articolo precedente
  • Advances in the Diagnosis and Management of Nocturnal Polyuria
  • Jeffrey P. Weiss
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  • Pathophysiological Mechanisms of Nocturia and Nocturnal Polyuria: The Contribution of Cellular Function, the Urinary Bladder Urothelium, and Circadian Rhythm
  • Lori A. Birder, Philip E.V. Van Kerrebroeck

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