Demystifying Nocturia: Identifying the Cause and Tailoring the Treatment

Paula Laureanno, RN; Pamela Ellsworth, MD, FACS, FAAP

Disclosures

Urol Nurs. 2010;30(5):276-287. 

In This Article

Impact of Nocturia

The impact of nocturia is significant. A number of studies has demonstrated that a high proportion (63% to 75%) of individuals with nocturia perceive it to be troublesome (Jolleys, Donovan, Nanchahal, Peters, & Abrams, 1994; Scarpa, 2001; Swithinbank et al., 1999). Nocturia has a significant impact on sleep, and according to Marschall-Kehrel (2004), uninterrupted sleep is necessary for the maintenance of physical, mental, and emotional well-being. In a Dutch cross-sectional epidemiologic study, nocturia was found to be one of the two most important causes of sleep disturbance in adults over 50 years of age (Middelkoop et al., 1996). In an elderly population in Sweden, nocturia was found to be associated with an increased prevalence of sleep disorders, poorer quality sleep, and increased day time fatigue (Asplund & Aberg 1992). This population experienced frequent awakenings and a general feeling of insufficient and nonrestorative sleep. In addition, normal somatic symptoms, such as muscle cramps in the calves, leg tingling, and nocturnal sweating, are also increased in parallel with increasing number of voids (Asplund & Aberg 1992). The changes in sleep associated with nocturnal voiding result in day time sleepiness and impaired perception and balance, which can also increase the risk of fall injuries (Van Balen et al., 2001). In a study of night time falls in the elderly, it was found that the occurrence of two or more nocturnal voids was associated with a two-fold increase in falls compared with fewer than two voids (Stewart, Moore, May, Marks, & Hale, 1992).

Nocturia is associated with an increased mortality. In an epidemiologic study of over 6000 men and women 65 years of age and older in northern Sweden, 190 men and 287 women reported having three or more nocturnal voids. Fifty-four deaths were noted among the men with three or more nocturnal voids and 34 deaths among the women. The death rate was twice as high for males and females, with three or more voids per night as all men and women in the study (Asplund, 1999). Finally, there is some evidence to suggest that sleep deprivation may have an effect on the function of the immune system (Benca & Quintas, 1997) and that sleep is important in maintaining host defenses (Irwin et al., 1996).

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