Night-shift Workers Bothered by Nocturia, Urgency

Neil Osterweil

March 19, 2019

BARCELONA, Spain — Nocturia, which commonly wakes up older people during the night, can also affect younger adults who are wide awake and working the night shift, results of a new study suggest.

In a survey of Italian nurses and medical residents younger than 50 years, "night-shift workers reported more lower urinary tract symptoms, particularly urgency and nocturia," than day-shift workers, said Cosimo De Nunzio, MD, from Sant'Andrea Hospital in Rome.

The night-shift workers also had worse quality-of-life scores, he said here at the European Association of Urology 2019 Congress.

An abstract reporting that taxi drivers who worked the late shift had increased lower urinary tract symptoms prompted De Nunzio to wonder about healthcare workers, so he decided to apply the same hypothesis to night-shift workers in the health system.

Of the 136 study participants, 66 worked overnight and 70 worked from 6 AM to 2 PM in the Italian national healthcare system.

Half of the participants were men and half were women, and half were nurses and half were residents. Mean age was 39.5 years. The day and night groups were matched for, age, sex, and body mass index.

All completed the Overactive Bladder Questionnaire (OAB-q), a validated instrument that focuses on symptoms and quality of life. In addition, the researchers assessed clinical variables from each participant, such as age, medical history, and potential risk factors.

Difference Between Night and Day

Nocturia was reported by more night-shift than day-shift workers (10% vs 1%).

On multivariate analysis, night-shift work was an independent predictor of an OAB-q score above 30 (P = .001).

Although the underlying pathogenesis is not well understood, it could be related to changes in circadian rhythms or in lifestyle changes associated with night work, such as excess coffee consumption and poor diet, De Nunzio told Medscape Medical News.

"I would recommend that physicians investigate their patients' work activities, because sometimes if they have urinary symptoms, they may be able to vary their activities or the type of work," he said.

De Nunzio said he recommends that night-shift workers avoid excess caffeine, maintain a healthy diet, and rest after working all night.

Mechanisms Need Exploring

"Increased urinary frequency is an issue for millions of people worldwide," said Jean-Nicolas Cornu, MD, PhD, from Rouen University Hospital in France, who was not involved in the study.

This study highlights the effect of night shifts on quality of life. However, "whether the changes described in this study depend on confounding factors or modification of urinary production by the kidneys cannot be assessed," he pointed out.

Additional studies are needed to help clinicians better understand the underlying pathogenesis, Cornu said.

This study was internally funded. De Nunzio and Cornu have disclosed no relevant financial relationships.

European Association of Urology (EAU) 2019 Congress: Abstract 659. Presented March 17, 2019.

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