![]() suggested still defining nocturnal polyuria based upon the NPi but raising the threshold to 53%, which corresponds to the 95% of NPi valuesġ7. ![]() These limitations have led to several alternative definitions for nocturnal polyuria. Furthermore, a longitudinal, community-based study of 1,688 men aged 50–78 in Krimpen found that nocturnal polyuria was present in 70.1% of men without nocturia when the ICS definition was applied found a mean difference in NVF of only 0.59ġ5. ![]() In a meta-analysis of the difference in mean nocturnal voiding frequencies (NVFs) between patients with and without nocturnal polyuria, HofmeesterĮt al. Some have argued that this definition is too broad and lacking in clinical significance. The ICS defines nocturnal polyuria in an age-dependent manner as nocturnal output greater than 20% of the daily total in the young and greater than 33% of the daily total in the elderly (NP33)īy the NP33 definition, nocturnal polyuria may be present in up to 83% of those with nocturiaħ. Importantly, the NUV is defined as the total volume of urine voided during the night, including the first morning void. The proportion of urine produced at night can be quantified using the nocturnal polyuria index (NPi), which is calculated as the nocturnal urine volume (NUV) divided by 24-hour urine volume. Nocturnal polyuria occurs when urine is overproduced at night while 24-hour urine production volume remains normal. Several studies have explored even more severe consequences of nocturia, and a meta-analysis of 28,366 patients found that nocturia was associated with a 28% excess mortality risk per year Falls and bone fractures have been reported to occur at higher rates among those with nocturia these events may occur during the day because of fatigue caused by nocturia or during the night when individuals rise to voidġ2. Sleep interruption has numerous negative consequences for those with nocturia, including daytime fatigue, difficulty concentrating, mood alterations, and decreased workplace productivityġ1. The first nocturnal void in particular has the potential to lower sleep quality, since it may occur during the first few hours of sleep, interrupting the restorative slow-wave sleep that takes place during this time In a cross-sectional analysis of the Sleep Heart Health study, patients with nocturia reported higher degrees of subjective sleepiness and had corresponding polysomnographic changes that indicated objectively worse sleep qualityĩ. A multivariate analysis of elderly individuals (55–84 years of age) interviewed by the National Sleep Foundation showed that nocturia was an independent predictor of self-reported insomnia and poor sleep qualityĨ. A classification scheme for nocturia is presented and corresponding management strategies for each category are discussed.īy definition, nocturia results in sleep interruption, and thus it is axiomatic that this condition is associated with lower sleep quality. This article aims to review the prevalence of nocturia along with its clinical consequences. Unfortunately, many individuals do not seek medical consultation for nocturia because of the perception that it is a normal part of aging or even that it is untreatable Furthermore, this study demonstrated that nocturia is associated with impaired health-related quality of life (HRQoL) as measured by the generic 15D HRQoL instrumentĤ. The Finnish National Nocturia and Overactive Bladder (FINNO) study found that the majority of people report having at least moderate bother when they experience three or more nocturnal voids and that the degree of bother increases with the number of nightly voidsģ. Part of the controversy over the original definition stemmed from the fact that there may be no “complaint” from those who wake only once during the night to void, as a single episode of nocturia may not be bothersome at all. There has since been much debate around this definition, and it was revised in 2017 to be “waking to pass urine during the main sleep period”Ģ. In 2002, the International Continence Society (ICS) defined nocturia as “the complaint that the individual has to wake at night one or more times to void”ġ. Nocturia is a prevalent and highly bothersome lower urinary tract symptom (LUTS).
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