Nocturia reported in nightly sleep diaries: common occurrence with significant implications?
OBJECTIVE
Nocturia (nocturnal awakenings associated with urination) is so common a nocturnal behavior that its association with poor sleep is often overlooked. This study examined nocturia and its potential role in poor sleep by examining reported nightly awakenings and associated bathroom trips.


METHODS
Sleep diaries were kept by 119 adults with poor sleep for intervals up to 14 days. Diaries collected data on nightly number of awakenings and nightly number of bathroom trips. The proportion of nocturnal awakenings accompanied by voiding for each night was calculated and averaged within each individual. Demographics and various health conditions were examined in relation to this measure.


RESULTS
Nocturia was defined when at least two-thirds of all awakenings were associated with nocturnal voiding. Absence of nocturia was defined when less than one-third of awakenings were associated with voiding. Remaining cases were defined as having possible nocturia. Estimates of nocturia derived from prestudy screening were related to nocturia as defined by sleep diaries. Neither gender nor sleep apnea was associated with nocturia. Unadjusted analyses indicated that individuals with nocturia were more likely to have arthritis and attribute their nighttime awakenings to urge to void than individuals without nocturia.


CONCLUSIONS
Nocturia is an exceedingly common phenomenon and may be associated with multiple morbidities. RESULTS are discussed in terms of causality and whether the perceived urge to void precedes or follows nocturnal awakening. Correlates of nocturia have important implications, because they can inform interventions that target brain (e.g., cognitive-behavioral treatments for insomnia, sedative/hypnotic medications) versus bladder (e.g., bladder control exercises, medications affecting urine production or urgency).
Department of Neurology, Emory University School of Medicine.
Donald L
DL
Bliwise
Stanford University School of Medicine.
Leah
L
Friedman
Stanford University School of Medicine.
Beatriz
B
Hernandez
Stanford University School of Medicine.
Jamie M
JM
Zeitzer
Stanford University School of Medicine.
Clete A
CA
Kushida
Stanford University School of Medicine.
Jerome A
JA
Yesavage
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000453:epidemiology*; D057566:Self Report; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*