How is nocturia diagnosed and managed in the clinical setting?

This study investigated how nocturia is currently diagnosed and treated in the clinical setting. They found that nocturia management was not effective by using nonspecific treatments and that newer specific therapies might increase patient satisfaction. 

Nocturia involves an increased frequency of wakening at night to urinate. It can be caused by a number of factors. Increased nighttime urine production is one cause of nocturia. This is called nocturnal polyuria (NP).

Nocturia can lead to reduced sleep duration and quality. This can have a negative effect on a patient’s quality of life. The cause of nocturia is not always clear. Medication can be used to improve symptoms. Many of these medications treat conditions that cause nocturia, such as benign prostatic hyperplasia (BPH; an enlarged prostate) or overactive bladder (OAB). However, many patients with nocturia do not respond to medication. To improve patient care, its important to review current treatments in use.

This study included 403 patients with nocturia. The authors analyzed patient information on the diagnosis and treatment of nocturia.

Patients with nocturia reported waking an average of 4 times per night. 48% of patients had previously been treated for nocturia. The most common medications prescribed were anticholinergics (56%) and alpha-blockers (41%) commonly used for the treatment of OAB and BPH.

50% (199) of patients were recommended to use a bladder diary (BD) to monitor their urinary output. Only 62% (124) patients used a BD. Treatment satisfaction was similar in patients that kept a BD and those that did not (46% vs. 43%). NP was the cause of nocturia in 76% of patients. Desmopressin (Noctiva), a drug that reduces urine production was only prescribed to 5% of patients.

The authors concluded that nocturia management is not effective by using nonspecific treatments. They suggest that newer specific therapies like desmopressin have the potential to affect clinical practice. 

Quality of life was not measured in this study. This is very important in patients with nocturia. Sleep duration or quality was also not measured. 

If you have any concerns about nocturia, please consult with your physician.