Nocturia: aetiology and treatment in adults

Key Points

  • Nocturia remains underreported and undertreated, despite its prevalence and association with significant morbidity and mortality

  • Nocturia has multiple aetiologies, including overproduction of urine (global polyuria and nocturnal polyuria), reduced bladder storage capacity, sleep disorders and a combination of these conditions

  • The frequency volume chart, Nocturia Quality of Life questionnaire and the duration of the first uninterrupted sleep period should be used in the assessment and follow-up monitoring of each patient

  • Management strategies should be targeted to each patient's specific aetiology of nocturia; some patients might require multicomponent therapies

Abstract

Nocturia is an extremely common condition that has major sequelae for affected patients. Through disruption of sleep, nocturia impairs quality of life and worsens health outcomes, and is associated with a variety of morbidities including diabetes, coronary artery disease, obstructive sleep apnoea, obesity, metabolic syndrome, and depression. Unsurprisingly, several studies have also linked nocturia with reduced survival. Nocturia is not simply a consequence of lower urinary tract disease; rather, it is a multifactorial disorder that is often a manifestation of an underlying renal or systemic disease. Through the use of the frequency volume chart, clinicians can accurately quantify nocturia and determine its aetiology. Evaluation of quality of life and sleep using simple measures is essential in order to assess the impact of nocturia on a patient. Numerous treatment options for nocturia exist, but most are associated with minor benefit or lack sufficient evidence supporting their use. By systematically analysing an individual's causes of nocturia, clinicians can design appropriate treatment strategies to most effectively treat this condition.

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J.P.W. and H.D. discussed the content for this article and wrote it, H.D. researched data for this article and all authors were involved in the review and editing of the article before submission.

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Correspondence to Jeffrey P. Weiss.

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J.P.W. declares that he serves as consultant for Allergan, Astellas, Elsevier, Ferring, Pfizer, Symptelligence and Vantia. H.D. and A.E. declare no competing interests.

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Dani, H., Esdaille, A. & Weiss, J. Nocturia: aetiology and treatment in adults. Nat Rev Urol 13, 573–583 (2016). https://doi.org/10.1038/nrurol.2016.134

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