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As Waking Up Multiple Times a Night to Urinate Can Lead to Memory Deficits, Obesity, Lowered Sex Drive, Falls and Depression, a New Council Urges Awareness and Action

San Francisco, CA (UroToday.com) -- Nocturia Awareness Week, part of Bladder Health Month, which encourages people to take control of their urinary health. Nocturia, a treatable medical condition that forces you to wake up multiple times a night to urinate, affects nearly 50 million Americans and is a leading cause of sleep disruption.1,2 Nocturia can have mental and physical consequences, including impaired memory3 and concentration, moodiness, depression, obesity, diabetes, and a weakened immune system. However, most Americans have never heard of nocturia and think waking multiple times at night to urinate is normal.

To help inform Americans so they do not unknowingly endure the consequences of nocturia, Avadel Pharmaceuticals, a leader in urological health and education, has brought together the most influential patient advocacy groups across specialty areas to form the Nocturia Council: American Alliance for Healthy Sleep, Caregiver Action Network, Healthy Women, Men’s Health Education Council, Men’s Health Network, Multiple Sclerosis Association of America, National Association for Continence, National Sleep Foundation, Simon Foundation for Continence and ZERO – The End of Prostate Cancer.

Over the next few months, the Nocturia Council, with support from Avadel Pharmaceuticals, will kick off several educational initiatives to lessen the stigma of night-time urination and promote conversations with a healthcare professional about managing nocturia.

“People with nocturia don’t realize the dangerous impact that sleep disruption can have on nearly all aspects of their health,” said Steven Lamm, M.D., internal medicine physician and medical director at NYU Langone’s Preston Robert Tisch Center for Men’s Health. “Based on my experience with patients, sleep disruptions can weaken the immune system and lead to increased risk for erectile dysfunction, diabetes, heart disease, depression, and weight gain. Waking up also interrupts your brain’s restoration process at night, which affects mental well-being. Let me be clear, if you’re constantly waking to urinate two or more times during the night, you need to talk to your doctor.”
According to a recent Harris Poll, 66 percent of Americans who suffer from nocturia have never spoken about it with their doctor, believing it’s a “normal part of getting older” and there is nothing that can be done about it. Women are also 40 percent less likely to speak to their doctor about nocturia. According to the Harris Poll and several clinical studies, the sleep loss impact from nocturia is hazardous to one’s health:

  • Nocturia is associated with an increased likelihood of depression, especially among men and women in their 30s, 35 to 40 percent of whom have been diagnosed with depression.4,5
  • Most night-time falls in older adults are associated with bathroom trips, of which nocturia increases the risk by 25 percent over three years.6
  • Daytime drowsiness, irritability, and lack of ability to concentrate are reported in over 60 percent of nocturia sufferers.
  • Adults who wake three or more nights a week to urinate are 37 percent more likely to take sick leave than those who do not.7
  • Nocturia is associated with an increased risk of obesity.8
  • Low sex drive and low testosterone levels are linked to poor quality and disrupted sleep.9
  • Sleep loss impacts a woman’s sex drive: one extra hour can increase sex drive by 14 percent.10
“I’d always told myself that getting up to pee was just a normal part of getting older,” said Neil Cavner of Midwest City, Okla. “I was waking up three or four times every single night for 18 years. I work in construction, and if you’re getting sleepy on the job, you or someone around you can accidentally get hurt. The day I fell asleep behind the wheel waiting at a stoplight, I thought, this is just not an acceptable way to live. I need to get treated.”

Cavner says that waking up throughout the night was ruining his sleep and radically impacting his life. Like most people who wake multiple times at night to urinate, Cavner says that he did not realize that he suffered from a medical condition called nocturia due to nocturnal polyuria, which is treatable.11

“Most nocturia sufferers sleep an average of two to three hours before being awoken by the need to urinate,” said Susann Varano, M.D., a Yale University-trained physician, double board certified in Geriatrics and Internal Medicine, and medical counsel for the UroToday [Patient Advisory Board]. “Restorative sleep is crucial and takes place during the first three to four hours of the night. If this period is constantly interrupted, sleep quality will suffer, which can result in decreased daytime energy and overall well-being.”


Survey Method: This survey was conducted online within the U.S. by The Harris Poll with funding from Avadel Pharmaceuticals and Serenity Pharmaceuticals, from August 6-8, 2018, among 2,040 U.S. adults ages 18 and older, among whom 724 wake up to urinate at least twice per night. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. For complete survey methodology, including weighting variables and subgroup sample sizes.
Susann Varano, M.D., is a consultant for Avadel Pharmaceuticals.

References:
1. Van Kerrebroeck P, Hashim H, Holm-Larsen T, Robinson D, Stanley N. Thinking beyond the bladder: antidiuretic treatment of nocturia. Int J Clin Pract. 2010;64(6):807-816.
2. Stanley N. The underestimated impact of nocturia on quality of life. Eur Urol. 2005;4(7)(suppl):17-19.
3. Marinkovic SP, Gillen LM, et al. Managing nocturia. BMJ. 2004 May 1; 328(7447): 1063–1066.
4. Kupelian V, Wei JT, O’Leary MP, Norgaard JP, Rosen RC, McKinlay JB. Nocturia and quality of life: results from the Boston Area Community Health Survey. Eur Urol. 2012;61(1):78-84.
5. Van Der Vaart CH, Roovers JP, de Leeuw JR, Heintz AP. Association between urogenital symptoms and depression in community dwelling women aged 20 to 70 years. Urology 2007;69:691–6.
6. Weiss, J. P., Blaivas, J. G., Bliwise, D. L., Dmochowski, R. R., DuBeau, C. E., Lowe, F. C., Petrou, S. P., Van Kerrebroeck, P. E., Rosen, R. C., and Wein, A. J. (2011), The evaluation and treatment of nocturia: a consensus statement. BJU International, 108: 6-21. doi:10.1111/j.1464-410X.2011.10175.
7. Ohayon MM. Nocturnal awakenings and comorbid disorders in the American general population. J Psychiatr Res. 2008;43(1):48-54.
8. Weiss, J. P., Blaivas, J. G., Bliwise, D. L., Dmochowski, R. R., DuBeau, C. E., Lowe, F. C., Petrou, S. P., Van Kerrebroeck, P. E., Rosen, R. C. and Wein, A. J. (2011), The evaluation and treatment of nocturia: a consensus statement. BJU International, 108: 6-21. doi:10.1111/j.1464-410X.2011.10175.
9. Leproult R, van Cauter, E.Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men. JAMA. 2011;305(21):2173-2174.
10. Kalmbach D, Arnedt TJ, et al. The Impact of Sleep on Female Sexual Response and Behavior: A Pilot Study. The Journal of Sexual Medicine. 2015;12(5):1221-1232.
11. Bliwise DL, Foley DJ, Vitiello MV, et al: Nocturia and Disturbed Sleep in the Elderly. Sleep Med. 2009 May; 10(5): 540-548.

Further Related Content:
A Harris Poll Interview with Benjamin Brucker 
Harris Poll: The Medical Condition 72 Percent of Americans Don’t Know About is Stealing Sleep and Disrupting Lives, Survey Shows