Nocturia is common and bothersome in older adults especially those who are also incontinent. Since nocturnal polyuria (NP) is a major contributor, we examined factors associated with NP in this population to identify those possibly amenable to intervention.
We analyzed baseline data from two previously-completed studies of urge urinary incontinence (UUI). The studies involved 284 women (mean 72.9 ±7.9 years) who also completed 3-day voiding diaries. Participants with nocturnal polyuria index (NPi) of > 33% were categorized as having NP (NPi= nocturnal urinary volume/24-hour urine volume). Associations between NP and various demographic, clinical, and sleep-related parameters were determined.
Fifty-five percent of the participants had NP. Multivariable regression analysis revealed that age, body mass index (BMI), use of angiotensin-converting-enzyme inhibitor (ACE-I)/ angiotensin receptor blocker (ARB), time spent in bed, and duration of first uninterrupted sleep (DUS) were independent correlates of NP. Participants with larger nocturnal excretion reported shorter DUS and worse sleep quality despite spending similar time in bed.
BMI, use of ACE-I/ARB, time in bed and DUS are independently associated with NP in older women with UUI, and are potentially modifiable. These findings also confirm the association between sleep and NP. Further studies should explore whether interventions to reduce NP and/or increase DUS help to improve sleep quality in this population and thereby reduce or eliminate the need for sedative hypnotics.
The Journal of urology. 2016 Sep 24 [Epub ahead of print]
Shachi Tyagi, Subashan Perera, Becky D Clarkson, Stasa D Tadic, Neil M Resnick
Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine University of Pittsburgh. Electronic address: ., Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine University of Pittsburgh.