Nocturia and Nocturnal Polyuria: What Keeps the Urologist Awake at Night

Dean Elterman, MD, FRCSC, 1Co-authors: Brandon Van Asseldonk B. Eng 2

1Assistant Professor, University of Toronto, Toronto Western Hospital, Toronto, ON

2Faculty of Medicine, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract: Nocturia is a common urologic condition with prevalence increasing in the elderly and can result in fragmented sleep, impaired daytime functioning, and falls. It can be a symptom of BPH or OAB but is commonly multifactorial with fluid intake, sleep apnea, and diabetes contributing. Nocturia is often a result of nocturnal polyuria which is best diagnosed by recording voiding frequency and volumes. Treatment is driven by patient symptoms and reported level of bother, with first-line therapy being lifestyle modification and second-line therapy being desmopressin (Nocdurna).
Key Words: Nocturia, Nocturnal Polyuria, Nocdurna, Desmopressin.
Nocturia is a common urologic condition, particularly in elderly populations.
Nocturia, or waking twice or more during the night to void, can cause fragmented sleep and can impair function during the day.
It is essential that primary care physicians and specialists diagnose nocturia because it can lead to poor health, including conditions like: an increased risk of falls and accidents, cardiovascular disease, diabetes, depression, and increased morbidity and mortality.
A thorough history will aid in the diagnosis of nocturia.
Lifestyle modifications, including: timed voiding, dietary and fluid restrictions, medication timing, sleep hygiene, and evening leg elevation can provide some relief for nocturia patients.
Second-line treatment is the use of desmopressin, an antidiuretic that can reduce the number of nighttime voids and thus improve sleep, particularly in women.
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This article was published as part of THE LATEST IN THE DIAGNOSIS AND MANAGEMENT OF NOCTURIA eCME resource.
The development of THE LATEST IN THE DIAGNOSIS AND MANAGEMENT OF NOCTURIA eCME resource was supported by an educational grant from Ferring Inc.