ICI‐RS 2015—Is a better understanding of sleep the key in managing nocturia?

Denys, Marie‐Astrid; Cherian, Jerald; Rahnama’i, Mohammad Sajjad; O’Connell, Kathleen A.; Singer, Jonathan; Wein, Alan J.; Dhondt, Karlien; Everaert, Karel; Weiss, Jeffrey P.

doi:10.1002/nau.23032

Cited by 27 publications

(45 citation statements)

References 30 publications

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“…Research has shown that physiological changes are the cause of urological disorders, including nocturia. However, this study supports recent research that psychological causes, including cue sensitivity, can be highly predictive of experiencing nocturnal voids in a younger female cohort. This sample reported somewhat lower rates of nocturia (defined as two or more voids per night) (43%) than our prior sample (65%), which was comprised of predominantly older individuals.…”

Section: Discussionsupporting

confidence: 90%

“…Individuals may awaken during the night for other reasons (eg, noise, anxiety, and children waking them) and are conditioned to respond to awakening by urinating. Denys et al investigated the reason why people get up to urinate at night and found that 58% of those who reported nocturia, reported being awakened for reasons other than the urge to urinate, which have been defined as convenience voids . Convenience voids were not differentiated from urge‐related awakening in this study.…”

Section: Introductionmentioning

confidence: 59%

“…Although physiological factors clearly have a role in nocturia, our research suggests that behavioral processes, especially Pavlovian or classical conditioning may play an important role in nocturia and other lower urinary tract symptoms. With respect to urological disorders, key‐in‐the‐lock urgency and incontinence are examples of Pavlovian conditioning.…”

Section: Introductionmentioning

confidence: 81%

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Relationship of cue‐induced urinary urges to nocturia in women ages 18 to 40 years

Singer

O’Connell

2019

Neurourology and Urodynamics

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Aims Although physiological factors have a role in nocturia, research suggests that behavioral processes, especially classical conditioning may also play an important role in nocturia and other lower urinary tract symptoms. The study aimed to assess the relationship of stimulus‐associated urges during the day to nocturia in a sample of women aged 18 to 40, after controlling for physiological symptoms (eg, overactive bladder [OAB]; daytime frequency). Methods An online study was conducted using a panel of 356 female participants between the ages of 18 to 40. One‐third of the participants self‐reported an OAB diagnosis as determined by their physician. Almost 80% of participants reported having at least one nocturnal voiding per night. Participants completed the Urinary Cues Questionnaire, which assessed the frequency with which respondents experienced the urge to urinate in the presence of a variety of cues and the Overactive Bladder Screening Scale (OABSS), which assesses symptoms of OAB syndrome. Results Controlling for OABSS scores and daytime urinary frequency, the Situational Cues Subscale had a significant relationship with nocturia such that with each unit increase in the subscale, the probability of nocturia increased by 12% to 14% depending on the definition of nocturia. Discussion Behavioral techniques, such as habituation to decrease the association between awakening at night and feeling an urge to urinate, may be an appropriate intervention to mitigate nocturnal urination. Theoretically, this would translate to decreasing this disorder throughout the lifespan, if behavioral techniques could be effectively utilized in early adulthood.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 81%

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Relationship of cue‐induced urinary urges to nocturia in women ages 18 to 40 years

Singer

O’Connell

2019

Neurourology and Urodynamics

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“…Sleep disruption and deprivation are associated with low dopamine levels in the central nervous system . Both Parkinson’s disease and restless legs syndrome are associated with NP and a reduced bladder capacity due to OAB and sphincter dysfunction . However, a recent study suggested that the prevalence of NP in Parkinson’s disease is no higher when compared with a control population, indicating some uncertainty in this regard .…”

Section: Resultsmentioning

confidence: 99%

“…There is level 1a evidence for the use of CPAP in patients with OSAS. There is only low level 2 or lower level evidence that sleep aids, treatment of low dopamine and treatment of restless legs syndrome have an impact on nocturia (ICI‐RS 2015) …”

Section: Resultsmentioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

Neurourology and Urodynamics

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104

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Introduction Patients with nocturia have to face many hurdles before being diagnosed and treated properly. The aim of this paper is to: summarize the nocturia patient pathway, explore how nocturia is diagnosed and treated in the real world and use the Delphi method to develop a practical algorithm with a focus on what steps need to be taken before prescribing desmopressin. Methods Evidence comes from existing guidelines (Google, PubMed), International Consultation on Incontinence‐Research Society (ICI‐RS) 2017, prescribing information and a Delphi panel (3 rounds). The International Continence Society initiated this study, the authors represent the ICI‐RS, European Association of Urology, and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). Results Diagnostic packages: consensus on, history taking for all causalities, intake diary (fluid, food) and bladder diary, not for its duration. Pelvic (women) or rectal (men) examination, prostate‐specific antigen, serum sodium check (SSC), renal function, endocrine screening: when judged necessary. Timing or empty stomach when SSC is not important. Therapeutic packages: the safe candidates for desmopressin can be phenotyped as no polydipsia, heart/kidney failure, severe leg edema or obstructive sleep apnea syndrome. Lifestyle interventions may be useful. Initiating desmopressin: risk management consensus on three clinical pictures. Follow‐up of desmopressin therapy: there was consensus on SSC day 3 to 7, and at 1 month. Stop therapy if SSC is <130 mmol/L regardless of symptoms. Stop if SSC is 130 to 135 mmol/L with symptoms of hyponatremia. Conclusion A summary of the nocturia patient pathway across different medical specialists is useful in the visualization and phenotyping of patients for diagnosis and therapy. By summarizing basic knowledge of desmopressin, we aim to ease its initiation and shorten the patient journey for nocturia.

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Effect of advanced glycation end products on nocturia or sleep disorders: A longitudinal study

Konishi

Imai²,

Okita

et al. 2021

BJUI Compass

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Objective: This study aimed to investigate the effect of advanced glycation end products (AGEs) on nocturia and sleep disorders in community-dwelling adults. Materials and Methods: This longitudinal study evaluated AGEs level, sleep disorders and nocturia frequency in 447 community-dwelling adults between May 2011 and May 2016. Sleep disorders were evaluated using the Pittsburgh Sleep Quality Index (PSQI) score. Participants were divided into two groups: AGEs-low (≤1.80) and AGEs-high (>1.80). The longitudinal nocturia and PSQI changes for 5 years between the AGEs-low and AGEs-high groups were compared. The effect of baseline oxidative stress on worsening of nocturia or PSQI score 5 years later was evaluated using multivariable logistic regression analyses.Results: There was no significant difference in PSQI score and nocturia frequency between the AGEs-low (n = 223) and AGEs-high (n = 224) groups at baseline. The PSQI score and nocturia frequency increased significantly over 5 years in both groups. However, the PSQI score increased significantly in the AGEs-high group compared with the AGEs-low group, although there was no difference in nocturia.Background-adjusted multivariable analysis showed that the AGE-high was significantly associated with PSQI score worsening, but AGE-high was not significantly associated with nocturia worsening.Conclusions: Oxidative stress may be significantly associated with worsening sleep disorders, although oxidative stress may not significantly worsen nocturia frequency.

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ICI‐RS 2015—Is a better understanding of sleep the key in managing nocturia?

Cited by 27 publications

References 30 publications

Relationship of cue‐induced urinary urges to nocturia in women ages 18 to 40 years

Relationship of cue‐induced urinary urges to nocturia in women ages 18 to 40 years

International Continence Society consensus on the diagnosis and treatment of nocturia

Effect of advanced glycation end products on nocturia or sleep disorders: A longitudinal study

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