A modern approach to nocturia management

October 1, 2004

Nocturia is a bothersome condition brought on by a host of factors in a broad segment of the population, particularly the elderly. It may have a significant impact on quality of life, and the associated sleep deprivation may lead to psychological and physical illness. Management of nocturia can only be pursued once the specific etiology of the condition is defined. This article describes a modern approach to pinpointing the underlying etiology, which in turn leads to appropriate treatment.

Nocturia is a bothersome condition brought on by a host of factors in a broad segment of the population, particularly the elderly. It may have a significant impact on quality of life, and the associated sleep deprivation may lead to psychological and physical illness. Management of nocturia can only be pursued once the specific etiology of the condition is defined. This article describes a modern approach to pinpointing the underlying etiology, which in turn leads to appropriate treatment.

In order to characterize nocturnal bladder capacity, two terms need to be defined:

Continuing with the example above, if the patient actually arose seven times to void the same 1,000 mL, he or she would have a nocturnal bladder capacity index of 5 (7 [actual number of nightly voids] minus 2 [predicted number of nightly voids]). This patient, for whatever reason, has significantly diminished bladder capacity during sleep hours. The higher the nocturnal bladder capacity index, the more nocturia occurs due to nighttime voiding at volumes less than capacity. Some common causes of decreased nocturnal bladder capacity are listed in table 1.