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The Impact of Nocturia

Nocturia is a symptom reported by patients way too often.  As an expert in urology, I see the impact that nocturia has on both men and women, many of whom have been seeking help for a long time. I am leading this Center of Excellence to broaden awareness of nocturia and bring new treatments to patients. My practice is a tertiary, specialized practice and most of my patients have seen multiple providers prior to being referred. In the case of nocturia, roughly 40% do not see an improvement in symptoms with current treatments, although these treatments improve other bladder-related symptoms. People arrive in my office, desperately seeking relief from getting up in the middle of the night – twice or more – to urinate.

These patients present tired – and frustrated – because getting up at night to urinate has a significant impact on a person’s quality of life, especially on daily alertness and activity. Nocturia can result in many problems: fatigue, sleepiness, falls, fractures, and traumatic injuries. Nocturia can also have an impact on spouses, who complain that they awaken also, interfering with their sleep. Sadly, many patients and their partners or caregivers report being unable to fall back asleep after getting up to go the bathroom. In addition to being frustrated because of awakening multiple times per night to void, nocturia is not being treated with the same urgency as other “serious conditions.” But to a patient who has nocturia, nocturia is a serious condition, usually the most bothersome bladder symptom reported. And sadly, nocturia is sorely lacking in specific treatment. If a person’s nocturia is not caused by prostate conditions or an overactive bladder, they have no treatment options and no choice but to live their lives with diminished quality.

Nocturia isn’t an “inconvenience” and doesn’t just cause my patients to feel a little sleepy – it affects their productivity and general well-being. Many patients suffer from depression from the constant lack of sleep, which in turn affects their relationships – with their partners, with their children, with their friends. In many cases, it is the wife, husband or partner who has been driven to seek help because the problem is affecting both of them.

Those who are still in the workforce lose productive time during their days if they don’t have to miss work entirely due to depression or other comorbidities of sleep deprivation. In the United States, sleep-related issues cost society $13.6 billion, with 76% of those costs directly related to absenteeism and lost productivity due to lack of sleep. It is not uncommon for a patient to complain that they “fear falling asleep at the wheel” while driving to and from work because of fatigue and not getting adequate sleep. Nocturia has an impact on those who are retired as well. I have met with patients so sleep deprived because of their nocturia, that they report significant daytime fatigue. Not getting enough sleep is not merely an inconvenience – it can be downright dangerous.

As patients experience more and more episodes of nocturia per night, the comorbidities – lost productivity, depression, not to mention the increased risk of falls in the night – rise as well. The greater the number of voids per night, the more impact nocturia has on a patient’s life. An elimination of the need to get up to urinate at night would be ideal, but a small reduction of even one incidence per night could drastically improve the quality of life of numerous patients suffering from nocturia.
Nocturia a truly serious condition, one in need of its own treatment, in order to provide relief and a higher quality of life to my patients and the millions of other Americans across the country suffering from nocturia.

Written by: Diane Newman, DNP, CRNP, FAAN, BCB-PMD, Nurse Practitioner (NP), Co-Director, Penn Center for Continence and Pelvic Health Director, Clinical Trials, Division of Urology, Adjunct Professor of Urology in Surgery, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Published Date: March 13th, 2018