New patient survey data presented at the European Association of Urology (EAU 14) congress shows that nocturia (waking to void one or more times a night followed by sleep) has a strong negative impact on utility, work productivity, and health-related quality of life (HRQL). The impact increases with the severity of the condition.1,2

An analysis of survey data drawn from a cross-sectional survey of physicians and their urology patients (n=8,738) in Europe and the United States showed that as the number of voids caused by nocturia increased, measures of utility, work productivity. and HRQL decreased.1

A serious consequence of nocturia is the disruption it causes to a patient’s sleep as a result of frequently waking with a need to urinate. In particular, it is the disruption of restorative slow wave sleep in the first 4 hours that tends to have the biggest effect. Results from a real-world setting showed that the severity of a patient’s nocturia (as measured by the number of hours in the first undisturbed sleep period) had a significant negative impact on their activity levels, how refreshed they felt the next day, the average number of daily naps they took, and their HRQL (p<0.0001).2

For those patients getting more than 4 hours of undisturbed sleep before waking to urinate, there were highly significant improvements in symptom bother, HRQL, activity levels, health status, and how refreshed they felt the next day compared to those getting 4 or less hours of undisturbed sleep (p<0.0001).2

Furthermore, results also showed that as nocturia gets worse (as measured by an increase in number of nighttime voids), there was a significant negative impact across all outcome measures including HRQL, utility, and work productivity (p<0.0001). Patients who woke to void two or more times per night were significantly more negatively impacted on measures of HRQL, utility, and work productivity compared to those patients who voided once or not at all per night (p<0.001).1

Commenting on these results, Professor Donald Bliwise, professor of Neurology, Emory University School of Medicine, Atlanta, says: “Nocturia is common and bothersome, but it is often under-recognized as a separate condition and its burden underestimated. This new data highlights the need for physicians to take nocturia seriously, given how profound its impact can be on a patient’s quality of life. For people who suspect they have nocturia, they should visit their doctor to discuss treatment options.”

Sufferers of nocturia consider disturbed sleep to be the most burdensome symptom, and around a third of people with nocturia are unable to get back to sleep after urinating, leading to insomnia.3 Given the prevalence of nocturia is high with estimates suggesting 77% of men and women aged 60-80 years suffer from the condition, it is important that nocturia is recognized and treated accordingly.4

References

1. Andersson F, et al. Negative impact of nocturia on utility, productivity and health-related quality of life: Results of a real world survey of patients in Europe and USA. Abstract number #588 [data presented at EAU 2014, poster session, Nocturia and Nocturnal Polyuria].

2. Bliwise D, et al. Negative impact of reduced first undisturbed sleep period on utility, productivity and health-related quality of life: Results of a real world survey of patients in Europe and USA. Abstract number #591 [data presented at EAU 2014, poster session, Nocturia and Nocturnal Polyuria].

3. Holm-Larsen T, et al. “My sleep pattern is a series of naps.” Subjective patient-reported data on what is most bothersome about nocturia. Abstract number #405 [data presented at EAU 2013, poster session, Nocturia, OAB, metabolic syndrome—towards a new management].

4. Bing MH, et al. Prevalence and bother of nocturia and causes of sleep interruption in a Danish population of men and women aged 60-80 years. British Journal of Urology International. 2006;98(3):599-604.