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PubMed2005

What affects the occurrence of nocturia more: menopause or age?

OBJECTIVES: Prevalence studies show that nocturia is a very common condition, affecting older age groups in particular. In this study, we evaluate (1) the community-based prevalence of nocturia and its associated overactive bladder according to the patient's perception and disturbance to sleep and (2) whether age or menopausal (MP) transition has a greater effect on the occurrence of nocturia. METHODS: The questions regarding nocturia were part of the Bristol female lower urinary tract symptoms questionnaire (translated into Mandarin, the correlation coefficient r = 0.91). A total of 1253 (79.1% response rate) women were randomly sampled from a community-based female population, aged 20 years or older. Samples were subdivided into reproductive age, perimenopausal stage and elderly. If the participants reported having nocturia, they were further questioned with, "Does it interfere with your sleep or bother your daily life?" The chi-square test and the Cochran-Armitage trend test were used to analyze the data. RESULTS: Nocturia in older age groups was significantly higher than that of the younger age groups. The occurrence of nocturia was significantly associated with the elderly (compared with the reproductive age, P < 0.05). There were no significant differences in the prevalence of nocturia between the perimenopausal stage and the reproductive age (P > 0.05). CONCLUSIONS: Our data implies that the increasing occurrence of nocturia is age-related and is not affected by the transition from pre- to postmenopause. Large-scale prospective longitudinal studies need to be conducted to clarify the effects of the aging process and estrogen deficiency.

Adult↗
PubMed2006

Impact of nocturia on symptom-specific quality of life among community-dwelling adults aged 40 years and older.

OBJECTIVES: To evaluate factors predicting the effect of nocturia in a community-based cohort of adults using a nocturia-specific quality-of-life (N-QOL) questionnaire. METHODS: From October 2004 to February 2005, adults aged 40 years old or older living in Matsu, Taiwan and reporting nocturia of one episode or more per night were interviewed with a 12-item N-QOL questionnaire consisting of Sleep/Energy and Bother/Concern subscales. Univariate analyses were used to analyze the effects of demographic characteristics, frequency and duration of nocturia, and sleeping characteristics on the N-QOL score. Multiple linear regression analysis was used to identify factors predicting the N-QOL score. RESULTS: A total of 663 adults completed this study (mean age 59.4 years). The average N-QOL scores (a lower score indicates worse QOL) were 91.4 +/- 11.2, 83.7 +/- 13.2, 77.6 +/- 16.8, and 67.6 +/- 21.2 for nocturia episodes of 1, 2, 3, and 4 or more per night, respectively (P < 0.001). Men reported significantly lower N-QOL (85.6 +/- 15.1 versus 88.9 +/- 13.1, P = 0.003) and Bother/Concern subscale scores (42.0 +/- 8.4 versus 44.0 +/- 7.4, P < 0.001), but not Energy/Sleep subscale scores (43.6 +/- 7.8 versus 44.4 +/- 7.3, P = 0.158) than women. On multiple linear regression analysis, increasing nocturia episodes (regression coefficient -6.2, 95% confidence interval -7.4 to -5.0), male sex (regression coefficient -3.5, 95% confidence interval -5.4 to -1.5), and degree of sleeping disturbance after nocturia (regression coefficient -4.5, 95% confidence interval -5.6 to -3.4) independently predicted a significantly lower N-QOL score. CONCLUSIONS: The results of our study have confirmed that nocturia has a more significant QOL impact when the patient has two or more episodes per night. Moreover, men experienced a greater impact from nocturia than women, particularly in the Bother/Concern domain.

Adult↗
PubMed2002

Nocturia in the Dutch adult population.

OBJECTIVE: To estimate the prevalence of nocturia in the Dutch adult population, its association with sociodemographic and health characteristics, and to assess problems experienced by persons with nocturia. SUBJECTS AND METHODS: In spring 2001 a telephone survey was conducted among a representative sample of 4721 Dutch respondents (response 53%). Using questions from the Bristol Lower Urinary Tract Symptoms questionnaire respondents were asked about having nocturia and the problems they experienced. In addition, questions were asked about sociodemographic and health characteristics. RESULTS: The prevalence of nocturia (a mean of twice or more/night) among Dutch men and women over 18 years old was 13%, standardized for age and sex. Women had nocturia more often than men (16% vs 9%) and the prevalence was positively associated with age, poor health status and use of medication. CONCLUSION: The prevalence of nocturia in Dutch men and women differs more than reported in earlier studies. The prevalence in the Netherlands seems slightly higher than in other Western countries, but Dutch persons with nocturia report fewer problems. Nocturia does not occur in isolation and is associated with sleep disturbances. It is worthwhile for general practitioners to routinely check whether patients who contact them for lower urinary tract symptoms or sleeping disorders have nocturia.

Adult↗
PubMed2006

A population study of nocturia in Singapore.

OBJECTIVE: To estimate the prevalence of nocturia in the multiracial Asian population of Singapore, using the new International Continence Society standardized definition of one or more voids per night, and to assess its associations, bothersomeness and impact on sleep. SUBJECTS AND METHODS: A door-to-door interview questionnaire survey was conducted amongst a randomly selected sample of 3000 individuals (response rate 78.2%). Nocturia and its associated problems were evaluated using questions from the International Prostate Symptom Score (IPSS), and concurrently, sociodemographic and health variables were recorded. RESULTS: Data from 1134 women (aged 20-95 years) and 1139 men (aged 20-92 years) were analysed; the overall prevalence of nocturia (one or more voids/night) was 55.5%, with an increasing proportion in older groups (P < 0.01). Women had nocturia significantly (P = 0.015) more often than men (58% vs 53%), and it was positively associated with poor health, with the highest odds ratios (95% confidence interval) for diabetes mellitus of 2.0 (1.3-3.1), for renal disease of 6.4 (2.3-18.2), and for strokes of 3.1 (1.1-9.2). In both men and women, the median IPSS in patients with nocturia was significantly higher than that in patients without nocturia (P < 0.001). For individuals waking once a night, only 9.5% considered nocturia a problem and 13.5% complained of sleep disturbances; these values increased to 36% and 40% for individuals waking up twice or more /night. CONCLUSION: Nocturia is a common condition amongst Singaporean adults, especially in the elderly; it has strong associations with poor health and other lower urinary tract symptoms. The degree of nocturia determines whether patients are likely to be bothered by it or have sleep disturbance, which will influence their help-seeking behaviour.

Adult↗
PubMed2006

alpha-blocker monotherapy in the treatment of nocturia in men with lower urinary tract symptoms: a prospective study of response prediction.

OBJECTIVE: To determine the efficacy of an alpha-adrenoceptor antagonist, terazosin, in reducing nocturia in men with lower urinary tract symptoms (LUTS), and to identify the factors predicting treatment outcome. PATIENTS AND METHODS: In all, 100 patients were treated with 2 mg of terazosin once daily for the first 7 days, and continued to receive 4 mg of terazosin once daily for the following 3 weeks. The men were assessed at baseline and at the end of treatment using uroflowmetry, the International Prostate Symptom Score (IPSS), and the degree of nocturia estimated from a frequency-volume chart (FVC) and objectively. RESULTS: On the FVC, 27 patients reported that the terazosin treatment reduced their nocturia by more than half, and 14 reported a reduction of 25-49%. On the IPSS, 31 patients reported that the treatment reduced their nocturia by more than half and 27 reported a reduction of 25-49%. On multivariate regression analysis, only the actual number of nightly voids on the FVC was associated with a 2.1-fold chance of an improvement of >25% in objective nocturia (P = 0.016). Using a comparable model, a greater nocturia score on the IPSS was associated with a higher likelihood of improvement in subjective nocturia (odds ratio, 1.653; 95% confidence interval, 1.079-2.533; P = 0.021). CONCLUSION: Treatment with terazosin can reduce patients' episodes of nocturia both subjectively and objectively in some men with LUTS. Our results suggest that both subjective and objective numbers of nocturia episodes are associated with improvements in subjective and objective nocturnal frequencies, respectively.

Adrenergic alpha-Antagonists↗
PubMed1998

Nocturia in adults: etiology and classification.

Nocturia is one of the most bothersome of all urologic symptoms, yet even a rudimentary classification does not exist. We herein propose a classification system of nocturia based on a retrospective study. The records of 200 consecutive patients with nocturia were reviewed. Evaluation included history, micturition diary (including day, night, and 24-hr voided volume), postvoid residual urine (PVR), and videourodynamic study (VUDS). Functional bladder capacity (FBC) was determined to be the largest voided volume in a 24-hr period. The etiology of nocturia was thus classified into one of three groups: nocturnal polyuria ([NP] in which voided urine volume during the hours of sleep exceeds 35% of the 24-hr output), nocturnal detrusor overactivity ([NDO] defined as nocturia attributable to diminished bladder capacity during the hours of sleep), and mixed (NP+NDO); polyuria (24-hr urine output >2,500 cc) was classified separately. There were 129 women and 65 men ranging in age from 17 to 94 years (x=59). Overall 13 (7%) had NP, 111 (57%) NDO, and 70 (36%) had a mixed etiology of their nocturia (both NP and NDO). Forty-five (23%) also had polyuria. These data confirm that the etiology of nocturia is multifactorial and in many instances unrelated to the underlying urologic condition. Nocturnal overproduction of urine is a significant component of nocturia in 43% of patients, most of whom will also have NDO. We believe that treatment should be directed at both conditions.

Adolescent↗
PubMed2006

Nocturia and circadian blood pressure profile in healthy elderly male volunteers.

PURPOSE: Nocturia is attributed to nocturnal polyuria and/or decreased functional bladder capacity. In this study we elucidated the mechanisms behind circadian fluid regulation and the occurrence of nocturia in healthy elderly males, specifically to determine the role of urine output and regulating hormones, blood pressure, and average voided volumes. MATERIALS AND METHODS: A total of 18 males 55 to 73 years old (mean age 61.1) were included in the study. Voiding habits were assessed by completion of a 7-day frequency volume chart recording all fluid intake and voiding. The subjects subsequently underwent inpatient circadian studies measuring the diurnal rhythm of blood pressure, vasopressin, atrial natriuretic peptide, angiotensin II, aldosterone and urine volume. RESULTS: Of the nightly home recordings 25% showed nocturia, characterized by a higher 24-hour and nighttime urine volume. During the inpatient studies 12 of the 18 participants experienced a nocturnal void. Nocturia nights were characterized by significantly decreased day-to-night ratios in urine output and a higher nighttime mean arterial blood pressure. A circadian variation in plasma arginine vasopressin was seen only in the group without nocturia. The other hormones revealed a circadian rhythm similar in the 2 groups. CONCLUSIONS: In healthy males with occasional nocturia, the occurrence of nocturia seems to be associated with a blunting of the circadian rhythm of diuresis and increased arterial blood pressures during the night. These findings may implicate a role for a baroregulatory related mechanism in nocturia.

Aged↗
PubMed2005

Nocturia in men with lower urinary tract symptoms is associated with both nocturnal polyuria and detrusor overactivity with positive response to ice water test.

OBJECTIVES: To investigate whether detrusor overactivity (DO) and the response to the ice water test (IWT) influence nighttime urinary frequency in patients with lower urinary tract symptoms. METHODS: A total of 114 patients with lower urinary tract symptoms, who were older than 50 years, with an International Prostate Symptom Score 8 or more points and a quality of life index of 2 or greater, were evaluated by a 48-hour frequency-volume chart, free flowmetry, pressure flow study, and IWT. RESULTS: The DO-positive IWT responders had a significantly greater bladder outlet obstruction index than did the DO-positive IWT nonresponders and the DO-negative IWT nonresponders. The DO-positive IWT responders had significantly more frequent nocturia and smaller nighttime maximal and minimal voided volumes than did the DO-negative IWT nonresponders without any difference in the nocturnal voided volume. The patients with nocturia two or more times had a significantly larger nocturnal voided volume and smaller nighttime minimal voided volume than the patients with nocturia less than two times. The incidence of DO-positive IWT responders was significantly greater among the patients with nocturia three or more times than that among those with nocturia less than three times. In the multivariate logistic model, the nocturnal voided volume and nighttime minimal voided volume were independently associated with nocturia two or more times and the DO-positive IWT responders were independently associated with nocturia three or more times. CONCLUSIONS: Once high-grade bladder outlet obstruction induces C-fiber-related DO, it is strongly suggested that this process, together with nocturnal polyuria, plays an important role in the consequent clinical manifestations of nocturia in patients with lower urinary tract symptoms.

Administration, Intravesical↗
PubMed2004

A prospective study of nocturia and the quality of life of elderly patients with obstructive sleep apnea or sleep onset insomnia.

OBJECTIVE: To prospectively evaluate the relationship between obstructive sleep apnea syndrome (OSAS), nocturia and quality of life in elderly patients free of the urologic and medical conditions that lead to increased nocturia. METHODS: Prospective study of nocturia in men 65 years and older with isolated OSAS or sleep onset insomnia. After a 7-day nocturia evaluation and nocturnal polysomnography, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), Quality of Life (SF-36) were administered. RESULTS: OSAS patients with frequent nocturia had significantly greater body mass index (BMI), greater apnea-hypopnea index (AHI), lower lowest oxygen saturation and lower SF-36 subscale scores. Treatment with nasal continuous positive airway pressure (CPAP) for OSAS and behavioral techniques for insomnia improved ESS and BDI scores for all three groups. SF-36 subscale scores improved more in subjects with multiple nocturia. AHI and BMI explain 38% of the variance for nocturia. CONCLUSION: Nasal CPAP reduces OSA and nocturia and improves quality of life of elderly patients.

Aged↗
PubMed2000

Cross-sectional study of nocturia in both sexes: analysis of a voluntary health screening project.

OBJECTIVES: To assess the prevalence of nocturia and its impact on the quality of life in both sexes by analyzing almost 2500 individuals participating in a health survey. METHODS: During a 12-month period, we included an incontinence questionnaire, which was largely based on the Bristol female lower urinary tract symptoms questionnaire, in the voluntary health examinations in the area of Vienna. In parallel, we recorded the medical history, concurrent medical therapy, physical examination findings, sociodemographic parameters, and blood laboratory study results. RESULTS: The data of 1247 women (age 49.8 +/- 13.5 years) and 1221 men (age 48.5 +/- 11.9 years) were analyzed. The percentage of individuals with nocturia of two or more times increased constantly with age: less than 30 years, 3.1% of women and 3.4% of men; 30 to 59 years, 7.2% of women and 5. 7% of men; and 60 years old or older, 26.7% of women and 32.4% of men. Age-adjusted extrapolation to the general population (older than 20 years) currently living in Austria yielded that 10.8% of men and 11.8% of women have nocturia of two or more times. Overall, 66. 9% of women and 62.2% of men reported a negative impact of nocturia on their quality of life. The correlation was close between the degree of nocturia with the quality-of-life impairment in both sexes. Several voiding symptoms correlated significantly (P <0.001) with nocturia. CONCLUSIONS: Nocturia is almost equally present in both sexes, and the incidence and severity increase constantly from early adolescence to senescence. Approximately 10% of the general population (older than 20 years) have nocturia of two or more times, which impairs the quality of life in two thirds.

Adult↗
PubMed2005

[Nocturia in female with symptoms of urinary incontinence: analysis of associated clinical and urodynamic variables].

BACKGROUND: There is little information about urodynamic characteristics of females with symptoms of urinary incontinence (UI) and nocturia. METHOD: Descriptive study of 1731 females consecutively referred with symptoms of UI for study and treatment. Urogynaecological history, physical examination and urodynamic study were carried out. Patients with pelvic organ prolapse greater than second degree were excluded. Frequency of nocturia symptom and its relationship with urodynamic, personal and clinical variables were analysed. RESULTS: 743 patients (43%) of those included presented nocturia. Urodynamic diagnoses in patients with nocturia were: stress UI in 262 patients (35.4%); detrusor overactivity in 166 (22.3%); and both in 220 (29.6%). The rest (12.7%) had other diagnoses. Mean (S.D.) bladder capacity of patients with nocturia was less than that of the rest of patients: 459.8 (159.8) vs 530.6 (216.9) ml (p<0.001). Of all the variables associated with nocturia, those which showed independent association were (ExpB; 95%CI): age >65 years (1.88; 1.34-2.63); menopause (2.11; 1.56-2.86); hypertension (1.42; 1.04-1.94) and bladder cistometric capacity less than 300 (1.71; 1.01-2.91) and between 300 and 400 (1.67; 1.17-2.38). The urodynamic diagnosis of Stress UI was associated with the absence of nocturia. CONCLUSION: Nocturia is a frequent symptom among females complaining of urinary incontinence. Its presence is associated to age over 65 years, menopause, hypertension and reduced bladder capacity.

Aged↗
PubMed2001

Human atrial natriuretic peptide is a useful criterion in treatment of nocturia.

BACKGROUND: Nocturia is one of the major problems of elderly people. The possible causes of nocturia include irritation of lower urinary tract obstruction, disturbance of the fluid balance, and sleep disturbance. In a significant proportion of patients, the mechanism of nocturia is still unclear and a definitive method of treatment has yet to be determined. This study investigated how to treat nocturia. MATERIALS AND METHODS: We analyzed 51 patients who visited Kobe City General Hospital between January 1998 and June 1999 with nocturia (three or more nocturnal voidings) and no daytime urological problems. Twenty-two of these patients were given daytime diuretic therapy (azosemide 60 mg), while 29 other patients received a minor tranquilizer. The method of treatment was selected randomly. Correlations between the plasma level of atrial natriuretic peptide (hANP) and the effect of treatment were analyzed. RESULTS: Daytime diuretics decreased the nocturnal frequency of voiding in 10 out of 22 patients. The plasma hANP level at the first visit was significantly higher in the patients with improvement (p = 0.0026). Furthermore, the plasma hANP level was significantly decreased after daytime diuretic therapy in patients who showed improvement of nocturia with diuretic therapy (p = 0.0180). Minor tranquilizer administration decreased nocturia in 22 out of 29 patients. The plasma hANP level at the first visit was significantly lower in the patients who improved (p = 0.0021). CONCLUSIONS: These findings suggest that patients with higher plasma hANP levels should be treated as having subclinical heart failure, while nocturia in patients with a normal plasma hANP level might be caused by sleep disturbance.

Aged↗
PubMed2004

Prevalence of and risk factors for nocturia: Analysis of a health screening program.

BACKGROUND: We examined the prevalence of and risk factors for nocturia in Kurashiki city and the surrounding area, a rural area in Japan. MATERIALS AND METHODS: We collected data on 6517 individuals (4568 men and 1949 women) who participated in a multiphasic health screening. We analyzed the relationships between nocturia assessed by a questionnaire (voiding twice or more during night) and other variables including age, hypertension, cardiovascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes mellitus (DM), chronic renal failure, benign prostatic hyperplasia (BPH), smoking habit and alcohol intake. RESULTS: Overall, 1856 individuals (28.5%) answered that they arose to urinate at least twice during the night. This rate increased with age from 16.5% in individuals younger than 50 to 60.0% in those older than 69. Logistic regression analysis revealed that cohorts of subjects 50-59, 60-69, and 70 years old or over had, respectively, 1.75, 3.35, and 6.21 times the prevalence of nocturia of the 49 years or younger cohort. Hypertension (odds ratio [OR] 1.64) and DM (OR 1.70) were other independent positive risk factors for nocturia. On the other hand, current smokers who smoked 20 or more cigarettes per day were less likely to have nocturia than non-smokers (OR 0.72). In male individuals, BPH was another independent positive risk factor (OR 1.35). Gender was not associated with nocturia. CONCLUSIONS: Although population bias is an important limitation to this study, nocturia is associated with various factors suggesting that multiple approaches are needed to the treatment of patients with nocturia.

Age Distribution↗
PubMed2005

Fluctuation of night time frequency in patients with symptomatic nocturia.

BACKGROUND: We examined the fluctuation and causes of voiding frequency during the night in patients with symptomatic nocturia. MATERIALS AND METHODS: Actual night time frequency was recorded by 72 patients for a total of 769 nights (mean 10.7 nights per patient) and was compared with the 'nocturia score' of the International Prostate Symptom Scores (I-PSS). If a patient experienced nocturnal frequency higher or lower than usual, he or she checked the items on a questionnaire considered reasons for the changes. RESULTS: For 471 nights of 769 (61%), actual voiding frequency did not correspond with nocturia score. Patient-by-patient fluctuation in actual voiding frequency during the night was marked. The most prevalent patient-reported reason for fluctuation was amount of fluid intake, followed by duration of time in bed, feeling colder or warmer during time in bed and increased difficulty going to sleep. Fatigue, difficulty going to sleep and salt intake could affect night time frequency positively or negatively. When nocturia score and total score of the I-PSS were high, the differences between actual nocturnal frequency and nocturia score were significantly larger (3 or less, 0.71; 3-4 or more, 1.05, P<0.0001 and 13 or less, 0.78; 14 or more, 0.97; P=0.0030, respectively). Female patients tended to have nocturia scores differing from actual frequency of urination (1.03 versus male patients 0.84, P=0.0673). CONCLUSIONS: There is considerable discrepancy between the nocturia score of the I-PSS and actual voiding frequency, in addition to marked fluctuation of actual voiding frequency in symptomatic patients. Patient perception of fluctuation of night time frequency can provide clues to useful clinical education of patients regarding nocturia.

Adult↗
PubMed2005

Epidemiology of nocturia.

The incidence of nocturia episodes increases with age and is associated with interrupted sleep and distress. There are no large differences in the incidence of nocturia between men and women, but young women tend to have it more frequently than young men, and very old men have it more often than very old women. The International Continence Society has defined nocturia as 'the number of voids recorded during a night's sleep: each void is preceded and followed by sleep.' This simple and useful definition should facilitate further epidemiological study of nocturia. Although there are many direct prevalence studies of nocturia, there is a great need for more advanced analytical epidemiological data on risk factors and comorbidity. Clinicians should question patients about nocturia and should consider this symptom in a broader sense than in its traditional association with benign prostatic obstruction in men and incontinence in women. There are several classic studies of nocturia. The nature of future epidemiological research will depend on the resolution of several methodological issues. Further evaluation of nocturia is warranted because of its high incidence among the general adult population.

Adult↗
PubMed1992

Nocturia: a risk factor for falls in the elderly.

OBJECTIVE: To determine if nocturia is a risk factor for reported falls and bone fractures in older persons. DESIGN: Cross-sectional study comparing falls in men and women with and without nocturia. SETTING: Longitudinal health screening program of ambulatory elderly participants. PARTICIPANTS: Participants included 988 (65.5%) women and 520 (34.5%) men who had completed their tenth annual visit to the program. MAIN OUTCOME MEASURES: Reported falls in the past year and reported bone fractures in the past 5 years. RESULTS: Participants who reported nocturia at least twice during the night were at significantly greater risk to report falls (Odds Ratio = 1.84; 95% CI = 1.05-3.22), and the risk increased in subjects reporting more than three nocturia events (Odds Ratio = 2.15; 95% CI = 1.04-4.44). The significant increase in falls reported by nocturia participants did not result in an increase in reported bone fractures in the past 5 years (P < 0.4360). CONCLUSIONS: Nocturia is an important risk factor for falls in ambulatory elderly persons. Preventive measures should be taken to decrease nocturia events and to decrease the risk of falling during these nocturia events.

Accidental Falls↗
PubMed2004

Effectiveness of a nonsteroidal anti-inflammatory drug for nocturia on patients with benign prostatic hyperplasia: a prospective non-randomized study of loxoprofen sodium 60 mg once daily before sleeping.

We explored the effectiveness of loxoprofen sodium (loxoprofen), which is the most common non-steroidal anti-inflammatory drug (NSAID) in Japan, for patients with benign prostatic hyperplasia (BPH) complaining of nocturia. A total of 93 BPH patients aged 49-84 years were enrolled in the study. These patients had received standard drug therapy with alpha1-blocker for BPH, followed by anticholinergic drugs, hypnotics, tricyclic antidepressants, and/or antiduretic hormone, but they still complained about 2 or more episodes of nocturia. They each took a single 60-mg tablet of loxoprofen prior to sleeping at night for 14 days in addition to their BPH treatments. The effects were assessed by questionnaire before and after treatment as excellent (nocturia disappeared or decreased by 2 or more voids/night), improved (nocturia decreased by 1 void/night), unchanged, or worsened (nocturia increased). Nocturia improved or disappeared in 74.2% of patients: excellent, improved, unchanged, and worsened results were obtained in 37.6%, 36.6%, 21.5%, and 4.3% of patients, respectively. The effects were better in patients whose baseline nocturia was > 2 times than in those with a lesser frequency at enrollment (P = 0.04). Loxoprofen can be an effective and useful treatment option for patients with BPH complaining of refractory nocturia.

Aged↗
PubMed2006

Incidence of nocturia in 50 to 80-year-old Finnish men.

PURPOSE: We estimated the incidence and natural course of nocturia in an unselected Finnish male population. MATERIALS AND METHODS: A mail interview of a cohort of 3,143 randomly selected men 50 to 70 year old at study entry was done in Finland in 1994, 1999 and 2004. The questionnaire included questions on sociodemographic status, overall health and disease, urinary symptoms, sexual functioning and symptom bother. The overall response rate was 70% on the 1994 survey, 75% on the 1999 survey and 76% on the 2004 survey. A response to nocturia questions was obtained from 1,633 men at the 1994 to 1999 followup and from 1,618 at the 1999 to 2004 followup. RESULTS: The overall prevalence of 1 or more nocturnal voidings was 56% at baseline and 74% 10 years later. The crude incidence rate for nocturia was 75 new cases per 1,000 men annually (95% CI 66 to 85) during the first 5-year followup period and 126/1,000 (95% CI 113 to 140) during the second period. The incidence of moderate or severe nocturia was 9/1,000 (95% CI 7 to 11) and 14/1,000 men (95% CI 12 to 17), respectively. Incidence and prevalence increased clearly with age but also by calendar time, which was most prominent for the mild nocturia incidence. The incidence of moderate to severe symptoms increased, especially in the oldest cohort (incidence density ratio 5.6 to 5.7/5 years). CONCLUSIONS: Every year 10% more males older than 50 years start to void during the night. The incidence of mild nocturia increases, especially in men when they age from 50 to 60 years. In older men mild symptoms are more stable but the incidence of severe nocturia increases strongly after age 75 years.

Age Distribution↗