Short‐term effects of systematized behavioral modification program for nocturia: A prospective study

Cho, Sung Yong; Lee, S.; Kim, In Sung; Koo, Dong Hun; Kim, Hyeon Jun; Oh, Seung‐June

doi:10.1002/nau.21186

Cited by 31 publications

(21 citation statements)

References 16 publications

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“…The recommended treatment of nocturia in older adults includes optimizing therapy for fluid overload conditions such as congestive heart failure and diabetes mellitus and treating underlying bladder or prostate etiologies with antimuscarinics or alpha‐blockers, but such agents cause adverse events and further enhance the risk of falls, fractures, and mortality in older individuals with nocturia . Multicomponent behavioral or lifestyle interventions to improve nocturia, mostly focused on fluid restriction, preemptive voiding, or pelvic floor muscle training, have also shown promising results, although to the best of the knowledge of the authors of the current study, there has been no study of behavioral treatment of insomnia focused on nocturia as an outcome. A recently completed sleep study provided an opportunity to evaluate changes in nocturia in older adults receiving brief behavioral treatment of insomnia (BBTI).…”

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confidence: 90%

Behavioral Treatment of Insomnia: Also Effective for Nocturia

Tyagi

Resnick

Perera

et al. 2014

J American Geriatrics Society

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Objectives To evaluate changes in self-reported nocturia among community dwelling adults aged 60 and older who received behavioral treatment for chronic insomnia. Design Secondary analysis of an RCT of a behavioral intervention for sleep. Setting and Participants Of the 79 enrollees in the RCT, this analysis focused on 30 who in addition to insomnia, also reported at least one nightly episode of waking up to void Intervention The Brief Behavioral Treatment of Insomnia (BBTI) group received instructions on reducing time in bed and setting a regular sleep schedule. The Information control (IC) group received printed materials. Both interventions were delivered by a nurse clinician. Measurements Self-reported nocturnal awakenings to void assessed daily for 14 days at baseline and 4 weeks post-intervention. Participants (16 IC; 14 BBTI) who reported at least one episode of nocturia per night at baseline were included in this analysis. Results Among individuals with nocturia at baseline, the total number of nocturnal voids over the 14-day assessment period decreased by 6.5 [sd, 4.8] in the BBTI group compared to an increase of 1.3 [sd, 7.3] in the information only control group (p=0.04, effect size 0.82). After adjusting for baseline nocturia episodes, the difference remained significant (p=.05). Conclusion Among older adults with concurrent insomnia and nocturia, behavioral treatment directed solely at insomnia may also improve self-reported nocturia. Behavioral treatment of insomnia should be further investigated for its effect on nocturia among individuals with concurrent insomnia and nocturia.

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confidence: 90%

Behavioral Treatment of Insomnia: Also Effective for Nocturia

Tyagi

Resnick

Perera

et al. 2014

J American Geriatrics Society

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“…), medication timing (diuretics in the midafternoon), evening leg elevation to mobilize fluids, use of sleep medications or sleep aides, and use of protective undergarments [2]. Although no randomized controlled trials (RCTs) evaluating the effect of behavioral modification on nocturia as a primary outcome have been found, one study showed that the education about life style modification could reduce nocturia episode and related quality of life [17]. …”

Section: Managementmentioning

confidence: 99%

Current Evaluation and Treatment of Nocturia

Park

Kim

2013

Korean J Urol

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Nocturia is usually considered to be just one of the symptoms included with lower urinary tract symptoms (LUTS) and is treated with therapy based on LUTS. Recent research suggests, however, that nocturia is not merely a simple symptom of LUTS but is a multifactorial condition with many contributing etiological factors. The causes of nocturia can be classified into bladder storage problems, increased urine output, sleep disturbance problems, and other potential diseases. The frequency-volume chart (FVC) is very important in evaluating and diagnosing nocturia. Patients usually record the volume and timing of voids for a period of 1 to 3 days on the FVC. The FVC data can provide information on voiding patterns and clues about the etiology and treatment of nocturia. It is doubtful that alpha-blockers will have clinical significance for treatment because the difference in nocturia episodes between treatment with alpha-blockers and placebo is too small. Antimuscarinics also exert no effect on nocturnal polyuria, and the evidence supporting the efficacy of antimuscarinics for the treatment of nocturia is limited. However, several randomized placebo-controlled trials have shown the efficacy of oral desmopressin in the treatment of adults with nocturia. Short-acting hypnotics may be helpful for patients with sleep disturbances. Although surgical or interventional therapy is not indicated for nocturia, transurethral resection of the prostate appears to confer a greater improvement in benign prostatic hyperplasia symptoms including nocturia. The management of nocturia may require a team approach by making optimal use of multidisciplinary expertise.

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“…Current data on the therapy of nocturia support this notion. A study examining the effects of behavioral therapy, including evening fluid restriction, demonstrated a significant decrease in nocturic episodes and an average reduction of 106 ml in nocturnal urine volume, after two behavioral modification education sessions [20]. In contrast, a recent study showed mirabegron to have increased voided volume by 11 ml/void relative to placebo [21].…”

Section: Discussionmentioning

confidence: 99%