Objective
To examine the prevalence, predictors and effects of nocturia in women, and evaluate overlaps with established urinary tract disorders.
Methods
This was a cross-sectional analysis of 2,016 women, aged 40 years and older, recruited from Kaiser Permanente Northern California from 2008 to 2012. Nocturia and other urinary symptoms were assessed using structured interviewer-administered questionnaires. Nocturia was defined as patient-reported nocturnal voiding of two or more times per night over a typical week.
Results
Thirty-four percent (n=692) reported nocturia, and 40% of women with nocturia reported no other urinary tract symptom. Women with nocturia were older (mean age 58 versus 55) (OR per 5-year increase 1.21 [95% CI, 1.12-1.31]) more likely Black (45%) (OR 1.75, [95% CI, 1.30-2.35]) or Latina (37%) (OR 1.36 [95% CI, 1.02-1.83]) versus non-Latina White (30%), have worse depression (mean Hospital Anxiety and Depression Scale (HADS) score 3.8 versus 2.8)(OR per 1-point increase in HADS score 1.08 [95% CI, 1.04-1.12]) and worse mobility (mean Timed Up-and-Go (TUG) 11.3 versus 10 seconds) (OR per 5-second increase in TUG 1.29 [95% CI, 1.05-1.58]). Nocturia occurred more among women with hysterectomy (53% versus 33%) (OR 1.78 [95% CI, 1.08-2.94]), hot flashes (38% versus 32%) (OR 1.49 [95% CI, 1.19-1.87]), and vaginal estrogen use (42% versus 34%) (OR 1.50 [95% CI, 1.04-2.18]).
Conclusion
Nocturia is common in women and not necessarily attributable to other urinary tract disorders. Factors not linked to bladder function may contribute to nocturia risk, underlining the need for multi-organ prevention and treatment strategies.