Adherence to a personalized optimal bedtime shown to improve nocturia frequency

Use of a wearable watch to help patients determine when to go to sleep was shown to improve nocturia frequency, according to findings presented at the 2023 American Urological Association Annual meeting in Chicago, Illinois.¹

"Average nocturia urinary frequency was changed from 3.9 to 3.0 in the intervention period, [and] it was changed from 3.71 to 3.70 in non-intervention period," said Okumura.

“Patient[s] with severe nocturia have a tendency to go to bed earlier than their optimal bedtime. Sleeping regularly at personalized optimal bedtime determined by our method may significantly improve their nocturnal urinary frequency (NUF), nocturnal urine volume (NUV), and sleep quality,” said lead author Yoshinaga Okumura, MD, during a presentation of the results. Okumura is a urologist at the University of Fukui in Japan.

The prospective study enrolled 24 participants for whom therapy was not indicated or not effective. Among all patients, 17 were male and 7 were females. The mean age of participants was 79.8 years.

Patients participated in a crossover comparative analysis consisting of alternate 4-week intervention and non-intervention periods with a 2-week washout period. During the intervention periods, those included in the study were instructed to go to bed according to the personalized time determined by an Actiwatch Spectrum watch.

Optimal bedtime was determined using the steepest descent method, taking into account the bedtime and mid-awake time of each patient, which was obtained from the watch. Frequency volume charts and the Pittsburgh Sleep Quality Index (PSQI) questionnaire were also administered before and after the intervention period.

Data showed that patients’ average bedtime before the intervention was 21:30, compared with an average time of 22:11 after the intervention.

Okumura added, “In other words, ideal bedtime was 41 minutes later than their usual bedtime. Average nocturia urinary frequency was changed from 3.9 to 3.0 in the intervention period, [and] it was changed from 3.71 to 3.70 in non-intervention period.”

The difference in NUF before and after the intervention showed a negative correlation with the difference in bedtime (P = .002). Changes in NUV (P = .033) were shown to be significantly improved by the intervention period. PSQI values also improved from 7.6 in the non-intervention period to 5.4 in the intervention period (P = .008).

Changes in nocturnal bladder capacity and mid-wake duration were not found to be significant between the 2 periods.

Reference

1. Okumura Y, Nobukawa S, Ishibashi T, et al. Personalized bedtime determined by a wearable device improves nocturia; a prospective interventional crossover study. Presented at: American Urological Association Annual Meeting, April 28-May 1, Chicago. Abstract MP74-10