Nearly 30% of U.S. women report nocturia

San Francisco-Nocturia appears to be highly prevalent in the United States, with almost 30% of all women reporting significant nocturia, according to new data reported at the AUA annual meeting in San Francisco.

Researchers mined data from the National Health and Nutrition Examination Survey (NHANES) database and found that among all women surveyed, 28.8% reported significant nocturia.

The authors analyzed data on 7,620 women and found that nocturia rates increased with increasing age (p<.0001). In addition, among those women who underwent childbirth, delivery type had no association with nocturia (p=.23). The investigators conducted a multivariable analysis and found that only increasing age (odds ratio [OR]: 1.8), African-American race (odds ratio: 2.35), body mass index ≥30 (odds ratio: 1.5), urge incontinence (OR: 1.6), and poor overall health (OR: 1.48) were associated with increased rates of nocturia.

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“Urge incontinence and poor health status correlated with nocturia,” said study author Timothy Byler, MD, assistant professor of urology at SUNY Upstate Medical University, Syracuse, NY. “In terms of medical comorbidities associated with nocturia, depression, hypertension, and arthritis were highly associated.”

Obstetrical history not associated

Dr. Byler, who presented the study findings, said obstetrical history was found to have no association with nocturia. Factors not associated with nocturia were hysterectomy, prolapse, oophorectomy, menopause, and delivery type. He said the findings, while intriguing, are limited by their retrospective nature.

“There are certain limitations due to recall bias and survey bias,” said Dr. Byler.

Nocturia can be one of the most bothersome lower urinary tract symptoms that can significantly affect quality of life. In both men and women, nocturia has been associated with decreased overall health, but little evidence exists on the prevalence of nocturia in U.S. females.

“There is a lot of focus on male nocturia and treatment for it, but there is not a lot in the literature on female nocturia and how common it is,” Dr. Byler said in an interview with Urology Times.

Next:How the study was conducted

Dr. Byler and his colleagues wanted to look at prevalence and identify factors associated with significant nocturia. They examined the NHANES database and looked at females surveyed during the years 2009-2014. Nocturia information was obtained from a questionnaire and for this study, the authors defined significant as those women who urinated two or more times per night. The team investigated demographic characteristics, urinary incontinence history, and gynecologic/obstetrical history.

Dr. Byler said the Boston Area Community Health Study estimated 28 million U.S. adults regularly experienced significant nocturia (two or more times per night). In just loss of productivity based on that number, it is projected the costs at more than $61 million in 2008, according to Dr. Byler.

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He said conditions associated with nocturia in adults include an increased risk for mortality, increased risk in falls, increased risk in depression, a decreased risk in quality of life, and a risk for decreased work productivity. He said the disease states associated with nocturia include endocrine disorders and obstructive sleep apnea.

Based on their findings, the authors concluded that nocturia is prevalent in the U.S. in women and may need to be discussed more commonly.

“It may have associations with other medical issues and concerns, and we should remember to query women about nocturia. We should try to address it more,” Dr. Byler said.