Nocturia: Evaluation and Management
Nocturia (ie, awakening to void one or more times per night) is common in adults, with increasing prevalence in older age. Nocturia is associated with increased risk of falls and fractures, cognitive impairment, and depressed mood. In general, mechanisms for nocturia fall into one of four categories: increased nighttime urine production, decreased storage ability, incomplete bladder emptying, or primary sleep disorder. Although screening for nocturia currently is not recommended, patients reporting bothersome symptoms should be evaluated and treated. Initial workup includes assessing urinary symptoms, fluid intake, and comorbidities. Using validated nocturia questionnaires and frequency-volume charts (bladder diaries) can aid in diagnosis. A urinalysis should be performed for all patients. Lifestyle modifications and treatment of underlying comorbidities are first-line therapies for nocturia. Limitation of fluid intake, especially in the evening; addressing timing of diuretic intake; a
