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The articles selected represent some of the most important studies recently published about Nocturia and have been selected by the Nocturia Resource Center Editors.
The selection criteria was based on the scientific quality of the article, judgment of the highly impressive content for the readers involved in the field, and on the basis of the editorial resource of the journals themselves. Starting from these articles it is now strongly needed to consider nocturia one of the most troublesome condition in the adult population.
The survey on Nocturia conducted by Kupelian and co-workers, published in Eur Urol 2012 and performed in more than 5500 residents in the Boston area (MA-USA), well demonstrates a significant association of nocturia with decreased QOL and interference with daily activities in both men and women. In addition nocturia was found to be associated with increased likelihood of depression, especially among younger men and women.
These concepts have been also clearly indicated by Wyndaele in the Editorial recently published in European Urology: “Nocturia and Quality of Life”, in which the Author reports that sleep disturbances, as caused by nocturia, interfere with optimal functioning of the endocrine, metabolic, and immune systems, and increase the risk of type 2 diabetes, cardiovascular diseases (cardiac arrhythmia, angina pectoris, and myocardial infarction), and obstructive sleep apnea. Importantly, mortality may be increased in elderly patients with disturbed sleep.
To deeply examine what are the effects of nocturia on sleep it is proposed to read the Clinical Review entitled: “The effect of nocturia on sleep” (Sleep Medicine Review 2011), in which new data reinforce the concept of increased risks associated with insufficient sleep. In this review the duration of the initial sleep period, evaluated in combination with the number of voiding episodes per night, has been suggested as an indication of the severity of sleep disruption in patients with nocturia.
The causes, consequences and clinical approaches of nocturia have been further investigated and reported by Weiss and co-Authors in the homonymous Book from Springer. The problem of nocturia in older men has also been well addressed by van Doorn and Bosch in their article published in “Maturitas”. The Authors also pointed out what can be the therapeutic solutions for nocturia, which should include lifestyle advices with medications. A proper solution could be the use in combination of an anti-diuretic and an antimuscarinic drug, a subject of research for future clinical trials.
With regards to treatment of nocturia, in the last years antidiuretic therapy has been assuming a great relevance, as showed by the article entitled: “Antidiuresis therapy. Potential mechanisms of action and clinical implication” and published in 2007 in Neurourology and Urodynamics. In this article the mechanism of action of desmopressin and the potential benefits coming from the use of this agent have been well investigated.
Finally, it should be really important to analyze the article of Weiss and co-workers who report the results of an interdisciplinary conference on nocturia. In the Article a consensus on the current state and direction of the field of nocturia have been formulated by a group of panelists involved in this field of research. Particularly, the Authors report new information on epidemiology of nocturia, predictors and risk factors and treatment options, by examining lifestyle changes and supplements, non-antidiuretic pharmacotherapy, timed diuretics and antidiuretic therapy. Again, in this article desmopressin has proven to be well-tolerated and effective in several randomized, placebo-controlled trials and is recommended as a first-line treatment (either as monotherapy or in combination with other agents) for patients who have been appropriately evaluated and whose nocturia is related to NP whether or not accompanied by BPH or OAB.