Nocturia—treatment increases quality of life

Abstract

Nocturia, the need to urinate at night, affects about 3/4 of men and women over the age of 70. However, younger people may also be affected. The consequences of reduced quality of sleep, and reduced or impaired sleep efficiency can have a major impact on quality of life, performance, and the emergence of depressive symptoms. In this review article, we examine more closely the various triggers of nocturia and present causes with regard to urine production, storage and drainage, but also nonurological aspects. Thereafter the necessity of cause-adapted treatment of nocturia is discussed. In general, due to the multifactorial causes, nocturia can only be treated after precise diagnosis. For example, global polyuria due to polydipsia, diabetes insipidus or diabetes mellitus is treated differently compared to nocturia due to overactive bladder or benign prostatic hyperplasia. Finally, we also examine more closely the shift in antidiuretic hormone (ADH) secretion as a cause of nocturnal polyuria. A delayed or disturbed cycle or ADH receptor dysfunction consequently leads to the formation of larger amounts of urine even during sleep and thus often to nocturnal polyuria. In this case, the use of desmopressin, a synthetic analogue of the body’s own ADH vasopressin, as a therapeutic option must be mentioned. Desmopressin promotes the reabsorption of water and thus leads to a reduction of nocturia symptoms.