26 August, 2004
Millions of sufferers who take frequent night time toilet visits can now help to diagnose themselves with a simple home test
A recent study of 1,000 Nocturia patients presented this August at the ICS/IUGA Annual Meeting in Paris found that more than 76% had the troublesome condition known as Nocturnal polyuria. Studies also show that a significant proportion of adults under the age of 65 are losing sleep due to frequent urination at night (1).
The volume of urine a person expels at night is a key indicator in diagnosing whether a problem like Nocturia exists, experts say, and patients now have a way of charting urine output to determine if they have such a problem.
Healthy people of various ages with one or more nightly voiding episodes often experience problems such as sleep deprivation and work impairment. "Lack of sleep due to nightly urination is more than uncomfortable, say Dr. Poul Jennum, Danish sleep expert. "Sleepiness during the day can become a danger to overall health, safety, and strain interpersonal relationships in the workplace."
Nocturnal polyuria sufferers produce frequent and large discharges of urine at night that account for more than 1/3 of the total daily output.
Treatment with MINIRIN (desmopressin) reduces urine volume by increasing urine concentration. One nightly dose lasts up to 8 hours, and can significantly reduce the need to wake at night for urination. Studies indicate that around 30% of patients experience an undisturbed sleep of 5 hours or more after taking MINIRIN (2,3,4).
Those suffering from lack of sleep due to night time toilet visits now have an important tool to help'diagnose' their problem. By recording urine output for a few days with a simple Frequency Volume Chart (FVC) (see enclosed), patients can provide valuable data to a doctor evaluating their condition.
Nocturia can also be linked to depression
Sleep deprivation due to nighttime toilet visits can become a chronic problem with serious health consequences. Beyond the body's sleep threshold, a person will have difficulty undertaking normal daily activities. Cognitive functions such as concentration, memory, and creativity can all be negatively affected, according to experts (5).
Problems staying alert at work can also affect a person's productivity. Statistics show that Nocturia sufferers have about a 9.2% reduction in work output, when compared to healthy individuals (6).
A Swedish study presented in Feb 2004, suggests a strong link between major depression (MD) and Nocturia (≥2 voids per night)7. Researchers found a six-fold increase of Nocturia in men (mean age of 48), and a three-fold increase in women with a mean age of 50, associated with major depression.
Patients experiencing the need to urinate at night (more than once) and who excrete large volumes at night (350 ml or more per void) can try to make lifestyle changes such as limiting consumption of fluids in the late afternoon and evening such as coffee, soft drinks, or tea, experts say.
However, this lifestyle change does not work for most sufferers. Drug therapy is a viable option.
For treatment of Nocturia polyuria, MINIRIN (desmopressin) mimics the action of the naturally-produced antidiuretic hormone vasopressin, by reducing excessive nocturnal urine output.
1) Paul Abrams et al. Is nocturnal polyuria a key factor in nocturia? Abstract presented at ICS/IUGA 2004
2) Mattiasson A. et al. Efficacy of desmopressin in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int 2002;89:855-862
3) Lose G. et al. Efficacy of desmopressin (Minirin) in the treatment of nocturia: a double-blind placebo-controlled study in women. Am J Obstet Gynecol 2003;189:1106-1113
4) Van Kerrebroeck, P., Rezapour, M., Thüroff, J., Cortesse, A. (2002). "Efficacy and safety of oral desmopressin (MINIRIN) in treatment of nocturia in men and women." Int Urogynecol J 13:S5-S6
5) Jennum P. The impact on nocturia on sleep. Presented at First International Nocturia workshop, June, Malta.
6) Kobelt G et al. Productivity, vitality and utility in a group of healthy professionally active individuals with nocturia. BJU Int 2003;91:190-195
Asplund R et al. Nocturia and depression. BJU Int 2004;93:1253-1256
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