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Volume
of Urine is a Useful Indicator of Nocturnal Polyuria
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), 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 (greater than or equal to 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.
Treatment Options
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.
References
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
7) Asplund R et al. Nocturia and depression. BJU Int
2004;93:1253-1256
(8/9/04) |