Poor Quality of Sleep? Getting at the Root Cause

Waking to use the bathroom causes poor quality of sleep

By Nancy Muller, PhD
Executive Director of the National Association For Continence

As the U. S. population ages and Baby Boomers, in particular, move well past the threshold of midlife, loss of sleep quality becomes a common topic of conversation for many. One of the leading causes of sleep disturbance is nocturia. To understand how people are impacted by urinary symptoms causing sleep to be interrupted, NAFC conducted in 2009 a nationwide survey of women ages 40 – 651. The purpose of this research was to assess the severity of overactive bladder (OAB) and nocturia in middle-aged American women, their attitudes about seeking treatment and the impact of symptoms of overactive bladder (OAB), accompanied by symptoms of nocturia, on quality-of-life.

The American Urological Association (AUA) defines nocturia as the need to urinate at least twice during the night. This definition was used by NAFC in its study to analyze the impact of nocturia. In the online study, a control group was comprised of 500 female, non-OAB sufferers, ages 40-65. The remaining 611 women, with a similar demographic profile and with symptoms of OAB, were divided into three categories: women who have never been treated, women who were currently undergoing treatment and women who had been diagnosed and started treatment but had stopped their treatment. Treatment was defined as adherence to the daily administration of a pharmacologic agent and/or behavioral strategies prescribed by a physician.

Based on this study, 63% of the nationally represented American women in the control group reported that not getting enough sleep disrupts their sense of normalcy. The results of this study illustrate how nocturia impacts quality-of-life and could be a factor for disrupting a persons sense of normalcy. NAFC found that nearly half of women with OAB report that they experience nocturia, with one in five experiencing severe nocturia, i.e., going to the bathroom four or more times per night. Respondents with nocturia were more likely to report suffering from depression than those self-reporting OAB but without nocturia. These results suggest that nocturia significantly impacts a middle aged womans quality-of-life and deserves medical intervention.

While little appeared in scientific literature about nocturia until very recent years, the topic is receiving more attention because so many aging Americans are now complaining about their lack of sleep or poor quality sleep. Rather than discussing the problem superficially with your primary doctor and reaching for prescription or over-the-counter sleep aids, it is important to get at the root causes of the interruptions, which may include urinary symptoms associated with nocturia.

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