Adjustment to an Appropriate Bedtime Improves Nocturia in Older Adults: A Crossover Study

Abstract

Purpose

We examined whether nocturia could be improved by adhering to an appropriate bedtime as determined using a wearable device that measures sleep–wake activity.

Materials and Methods

We enrolled patients aged 65 years or older with nocturia at our institution and associated hospital, for whom medical therapy was either not indicated or ineffective. We conducted a prospective crossover comparative study with alternate 4-week intervention and non-intervention periods with a 2-week washout period. During the intervention, participants were instructed to go to bed at a personalized bedtime determined via the steepest descent method, using the data of bedtime and mid-wake time from an Actiwatch Spectrum (Philips Respironics). A frequency volume chart was administered before and after each period. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI).

Results

The analysis included 24 patients enrolled for the study. The mean age was 79.7 years. The mean bedtime changed from 21:30 to 22:11 after intervention (p < 0.01). During the intervention and non-intervention periods, the mean changes were as follows: nocturnal urinary frequency (−0.90 vs. −0.01 times, p < 0.01), nocturnal urine volume (NUV) (−105.6 vs. +4.4 mL, p = 0.04), hours to undisturbed sleep (HUS) (62.8 vs. 12.7 min, p < 0.01), NUV per hour during HUS (−28.4 vs. −0.17 mL/h, p = 0.04), and PSQI scores (−2.4 vs. 1.2, p = 0.022).

Conclusions

In older patients with nocturia, going to bed at appropriate times, determined using a wearable device that measures sleep–wake activity, might potentially prolong HUS, decrease NUV, specifically NUV/h during HUS, and consequently improve nocturia and sleep quality.