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Cooper, Sheldon J., and James A. Gessaman. "Nocturnal Hypothermia in Seasonally Acclimatized Mountain Chickadees and Juniper Titmice." Condor 107, no. 1 (February 1, 2005): 151–55. http://dx.doi.org/10.1093/condor/107.1.151.
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AbstractWe measured body temperature of Mountain Chickadees (Poecile gambeli) and Juniper Titmice (Baeolophus ridgwayi) at different times of day and under a range of ambient temperatures in order to determine the use of nocturnal hypothermia in seasonally acclimatized small passerines. Our findings show both species used nocturnal hypothermia year-round. Depth of hypothermia was inversely correlated to body mass in Juniper Titmice but not in Mountain Chickadees. In both species, depth of hypothermia did not vary seasonally but nocturnal body temperature was regulated 3–11°C lower than daytime values. Nocturnal energy savings range from 7%–50% in chickadees and from 10%–28% in titmice. These nocturnal energy savings translate into ecologically important reductions in daily energy expenditures for these two species.Hipotermia Nocturna en Individuos de Poecile gambeli y Baeolophus ridgwayi Aclimatados EstacionalmenteResumen. Medimos la temperatura corporal de Poecile gambeli y Baeolophus ridgwayi a diferentes horas del día y en un rango de temperaturas ambientales para determinar el uso de hipotermia nocturna en pequeñas aves paserinas aclimatadas estacionalmente. Nuestros resultados muestran que ambas especies presentaron hipotermia nocturna durante todo el año. La profundidad de la hipotermia estuvo inversamente correlacionada con la masa corporal en B. ridgwayi, pero no en P. gambeli. En ambas especies, la profundidad de la hipotermia no varió estacionalmente, pero la temperatura corporal nocturna estuvo regulada 3–11°C por debajo de los valores diurnos. El ahorro nocturno de energía varió entre 7%–50% en P. gambeli y entre 10%–28% en B. ridgwayi. Estos ahorros nocturnos de energía se tradujeron en reducciones ecológicamente importantes en los gastos diarios de energía para ambas especies.
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Broughton, Roger J. "The Parasomnias and Sleep Related Movement Disorders—A Look Back at Six Decades of Scientific Studies." Clinical and Translational Neuroscience 6, no. 1 (January 31, 2022): 3. http://dx.doi.org/10.3390/ctn6010003.
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The objective of this article is to provide a comprehensive personal survey of all the major parasomnias with coverage of their clinical presentation, investigation, physiopathogenesis and treatment. These include the four major members of the slow-wave sleep arousal parasomnias which are enuresis nocturna (bedwetting), somnambulism (sleepwalking), sleep terrors (pavor nocturnus in children, incubus attacks in adults) and confusional arousals (sleep drunkenness). Other parasomnias covered are sleep-related aggression, hypnagogic and hypnopompic terrifying hallucinations, REM sleep terrifying dreams, nocturnal anxiety attacks, sleep paralysis, sleep talking (somniloquy), sexsomnia, REM sleep behavior disorder (RBD), nocturnal paroxysmal dystonia, sleep starts (hypnic jerks), jactatio capitis nocturna (head and total body rocking), periodic limb movement disorder (PLMs), hypnagogic foot tremor, restless leg syndrome (Ekbom syndrome), exploding head syndrome, excessive fragmentary myoclonus, nocturnal cramps, and sleep-related epileptic seizures. There is interest in the possibility of relationships between sleep/wake states and creativity.
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Lewis, Tyler L., Daniel Esler, W. Sean Boyd, and Ramūnas Žydelis. "Nocturnal Foraging Behavior of Wintering Surf Scoters and White-Winged Scoters." Condor 107, no. 3 (August 1, 2005): 637–47. http://dx.doi.org/10.1093/condor/107.3.637.
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Abstract We studied the nocturnal foraging behavior of Surf Scoters (Melanitta perspicillata) and White-winged Scoters (Melanitta fusca) during winter in coastal British Columbia, Canada. Using radio telemetry, we collected nocturnal and diurnal data documenting the frequency of foraging dives and the location of scoters in relation to their intertidal foraging grounds. We found that dive foraging rarely occurred during nocturnal periods for either species. Only 2% of nocturnal observation blocks for both scoter species contained diving, compared with 98% of diurnal observation blocks. This corresponded to an average of only 0.1 min spent underwater per half-hour observation block during the night and over 7 min during the day. Both species of scoters were located farther offshore and in deeper waters during nocturnal hours, indicating that they were not using intertidal foraging areas at night. Our results suggest that Surf Scoters and White-winged Scoters face daylight-imposed limits on the amount of available foraging time. These potential day-length restrictions should be considered when reviewing human activities that potentially alter the amount of available foraging time or food supplies in winter habitats. Comportamiento de Forrajeo Nocturno de Melanitta perspicillata y M. fusca Resumen. Se estudió el comportamiento de forrajeo nocturno de Melanitta perspicillata y M. fusca durante el invierno en la costa de British Columbia. Utilizando radio-telemetría, se colectaron datos nocturnos y diurnos sobre la frecuencia de buceos para alimentarse y la ubicación de las aves con relación a la zona intermareal. Se encontró que los buceos nocturnos son infrecuentes para ambas especies. Sólo en el 2% de las observaciones nocturnas de ambas especies se presentaron instancias de buceo, en comparación con el 98% de las observaciones diurnas. Esto corresponde a un promedio de 0.11 minutos bajo el agua por cada 30 minutos de observación durante la noche y más de 7 minutos durante el día. Ambas especies se ubicaron más alejadas de la costa y en aguas más profundas durante la noche, indicando que los individuos no utilizaron zonas intermareales durante este periodo. Estos resultados sugieren que M. perspicillata y M. fusca enfrentan restricciones en el número de horas disponibles para alimentarse en función de la cantidad de luz. El efecto de la duración del día debe ser considerado cuando se estudia el impacto de actividades humanas que pueden alterar el tiempo disponible para forrajeo o la cantidad de alimento durante el invierno.
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Olesen, Tine, Jerome Paul, Pierre Gramme, Marcus J. Drake, Johan Vandewalle, and Karel Everaert. "Assessment of the Most Impactful Combination of Factors Associated with Nocturia and to Define Nocturnal Polyuria by Multivariate Modelling." Journal of Clinical Medicine 9, no. 7 (July 16, 2020): 2262. http://dx.doi.org/10.3390/jcm9072262.
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Background: Nocturia is common and associated with multiple disease states. Many potential mechanisms have been proposed for nocturia, which also remains challenging to manage. Purpose: To use multivariate analysis to determine which combinations of factors can accurately discriminate clinically significant nocturia in patients to facilitate clinical management and treatment decisions. Patients and methods: Data analysis was based on frequency volume charts from three randomized controlled trials. There were 1479 patients included, of which 215 patients had no/mild nocturia and 1264 had clinically significant nocturia with at least two voids per night. Factors studied that may influence nocturia were demographics, sleep duration, functional bladder capacity, 24 h urine volume and literature-suggested definitions of nocturnal polyuria. We used univariate analysis and cross-validated multivariate modelling to assess association between factors and nocturia status, redundancy between factors and whether the combined use of factors could explain patients′ nocturia status. Results: The multivariate analyses showed that the most useful definitions of nocturia are ’Nocturia Index’ (NI) and ‘Nocturnal Urine Production per hour’ (NUPh) in combination with functional bladder capacity and sleep duration. Published definitions providing binary nocturnal polyuria outcomes had lower performance than continuous indices. These analyses also showed that NI was not specific to nocturnal polyuria as it also captured nocturia due to low functional bladder capacity. By contrast, NUPh was demonstrated to be specific to nocturnal polyuria. Conclusion: NUPh has previously been shown among elderly males to be essential in nocturia and a very valid measure of nocturnal polyuria. However, the current, large and independent dataset now confirms that it can be applied in an adult population with a complaint of nocturia covering both males and females.
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Kim, Soo Rim. "Pharmacotherapy for female nocturia." Journal of the Korean Medical Association 64, no. 6 (June 10, 2021): 449–54. http://dx.doi.org/10.5124/jkma.2021.64.6.449.
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Background: In 2018, nocturia and nocturnal lower urinary tract function definitions were updated in a clinically and practically based consensus report by the International Continence Society Standardization Steering Committee. Previous research has suggested that the pathophysiology of nocturia has a multifactorial etiology, including obstructive sleep apnea, overactive bladder syndrome, diabetes mellitus, sleep disturbance, congestive heart failure, primary polydipsia, and other factors.Current Concepts: Three main mechanisms have been identified: low functional bladder capacity, nocturnal polyuria, and diurnal polyuria (24-hour polyuria). Multifactorial pathophysiology implies multiple possible targets for therapeutic intervention, and suggests that it is unlikely that one treatment modality, including drugs, will be successful in all patients. The bladder diary is the most important diagnostic tool.Discussion and Conclusion: Strong evidence supports the efficacy of desmopressin and continuous positive pressure breathing. Antimuscarinic drugs for treating nocturia display limited usefulness because of their low efficacy for nocturnal polyuria. Management of nocturia may require a multidisciplinary approach to visualization and phenotyping of patients for diagnosis and therapy.
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Kim, Sun-Ouck, Ho Song Yu, Ho Suck Chung, and Dongdeuk Kwon. "Effects of desmopressin for the treatment of nocturnal polyuria in elderly women: impact on related sleep quality." Canadian Urological Association Journal 9, no. 11-12 (November 4, 2015): 770. http://dx.doi.org/10.5489/cuaj.3097.
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Introduction: We investigated the efficacy, safety, and impact of desmopressin on quality of sleep in treating nocturnal polyuria in elderly women.Methods: We recruited 60 women over 60 years old with lower urinary tract symptoms (LUTS), including nocturia, and with nocturnal polyuria. Nocturnal polyuria was defined as nighttime urine production exceeding 33% of the 24-hour total urine volume determined by a frequency volume (FV) chart. All patients failed to respond to treatment of their underlying disease and evening fluid restriction. Desmopressin 0.1 mg was administered orally at bedtime for 12 weeks. The participants completed a series of questionnaires on the Medical Outcomes Study (MOS) sleep scale and FV chart before and after treatment.Results: The patient population had a mean age of 69.2 ± 9.4 years (range: 61–81). The mean duration of symptoms was 61.2 ± 45.1 months. Significant decreases were evident after desmopressin treatment in the number of nocturia episodes (3.63 ± 1.61 to 2.00 ± 1.13, p = 0.01), nocturnal urine volume (p = 0.01), nocturnal polyuria index (NPI) (p = 0.01), and nocturia index (NI) p = 0.01). Among the categories of the MOS sleep scale, sleep index (p = 0.003), sleep disturbance (p = 0.001), snoring (p = 0.028), and shortness of breath (p = 0.036) significantly changed, with a decreased number of nocturia episodes. Adverse events were mild.Conclusions: Desmopressin is an effective treatment for nocturnal polyuria in elderly women, where conservative treatment has failed. Sleep quality is also improved.
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Matsuo, Tomohiro, Hidenori Ito, Kensuke Mitsunari, Kojiro Ohba, and Yasuyoshi Miyata. "Relationship between Urinary Calcium Excretion and Lower Urinary Tract Symptoms." Metabolites 12, no. 3 (March 5, 2022): 229. http://dx.doi.org/10.3390/metabo12030229.
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To date, few detailed studies have been conducted on the convenient and useful markers for the prevalence of lower urinary tract symptoms (LUTS), including overactive bladder (OAB) and nocturia. A high level of calcium (Ca) excretion (hypercalciuria) is indicative of lifestyle-related diseases such as hypertension, which are associated with the onset of LUTS. Hence, in this study we attempted to clarify the relationship between urinary Ca excretion and OAB, nocturia, and nocturnal polyuria in adults. The present study showed that patients with hypercalciuria frequently experienced OAB, nocturia, and nocturnal polyuria. In addition, this study revealed that the severity of LUTS is significantly associated with urinary Ca excretion and that hypercalciuria is an important risk factor for OAB, nocturia, and nocturnal polyuria.
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N’goran, N’guessan Serge Pacôme, Noémie Cappelle, Eloi Anderson Bitty, Emmanuelle Normand, and Yves Aka Kablan. "Détermination par caméra piège des périodes d’activité de quelques mammifères terrestres au Parc National de Taï." International Journal of Biological and Chemical Sciences 14, no. 5 (September 14, 2020): 1673–88. http://dx.doi.org/10.4314/ijbcs.v14i5.15.
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Les périodes d’activité des animaux difficilement observables des forêts primaires sont peu connues. Des caméras pièges ont été utilisées pour établir les périodes d’activité de quelques mammifères au Parc national de Taï. Ces caméras non appâtées ont été installées d’octobre 2016 à août 2017. L’enregistrement de l’heure et la date de chaque observation a permis de déterminer des activités nocturnes, diurnes et cathémérales (actif le jour et la nuit) des espèces à travers le pourcentage des vidéos obtenues. Les heures d’activité pour chaque espèce étaient concentrées autour du vecteur moyen (heure moyenne autour de laquelle sont concentrées les heures d’activité de l’espèce) et réparties de manière non-uniforme pendant la période de 24h. Les mammifères de petite masse corporelle (< 10 kg) avaient des tendances nocturnes alors que ceux de grande masse corporelle (> 10 kg) avaient des tendances nocturnes, diurnes ou cathémérales. Certaines espèces cathémérales ont montré des périodes d’activité à prédominance diurne ou nocturne et doivent faire l’objet d’études supplémentaires enfin de connaître les facteurs influençant leur régime d’activité.Mots clés : caméra piège, taux de capture, mammifères, vecteur moyen.
English Title: Activity periods of some terrestrial mammals by using camera traps in Taï National ParkDetermination of cryptic animal’s activity periods is problematic in primary forests and reminds poorly known. Hence, in the Tai National Park, camera traps were used to establish the periods of activity of some mammals. These non-baited cameras were installed in the research area of the park from October 2016 to August 2017. Recording the time and date of each observation enabled to determine nocturnal, diurnal and cathemeral activities of each species through the percentage of videos obtained. Hours of activity for each species were concentrated around the mean vector and were not uniformly distributed over the 24-hour period. Furthermore, mammals with smaller body mass (<10 kg) had nocturnal tendencies whereas those with larger body mass (> 10 kg) had nocturnal, diurnal or cathemeral tendencies. Certain cathemeral species have predominantly shown day or night periods of activity and must be subject to further studies to find out more about the factors influencing their regimes of activity.Keywords: camera trap, detection rate, mammals, mean vector.
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Gillings, Simon, Robert J. Fuller, and William J. Sutherland. "Diurnal Studies do not Predict Nocturnal Habitat Choice and Site Selection of European Golden-Plovers (Pluvialis Apricaria and Northern Lapwings (Vanellus Vanellus)." Auk 122, no. 4 (October 1, 2005): 1249–60. http://dx.doi.org/10.1093/auk/122.4.1249.
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Abstract Many species, including shorebirds, feed during both day and night, yet little is known about how this affects behavior and habitat preferences. European Golden-Plovers (Pluvialis apricaria) and Northern Lapwings (Vanellus vanellus) feeding on arable farmland were more widely dispersed at night: nocturnal flocks were smaller, typically monospecific, and occurred in many more fields than diurnal mixed-species flocks. Diurnal numbers of European Golden-Plovers could not be used to predict nocturnal numbers; this indicates that ranging behavior differed between day and night. For both species, nocturnal feeding was recorded on almost all nights, irrespective of moon phase. Northern Lapwing nocturnal feeding activity decreased with increasing cloud cover and decreasing ground temperature, but no clear relationships were detected between European Golden-Plovers’ nocturnal feeding activity and environmental variables. Habitat selection differed between day and night, and between species at night. Diurnal studies of habitat choice and site selection may misrepresent the full requirements of such species. Los Estudios Diurnos no Predicen la Preferencia Nocturna de Hábitat ni la Selección Nocturna de Sitio en Pluvialis apricaria y Vanellus vanellus
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Monaghan, T. F., C. W. Agudelo, S. N. Rahman, K. P. Michelson, J. M. Lazar, K. Everaert, J. P. Weiss, and D. L. Bliwise. "1012 Urologic Features Related to the First Uninterrupted Sleep Period (FUSP) in Nocturia." Sleep 43, Supplement_1 (April 2020): A384—A385. http://dx.doi.org/10.1093/sleep/zsaa056.1008.
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Abstract Introduction In nocturia, longer FUSP (time to first void) correlates with better quality sleep (Bliwise et al, JCSM 2015;11:53-5) and, with treatment, longer FUSP is associated with decreased nightly voids (Epstein et al, Neurourol Urodyn 2018;37:186-91). We examined urologic correlates of FUSP in an outpatient nocturia population without comorbidities (CHF, OSA, ESRD, diuretics). Methods Participants (n=119; men) kept a home flow/volume diary, tracking clock time and quantity of each urination across a 24-hr period. FUSP was defined as time between going to bed and time of first void. We analyzed the urine volume at first nocturnal void (FNVV) (i.e., at end of FUSP). We also analyzed all nighttime volumes and divided by reported hours of sleep to impute nocturnal urine production (NUP) (in ml/hr, classified as high [>90 ml/hr] [n=49] vs low [<90 ml/hr] [n=60])—a measure correlated with number of nocturia episodes (van Doorn et al, J Urol 2014;191:1034-9). Nocturnal maximal voided volume (NMVV) at any single nocturnal void defined maximal functional nocturnal bladder capacity. Data were analyzed non-parametrically. Results For 53 of 119 patients, FNVV was identical to NMVV. This was more likely in patients with NUP >90 ml/hr vs <90 ml/hr (59% vs 40%, p=.046). High (vs low) NUP rates were also associated with higher FNVV (300 [225-420] vs 135 [100-200] ml, p<.001), as well as higher number of voids (3 vs. 2, p=.03). Conclusion For nearly half of these nocturia patients, the volume at first void occurred at their maximal nocturnal volume. In nocturia, higher FNVV also reflects greater overall nocturnal volume of urine produced, and excess urine volume (as opposed to insufficient bladder capacity) likely plays a central role in the pathogenesis of nocturia in these patients. The extent to which these higher initial volumes represent free-water vs solute-driven clearance is currently under investigation. Support N/A
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Hajdinjak, Tine, and Jurij Leskovar. "Comparison of Nocturia Response to Desmopressin Treatment between Patients with Normal and High Nocturnal Bladder Capacity Index." Scientific World Journal 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/878564.
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Objective. To compare efficacy of desmopressin for treatment of nocturia between patients with normal and high nocturnal bladder capacity index (NBCi).Methods. Retrospective analysis of adult patients treated with desmopressin for nocturia. Patients were analyzed according to high or normal NBCi value before treatment.Results. 55 patients were identified, aged 49–84, 47 males, 8 females, who started desmopressin 0.2 mg nocte between 2009 and 2011. Two groups (N: normal and H: high NBCi) were similar regarding number, gender, age, 24 h urine volume, and nocturnal urine volume. On treatment, nocturnal volume decreased by mean of 364 mL. Number of nightly voids decreased in N group from 3.11 to 1.50, in H from 3.96 to 1.44. Nocturnal polyuria and nocturia indices also decreased significantly. NBCi remained the same in N group (0.56 on therapy) and in H group decreased to mean 0.63. All on-treatment values were statistically similar in N and H groups. Pretreatment differences were abolished with treatment. NBCi was significantly correlated to nocturia reduction—larger reduction was observed in patients with higher NBCi. In 8/55 patients, hyponatremia was detected, but without clinical consequences.Conclusions. The results indicate that the effectiveness of desmopressin on nocturia is not dependent upon the patient's pretreatment NBCi.
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Monaghan, Thomas F., Adriana M. Kavoussi, Christina W. Agudelo, Syed N. Rahman, Kyle P. Michelson, Donald L. Bliwise, Jason M. Lazar, et al. "Nocturnal Urine Production in Women With Global Polyuria." International Neurourology Journal 24, no. 3 (September 30, 2020): 270–77. http://dx.doi.org/10.5213/inj.2040166.083.
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Purpose: Low nocturnal urine production (NUP) may be sufficient to rule out global polyuria (GP) in men. This study determines the sensitivity of indices for nocturnal polyuria (NP), defined as nocturnal polyuria index (NPi; nocturnal urine volume/24-hour urine volume) ≥0.33 or NUP ≥90 mL/hr, for detecting GP in women.Methods: Data were analyzed from 2 prospective protocols involving subjects recruited from a urology ambulatory care unit and a continence clinic. Women ≥18 years with nocturia were included if they met either of 2 common criteria for GP: (1) ≥40 mL/kg/24 hr or (2) ≥3,000 mL/24 hr.Results: Thirty-one women were included (NPi, 28.6 [21.3–40.7]; NUP, 100.8 [68.3–135.8] mL/hr). At the ≥40 mL/kg/24-hr cutoff, 40% and 63% of women reporting ≥1 nocturnal void(s) (n=30) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. Additionally, 53% and 71% of subjects reporting ≥2 nocturnal voids (n=17) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. At the ≥3,000 mL/24-hr cutoff, 38% and 69% of women reporting ≥1 nocturnal void(s) (n=13) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively, and 63% and 88% of subjects reporting ≥2 nocturnal voids (n=8) had NPi ≥0.33 and NUP ≥90 mL/hr, respectively. By extension, 37%–62% of women with nocturia and GP did not have NP by NPi ≥0.33 criteria, and 12%–37% did not have NP by NUP ≥90 mL/hr criteria.Conclusions: Indices of excess nighttime urination do not reliably predict GP in women. A full-length voiding diary may be particularly important in the evaluation of women with nocturia. Nocturia in women merits further consideration as a distinct entity.
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Kogan, M. I., V. L. Medvedev, I. V. Mikhailov, P. V. Shornikov, and M. E. Efremov. "Ways of solving diagnostic problems caused by nocturia in patients with benign prostatic hyperplasia." Innovative medicine of Kuban, no. 4 (December 28, 2019): 40–46. http://dx.doi.org/10.35401/2500-0268-2019-16-4-40-46.
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Relevance. Today LUTS cause a lot of complexity and misunderstanding among doctors and patients. Among the symptoms, nocturia is the most difficult to interpret. Nocturia affects a significant part of the population, especially in older age groups. Currently, there are no data on the ratio of nocturia in various diseases of neurological etiology which are manifested by nocturia. Nocturia can be classified only according to urination diaries: diurnal polyuria, nocturnal polyuria, decreased bladder capacity, sleep disorders, and circadian rhythm disorders. Nocturia is also classified by degree of severity: mild severity from 1 to 3 episodes of nocturnal urination and severe when the number of nocturnal awakenings for urination is more than 3.Objective. To prove the effectiveness of the analysis of additional data on the daily diary of urination, together with the determination of the specific gravity of urine in the daytime and at night in patients with nocturia.Material and methods. Two hundred eleven male patients were examined, with nocturia from 1 to 6 times and with a diagnosis of benign prostatic hyperplasia (BPH). The average age of the patients was 71 ± 4.7 years, the age interval of patients ranged from 50 to 84 years. the presence of symptoms of the lower urinary tract (LUTS), the total score on the I-PSS scale> 21, an indicator of the quality of life index QOL> 3, the maximum flow rate of urine (Qmax)> 10ml / s, residual urine volume (OOM) <150 ml.Discussions. The lack of improvement in urination disorders and the inability to determine the type of nocturia led to an in-depth analysis of urination diaries taking into account the duration of night sleep, determination of night and day diuresis, and also, features of deviation of the urine specific gravity at night. Together with one of the days of urination diary filling, it was recommended to perform a urinalysis according to Zimnitsky. In 4 (1.8%) patients, daily polyuria with diuresis of more than 40 ml / kg per day was determined. One hundred thirty-nine (65.8%) people had nocturnal polyuria with a predominance of nocturnal diuresis of 1.8 ± 0.8 ml / min. over daytime 1.32 ± 0.3 ml / min. A decrease in bladder capacity was detected in 56 (26.5%) male patients. Twelve (5.6%) patients had various sleep disorders, which was the reason for their awakening.Findings. An in-depth analysis of urination diary data, including information on the duration of sleep and the determination of the circadian rhythm of the specific gravity of urine, is the key to successfully determining the cause of nocturia, especially in patients with nocturnal polyuria.
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Wilson, C., J. Goldin, W. Bower, J. Stonehouse, A. Perkins, and K. Kee. "P159 Successful treatment of sleep disordered breathing improves comorbidities in patients with nocturia." SLEEP Advances 2, Supplement_1 (October 1, 2021): A73. http://dx.doi.org/10.1093/sleepadvances/zpab014.198.
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Abstract Introduction Sleep disordered breathing (SDB) has been shown to increase nocturia (waking with the need to void urine) frequency. Nocturia negatively affects sleep, autonomic dysfunction, mental health and mortality. Nocturia and these co-morbidities share central control areas in the brainstem. We hypothesised that treatment of SDB would decrease nocturia frequency and impact these co-morbidities. Methods A prospective repeated measures study with participants ≥40 years, naïve to treatment, with an AHI ≥30/hr and experiencing ≥1 episodes of nocturia was conducted. Participants undertook two months of CPAP with before and after measures of lower urinary tract symptoms (Overactive Bladder Symptom Score (OABSS) and urine volume), sleep quality (PSQI and actigraphy), autonomic dysfunction (blood pressure and orthostatic change) and wellbeing (Nocturia quality of life score (NQoL) and the Hospital anxiety and depression scores (HADS)). Results 490 diagnostic studies screened, 36 patients met criteria, and 30 participants (57% male) were recruited. 15 patients completed treatment with 55% of completed participants meeting the required compliance of >4 hours. Significant changes in OABSS (p=0.035), nocturnal voiding frequency (p=0.007), nocturnal urine volume (p=0.013) and nocturnal diuresis (p=0.013). Improvement was observed in PSQI perceived sleep quality (p=0.018) and actigraphy derived sleep efficiency (p=0.002). NQoL global score also showed significant improvement (p=0.037).No change was observed in autonomic dysfunction measurements. Conclusion With appropriate treatment of SDB an improvement was observed in nocturia frequency and associated co-morbidities in a sample of relatively healthy individuals. These results suggests that significant nocturia should prompt the assessment for and treatment of SDB.
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Fan, Zhipeng, Zhaodi Wang, Jiashuai Deng, and Yong Jiang. "Jingui Shenqi pill for nocturia due to nocturnal polyuria." Medicine 99, no. 51 (December 18, 2020): e23742. http://dx.doi.org/10.1097/md.0000000000023742.
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Fine, Noam D., Jeffrey P. Weiss, and Alan J. Wein. "Nocturia: consequences, classification, and management." F1000Research 6 (September 1, 2017): 1627. http://dx.doi.org/10.12688/f1000research.11979.1.
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Nocturia is a widespread condition that can negatively impact quality of sleep and overall health. This condition is multifactorial in nature and is best approached through the analysis of frequency volume charts. Through these charts, clinicians may classify each individual case of nocturia into one of four distinct categories: global polyuria, nocturnal polyuria, reduced bladder capacity, and mixed. Treatments should then be tailored to each individual based upon the category of their nocturia. In some cases, appropriate therapy will consist of behavioral modification techniques or addressing underlying systemic diseases. In other cases, medical therapy may be necessary, but, to date, medications have shown limited efficacy at treating nocturia.
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Suman, Sanjay, Dudley Robinson, Nadia Bhal, Susannah Fraser, Angus MacCormick, Ann Williams, and Sergey Tadtayev. "Management of nocturia: overcoming the challenges of nocturnal polyuria." British Journal of Hospital Medicine 80, no. 9 (September 2, 2019): 517–24. http://dx.doi.org/10.12968/hmed.2019.80.9.517.
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Nocturia may be a multifactorial condition and should be regarded as a syndrome rather than a diagnosis, with many factors contributing to the clinical presentation. The effects of sleep deprivation can have a severely detrimental impact on the quality of life and productivity of the working age population, with considerable economic implications. Patients are unlikely to seek an appointment with their GP complaining of nocturia – they are more likely to complain of the effects of the condition, such as chronic tiredness, or injuries resulting from falls. The main criterion in deciding whether a patient should undergo further investigations into suspected nocturia is the degree to which the patient finds the condition bothersome. In some patients, lifestyle modifications may be an effective way to manage nocturia before medication is considered. As the only licensed product for all adults including those over 65 years of age, low dose desmopressin (Noqdirna® (as lyophilisate) Ferring Pharmaceuticals Ltd) is highly effective in the management of idiopathic nocturnal polyuria, producing improvements in clinical symptoms, sleep parameters and quality of life. Care should be administered as a joint enterprise between the patient's GP and colleagues in secondary care. This article outlines the findings of a roundtable discussion into the optimal management of patients with nocturnal polyuria.
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SCHUITEMAN, ANDRÉ, JAAP JAN VERMEULEN, ED DE VOGEL, and ART VOGEL. "Nocturne for an unknown pollinator: first description of a night-flowering orchid (Bulbophyllum nocturnum)." Botanical Journal of the Linnean Society 167, no. 3 (October 17, 2011): 344–50. http://dx.doi.org/10.1111/j.1095-8339.2011.01183.x.
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Lee, Hye Won, Myung-Soo Choo, Jeong Gu Lee, Choal Hee Park, Jae-Seung Paick, Jeong Zoo Lee, Deok Hyun Han, Won Hee Park, and Kyu-Sung Lee. "Desmopressin is an Effective Treatment for Mixed Nocturia with Nocturnal Polyuria and Decreased Nocturnal Bladder Capacity." Journal of Korean Medical Science 25, no. 12 (2010): 1792. http://dx.doi.org/10.3346/jkms.2010.25.12.1792.
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Alwis, Upeksha S., Thomas F. Monaghan, Rebecca Haddad, Jeffrey P. Weiss, Saskia Roggeman, Erik Van Laecke, Johan Vande Walle, Alan J. Wein, and Karel Everaert. "Dietary considerations in the evaluation and management of nocturia." F1000Research 9 (March 5, 2020): 165. http://dx.doi.org/10.12688/f1000research.21466.1.
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Aim: This narrative review investigates the effect of dietary intake on nocturnal voiding severity. The primary aims of this review are to provide a framework for future research and ultimately contribute to more comprehensive, lifestyle-centered guidelines for the management of nocturia. Methods: A literature search was conducted in Web of Science, PubMed, and Google Scholar databases using the keywords “nocturia”, “diuresis”, “natriuresis”, “food”, “diet”, and “nutrients”. Results: High fruit and vegetable consumption was negatively associated with nocturia. High intake of tea and dietary sodium showed a positive association with nocturia. Several foods have also been directly linked to changes in diuresis rate, glycemic control, and endogenous serum melatonin concentration, offering potential mechanisms for this observed effect. Overall quality of the evidence was low. Conclusion: At present, there is limited evidence to suggest that certain foods, electrolytes, and specific compounds may contribute to the pathogenesis of nocturia. A greater understanding of the impact of food and nutrients on body fluid metabolism is needed to further refine the evaluation and treatment of nocturia.
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Monaghan, T. F., A. S. Wagg, C. W. Agudelo, S. N. Rahman, K. P. Michelson, M. R. Epstein, K. Everaert, J. M. Lazar, J. P. Weiss, and D. L. Bliwise. "0822 Frail Older Men With Nocturia are Disproportionately Affected by Excess Nocturnal Urine Production." Sleep 43, Supplement_1 (April 2020): A313. http://dx.doi.org/10.1093/sleep/zsaa056.818.
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Abstract Introduction Nocturia is a risk factor for falls and hip fractures in older adults. We determined whether the Frailty Index (FI), incorporating comorbidities, functional performance, and physical signs, was associated with nocturia frequency and/or overnight urine production. Methods We examined nightly (24-hour) voiding diaries (men ≥65 years) in an outpatient urologic clinic demonstrating ≥2 nocturnal voids (n=158). FI calculations followed Rockwood (CMAJ 2005;173:489-95). A total of 39 conditions were assessed. Three FI groups were established: Low (≤0.077) (n=59), Intermediate (>0.077 and <0.179) (n=58), and High (≥0.179) (n=41). We compared number of nocturnal voids (NV), nocturnal urine volume (NUV) (in mL), and 24-hr total urine volume (24-hr TUV) (in mL) across groups. Results NV did not differ by group (p=0.333) (median for all groups=3). However, NUV (916 [671-1419] vs. 690 [505-942] vs. 630 [500-1050] mL) differentiated the High, Medium and Low FI groups (p<0.001 via Kruskal-Wallis with Bonferroni pairwise adjustments), respectively. Similarly, 24-hr TUV differentiated the 3 groups (2200 [1800-2550] vs. 1620 [1259-2119] vs. 1650 [1390-2517] mL, p=0.005). Differences in NUV remained significant (p=0.006) after eliminating Diabetes Mellitus cases (n=44). However, differences did not persist for 24-hr TUV (p=0.180). Conclusion Higher NUV, but not 24-hr TUV, was a robust correlate of frailty in these older men. Accounting for diabetes did not diminish the effect. Although undiagnosed sleep apnea remains a possible cause, recent chronobiologic data (Monaghan et al, Age Aging, 2020, in press) suggest that nocturia in the aged is characterized by excess free water clearance early in the sleep period. This argues against solute-driven urine production (as might be expected in sleep apnea) in accounting for the effect. Nocturia may represent a conspicuous and important change in circadian rhythm of urine production occurring in old age. Support N/A
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Athanasopoulos, Anastasios. "Nocturia due to nocturnal polyuria (NP). A common disorder." Archivio Italiano di Urologia e Andrologia 94, no. 3 (September 26, 2022): 366–68. http://dx.doi.org/10.4081/aiua.2022.3.366.
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To the Editor,
Nocturia is a significantly underestimated medical problem that affects seriously patients' quality of life, work engagement, productivity, and overall life conditions per se. Nocturia is a common condition, proven to be the most bothersome for patients with Lower Urinary Tract Symptoms (LUTS). People with two or more events of micturition per night have a significant increase in mortality rate and an increased risk of fall-related fractures if they visit the toilet two or more times per night [...].
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Axell, Richard G., Habiba Yasmin, Kristina Aleksejeva, Eskinder Solomon, Bogdan Toia, Maria Thommyppillai, Mahreen H. Pakzad, Rizwan Hamid, Jeremy L. Ockrim, and Tamsin J. Greenwell. "Overnight Ambulatory Urodynamics Change Patient Management Strategies and Improve Symptomatic Outcomes." Société Internationale d’Urologie Journal 3, no. 4 (July 15, 2022): 202–8. http://dx.doi.org/10.48083/rdtd8562.
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ObjectivesTo determine the diagnostic value of overnight ambulatory urodynamics (aUDS) and to assess if a urodynamic diagnosis of detrusor overactivity (DO) or nocturnal enuresis resulted in a change in patient management and an improvement in their urinary symptoms.MethodsA retrospective review of 25 consecutive patients (28% male) with a median age of 38 years (range 18 to 86) having overnight aUDS for bothersome urinary symptoms of primarily nocturia and/or nocturnal enuresis following non-diagnostic conventional urodynamics between November 1998 and August 2018. Urinary symptoms were assessed before overnight aUDS and again after urological treatment following any changes in urodynamics diagnosis and treatment. Six patients were excluded as follow-up data were not available.ResultsTwenty-four patients (96%) presented with nocturia and 20 (80%) presented with nocturnal enuresis. DO was demonstrated in 19 (76%) patients (mean pressure 69.1±53.3 cmH2O). UUI was demonstrated in 16 (80%) out of the 20 patients who complained of nocturnal enuresis. Of the 19 patients with follow-up data, following overnight aUDS a change in urodynamic diagnosis was made in 15 patients (79%); 16 patients (84%) also had their clinical diagnosis and subsequent management changed; and 15 patients (79%) reported an improvement in their urinary symptoms following these changes in diagnosis and treatment. There was a significant improvement in ICIQ-OAB (120±44 versus 32±53, P < 0.0001) scores following the changes to clinical management post-overnight aUDS.ConclusionIn our study cohort, change in primary diagnosis following overnight aUDS led to a significant change in treatment care pathway and resulted in significant improvement in urinary symptoms at follow-up.
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Comiter, Craig V. "Oral Desmopressin as a Treatment for Nocturia Associated with Nocturnal Polyuria." Current Bladder Dysfunction Reports 6, no. 4 (July 27, 2011): 191–92. http://dx.doi.org/10.1007/s11884-011-0100-0.
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Yuen, John Wai-Man, Ivy Yuen-Ping Wong, Peter Ka-Fung Chiu, Jeremy Yuen-Chun Teoh, Chi-Kwok Chan, Chi-Hang Yee, and Chi-Fai Ng. "Predictive Values of Nocturia and Its Voiding Frequency on the Aging Males’ Symptoms." International Journal of Environmental Research and Public Health 19, no. 18 (September 15, 2022): 11632. http://dx.doi.org/10.3390/ijerph191811632.
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Background: The link between nocturia and aging male symptoms (AMS) has not been scientifically established. This study aimed to measure the degree of severity of AMS that impacts health-related quality of life (HRQoL) in adult males living with nocturia and to determine the predictive values of nocturnal factors on AMS. Methods: This is an extended analysis of new data collected by using the Hong Kong Traditional AMS (HK-AMS) scale and the Cantonese version of the Pittsburgh Sleep Quality Index (PSQI) in a recently published cross-sectional population-based survey. Results: Of the 781 respondents that completed the set of questionnaires, 68% and 61% of men living with nocturia reported clinically significant (at moderate-to-severe levels) somato-vegetative and sexual AMS; the prevalence and severity were increased with advancing nighttime voiding frequency. Age, the Global PSQI score, certain metabolic diseases, the nocturia-specific QoL (NQoL) score and bedtime voiding frequency were found to be significant predictive factors for composite somato-vegetative and sexual AMS. Conclusions: The current findings suggested the inclusion of nocturia when measuring male-specific HRQoL related to aging.
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Cruz, Rodrigo, Maria Garcia-Rosa, and Carlos Faria. "Prevalence and associated factors in community-dwelling subjects - a population-based study." Revista da Associação Médica Brasileira 66, no. 6 (June 2020): 830–37. http://dx.doi.org/10.1590/1806-9282.66.6.830.
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SUMMARY OBJECTIVES To assess the prevalence of nocturia and identify factors associated with it in a community-dwelling population. METHODS A cross-sectional study was conducted in subjects aged 45 years or more and registered with a Family Doctor Program. Information was collected about nocturia, other urinary symptoms, physical examination, co-morbidities, demographics, socio-economic, and lifestyle factors. Multiple logistics regression models were developed to analyze associated factors for nocturia according to gender and the number of nocturnal micturitions(≥1 and ≥2). RESULTS Out of the 661 individuals included in the study, 62.3% were women. Among the women, the prevalence rates for nocturia ≥1 time and ≥2 times were, respectively, 68.4% and 49%, whereas, among the men, they were 64.3% and 43.8%. Among the women, nocturia ≥1 time was associated with brown skin, a higher BMI, lower schooling, and calcium channel blockers(CCB) use, while nocturia ≥2 times showed association with higher BMI, lower schooling, obstructive sleep apnea (OSA), and the use of CCB. Among the men, nocturia ≥1 time was associated positively with age, alcohol intake, and OSA, and negatively with angiotensin receptor blockers and beta-blockers use. Besides, nocturia ≥2 times was associated with age, not having health insurance, and OSA. CONCLUSIONS Nocturia is a condition highly prevalent in the studied population. For the female subjects, a higher BMI, lower schooling, and the use of CCB were associated with nocturia regardless of the definition used, whereas, among the men, that same association was found with age, not having health insurance, and OSA.
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Mencias, Fernando, Telmo Salazar, and Marco Cerna. "Phytochemical screening and antioxidant activity of Epidendrum nocturnum." Bionatura 6, no. 1 (February 15, 2021): 1486–89. http://dx.doi.org/10.21931/rb/2021.06.01.8.
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The objective of this study was to evaluate the antioxidant capacity of Epidendrum nocturnum using the DPPH technique to determine the capacity for scavenging free radicals, as well as to identify secondary metabolites in ethanolic extracts of the previously mentioned species by phytochemical screening, with analysis of alkaloids, flavonoids, saponins, tannins, and triterpenes. The results determined in the phytochemical screening that the secondary metabolites that were most present were flavonoids, tannins, and saponins; no alkaloids or triterpenes were found. In the analysis of antioxidant activity, Epidendrum nocturnun in the three extracts showed that with an average concentration of 3.50 ppm, it could inhibit 50% of the free radicals present in the test solution.
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Fehér, Ádám Miklós, and Zoltán Bajory. "Nocturia." Orvosi Hetilap 157, no. 36 (September 2016): 1419–26. http://dx.doi.org/10.1556/650.2016.30492.
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Nocturia is a significantly underestimated disorder, resulting in general worsening of patients’ quality of life, while morbidity and mortality are increasing. Several urologic and other pathologic causes can be described in the background including relatively severe conditions. Therefore, accurate evaluation and adequate treatment is recommended. In this review the authors summarize the international literature regarding nocturia. PubMed and ScienceDirect databases were accurately reviewed for the relevant information. Epidemiology, etiology, unfavourable effects, diagnosis and possible treatment options were analysed. They found that symptoms can be releaved by lifestyle changes and traditional therapy in several cases, but clinically significant improvement can be reached using desmopressin in patients suffering from nocturnal polyuria. The authors conclude that nocturia may have negative effects on patients’ quality of life and also on the society. Early detection and proper treatment is essential. Orv. Hetil., 2016, 157(36), 1419–1426.
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Fernández Gavira, Jesús, Pablo Álvarez Domínguez, Moisés Grimaldi Puyana, and Aurora Llopis Garrido. "Yinca-Exprésate con el deporte: haciendo historia a través de una yincana nocturna." REDU. Revista de Docencia Universitaria 13, no. 1 (March 28, 2015): 377. http://dx.doi.org/10.4995/redu.2015.6457.
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<p>La Universidad actual -retada a diseñar y configurar procesos de enseñanza aprendizaje mucho más significativos y experienciales-, ha de seguir apostando por el desarrollo de metodologías y experiencias didácticas que se ajusten a las exigencias de una nueva cultura del aprendizaje competencial integrada en el Espacio Europeo de Educación Superior (EEES). La yinkana nocturna “Yinca-exprésate con el deporte”, que se presenta en este trabajo, hace referencia a una práctica pedagógica extraacadémica que lleva realizándose durante varios cursos académicos con el alumnado de varias promociones de Grado y Licenciatura en Educación Física de la Facultad de Ciencias de la Educación de la Universidad de Sevilla. A través del esbozo y ejecución de esta propuesta didáctica, profesorado de los Departamentos de Educación Física y Deporte y de Teoría e Historia de la Educación de esta Universidad, ofrece a diferentes grupos de estudiantes la oportunidad de experimentar en el entorno natural las potencialidades y utilidades de las veladas nocturnas de campamento, las cuales tendrán que desarrollar y poner en marcha en alguna ocasión en su futuro profesional. En este trabajo se recogen una serie de pautas y reflexiones, ligadas el diseño, puesta en práctica y descripción de una yincana nocturna desarrollada en el Parque del Alamillo de Sevilla, que bien pueden resultar de interés personal y profesional, particularmente, para los actuales profesionales de la Educación Física y para los futuros.</p><p><strong>ABSTRACT</strong></p><p><strong>Gymkha-Express yourself throught sports: making history through a nightly gimkhana.</strong></p><p>Current University is challenged to design and configure processes of teaching more meaningful and experiential learning, it must continue investing in the development of methodologies and learning experiences that meet the demands of a new culture of learning competence integrated into the European Higher Education Area (EEES). The nocturnal gymkhana “Gymkha-express yourself throught sports” presented in this paper, refers to a non-formal educational event performing for several academic courses, with students from various promotions of Bachelor Degree in Physical Education of the Faculty of Educational Sciences of the Seville University. Through this teaching proposal, faculties from the Departments of Physical Education and Sport and Theory and History of Education of this University, offers to different groups of students the opportunity to experience the potential and utility of the evenings night of camp in the natural environment, which will have to develop and launch sometime in their careers. This paper presents a number of patterns and reflections, related design, implementation and description of a nocturnal gymkhana developed in the Alamillo Park of Seville, which may well result in personal and professional interest, particularly for current practitioners of Physical Education and the future ones.</p>
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Laketic, Darko, and Vesna Laketic. "Nocturia and benign prostatic hyperplasia." Vojnosanitetski pregled 65, no. 10 (2008): 751–54. http://dx.doi.org/10.2298/vsp0810751l.
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Background/Aim. Nocturia often occurs in patients with benign prostate hyperplasia (BPH). The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. Methods. Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Symptoms were evaluated with the International Prostate Symptom Score before, as well as three and six months after the surgery. All the results were compared with the control group. Results. There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, however, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. Conclusion. There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favorable result of the surgery because of a significant correlation between noctura and the age of a patient.
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Sugaya, K., S. Nishijima, M. Miyazato, K. Kadekawa, and Y. Ogawa. "Effects of Melatonin and Rilmazafone on Nocturia in the Elderly." Journal of International Medical Research 35, no. 5 (September 2007): 685–91. http://dx.doi.org/10.1177/147323000703500513.
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We compared the effects of melatonin, an antioxidant and sleep inducer in humans, and rilmazafone hydrochloride, a hypnotic, in elderly patients with nocturia. Patients received either melatonin (2 mg/day; n = 20) or rilmazafone (2 mg/day; n = 22) for 4 weeks. There were no significant differences in the mean age, the quality of life (QoL) score and the serum melatonin levels between the two groups at baseline. After 4 weeks' treatment, the number of nocturnal urinations was significantly decreased and the QoL score was significantly improved in both groups. There was no significant difference between the patient-reported effectiveness ratings between the two groups. The serum melatonin level was significantly increased in the melatonin-treated group, but it remained unchanged in the rilmazafone-treated group. Melatonin and rilmazafone were equally effective for nocturia in the elderly. We recommend that the problems of sleep disturbance should be considered when choosing a therapy for nocturia.
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Ferrara, P., F. Ianniello, E. Del Vescovo, G. Sodero, A. Gatto, and A. Ruggiero. "Oral Desmopressin Lyophilisate Formulation (MELT): Efficacy and Safety in Children and Adults." Biomedical and Pharmacology Journal 11, no. 1 (March 25, 2018): 171–77. http://dx.doi.org/10.13005/bpj/1359.
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Nocturnal enuresis (NE) is a common disorder in childhood and desmopressin is one of the most widely and well-tolerated medications for NE. The recent oral lyophilisate formulation of desmopressin (MELT) is effective in the treatment of NE in children and nocturia in adults. A MEDLINE literature search MEDLINE (2000-July 2017) was performed using the search terms MELT enuresis, MELT desmopressin, sublingual desmopressin, lyophilisate desmopressin. Twenty articles were analyzed with a number of patients of 3448. In 12 articles were reported 1275 pediatric patients (<18 years old), and in 8 articles 2213 adult patients. In pediatric population the indication was enuresis in 1269 patients and central diabetes insipidus in 6 patients. In adult population the indication was nocturia in 1941 patients, renal colic in 259 patients, healthy volunteers 13 patients. In 17 studies desmopressin was administered alone while in 3 studies in association respectively with Tolterodina, Ketorolac and Tamsulosin. In 7 studies were reported side effects in only 81 patients, 60 in pediatric population and 21 in adult population. The reported side effects in pediatric population were nausea, lethargy, lower limb weakness, headache, diarrhea, viral gastroenteritis. The reported side effects in adult population were asymptomatic hyponatriemia, nausea, diarrhea, dizziness, symptomatic hyponatriemia. Our review confirm that the MELT formulation of desmopressin guarantee the same response of other formulations with a lower doses and a lowest number of side effects. We believe according with the literature that this formulation is actually the first line and safety treatment for nocturnal enuresis and nocturia.
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Ihara, Tatsuya, Takahiko Mitsui, Yuki Nakamura, Satoru Kira, Tatsuya Miyamoto, Hiroshi Nakagomi, Norifumi Sawada, et al. "The Clock mutant mouse is a novel experimental model for nocturia and nocturnal polyuria." Neurourology and Urodynamics 36, no. 4 (June 27, 2016): 1034–38. http://dx.doi.org/10.1002/nau.23062.
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Brubaker, Linda, and Mary P. FitzGerald. "Nocturnal polyuria and nocturia relief in patients treated with solifenacin for overactive bladder symptoms." International Urogynecology Journal 18, no. 7 (November 28, 2006): 737–41. http://dx.doi.org/10.1007/s00192-006-0239-y.
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Khosla, Lakshay, Joseph U. Boroda, Joshua Salama, Syed N. Rahman, Danielle J. Gordon, Matthew W. Moy, Yonatan Akivis, et al. "Impact of Aging on Urinary Natriuretic Peptides in Nocturia and Nocturnal Polyuria." International Neurourology Journal 26, no. 2 (June 30, 2022): 135–43. http://dx.doi.org/10.5213/inj.2142330.165.
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Purpose: The pathophysiology of nocturia and nocturnal polyuria (NP), conditions that become more prevalent with aging, may in part be explained by changes in hormones involved in water homeostasis. The purpose of this study was to analyze the impact of aging on urinary natriuretic peptides in nocturia and NP.Methods: Patients aged ≥18 years completed 24-hour bladder diaries for assessment of nocturia and NP. They were divided into subgroups of ≥65 years old and <65 years old. Urine samples were collected and analyzed for natriuretic peptide (NT-proANP, NT-proBNP, and NT-proCNP) levels. Peptide levels were compared between patients with and without nocturia/NP and within age subgroups; correlation to the NP index (NPi) was determined.Results: Compared to patients without nocturia (N=15), patients with nocturia (N=36) had higher median levels of urinary NT-proANP (15.8 pmol/mmol Cr vs. 10.9 pmol/mmol Cr, P=0.016) and NT-proBNP (6.3 pmol/mmol Cr vs. 4.5 pmol/mmol Cr, P=0.021), but showed no differences in NT-proCNP (2.4 pmol/mmol Cr vs. 2.5 pmol/mmol Cr, P=0.967). Patients ≥65 years old with nocturia had higher NT-proANP (29.8 pmol/mmol Cr vs. 11.0 pmol/mmol Cr, P<0.001) and NT-proBNP (9.6 pmol/mmol Cr vs. 5.0 pmol/mmol Cr, P<0.001) than patients <65 years old. Additionally, patients with NP (N=30) showed higher urinary NT-proANP (19.6 pmol/mmol Cr vs. 10.5 pmol/mmol Cr, P<0.001) and NT-proBNP (6.7 pmol/mmol Cr vs. 4.7 pmol/mmol Cr, P=0.020) compared to patients without NP (N=21). NP patients ≥65 years had higher NT-proANP (29.8 pmol/mmol Cr vs. 12.5 pmol/mmol Cr, P<0.001) and NT-proBNP (9.6 pmol/mmol Cr vs. 4.4 pmol/mmol Cr, P=0.004) than patients <65 years old. NPi positively correlated with urinary NT-proANP (R<sub>S</sub>=0.417, P=0.002) and NT-proBNP (R<sub>S</sub>=0.303, P=0.031), but not with NT-proCNP (R<sub>S</sub>=-0.094, P=0.510).Conclusions: Since urinary NT-proANP and NT-proBNP were greater in aged patients with nocturia and NP, natriuretic peptides may contribute to the pathophysiology of these conditions and further research should aim to explore them as targets for management.
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Mirzayeva, Nurlana, Susanne Forst, Daniel Passweg, Verena Geissbühler, Ana Paula Simões-Wüst, and Cornelia Betschart. "Bryophyllum pinnatum and Improvement of Nocturia and Sleep Quality in Women: A Multicentre, Nonrandomised Prospective Trial." Evidence-Based Complementary and Alternative Medicine 2023 (February 7, 2023): 1–8. http://dx.doi.org/10.1155/2023/2115335.
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Nocturia is a pathologic condition that significantly affects the quality of sleep. The aetiology of nocturia is multifactorial, and the evidence available on its management remains limited. Besides behavioural measures, validated pharmaceutical treatment options exist but are, however, associated with marked side effects. Prospective clinical studies with tablets prepared from the leaf press juice of the plant Bryophyllum pinnatum revealed a tendency towards reduction of micturition in patients with overactive bladder (OAB) and several improvements in sleep quality. These observations are in part supported by in vitro and in vivo data. In the present study, we investigated the effectiveness of Bryophyllum 50% chewable tablets in the treatment of nocturia and associated sleep disorders. Altogether, 49 women with idiopathic OAB and nocturia of ≥2 voids/night were treated with Bryophyllum 50% tablets for 3 weeks (350 mg chewable tablets, dosage 0-0-2-2 oral tablets; WELEDA AG, Arlesheim, Switzerland). Nocturia, voiding volumes at night (ml), quality of life, sleep quality, and daily sleepiness were assessed before and after treatment with a 3-day micturition diary, the International Consultation on Incontinence evaluating overactive bladder and related impact on quality of life (QoL) [ICIQ-OAB], the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS), respectively. The age of the study population was 68.5 ± 11.6 y. After treatment, nocturia diminished from 3.2 ± 1.4 to 2.3 ± 1.3 ( P < 0.001 ) and the PSQI score decreased from 7.7 ± 3.7 to 6.6 ± 3.4 ( P = 0.004 ). Urgency, the ICIQ score, and the ESS lowered significantly, and the micturition volume showed a tendency to increase. No serious adverse drug reactions were reported, and compliance was good. The results show a beneficial effect on the nocturnal voids and sleep quality of women with OAB. Bryophyllum 50% tablets can be regarded as a well-tolerated alternative in the treatment of nocturia and broaden the repertoire of standard management.
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Alwis, Upeksha S., Joris Delanghe, Lien Dossche, Johan Vande Walle, John Van Camp, Thomas F. Monaghan, Saskia Roggeman, and Karel Everaert. "Could Evening Dietary Protein Intake Play a Role in Nocturnal Polyuria?" Journal of Clinical Medicine 9, no. 8 (August 5, 2020): 2532. http://dx.doi.org/10.3390/jcm9082532.
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Urea is the most abundant and the largest contributing factor for urine osmolality. Urinary urea excretion is highly interrelated with dietary protein intake. Accordingly, an increase of urinary urea excretion due to high protein diet may lead to urea-induced osmotic diuresis. This study aims to explore the association between nocturnal polyuria (NP) and urea. This is a post hoc analysis of a prospective observational study of subjects who completed a renal function profile between October 2011 and February 2015 (n = 170). Each subject underwent a 24 h urine collection, which included 8 urine samples collected at 3 h intervals. Urine volume, osmolality, creatinine, urea and sodium were determined. Urinary urea excretion was used to estimate dietary protein intake. Compared to the control group, subjects with NP exhibited significantly higher nighttime urea and sodium excretion. Estimated evening dietary protein intake was correspondingly significantly higher amongst the NP subgroup. Nighttime diuresis rate was positively associated with age and nighttime free water clearance, creatinine clearance, sodium excretion, and urea excretion in NP subjects. Therefore, increased nocturnal urinary urea excretion may reflect an additional important mediator of nocturia owing to excess nocturnal urine production.
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Rubilotta, Emanuele, Daniele Castellani, Marilena Gubbiotti, Matteo Balzarro, Giacomo Maria Pirola, Rita Righetti, Pierpaolo Curti, Antonella Giannantoni, Maria Angela Cerruto, and Alessandro Antonelli. "Nocturnal polyuria in men performing uroflowmetry for lower urinary tract symptoms." Archivio Italiano di Urologia e Andrologia 93, no. 4 (December 21, 2021): 445–49. http://dx.doi.org/10.4081/aiua.2021.4.445.
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Purpose: To assess the prevalence of nocturnal polyuria (NP) in males performing uroflowmetry (UF) for lower urinary tract symptoms (LUTS), the impact of NP on UF outcomes, and bladder emptying, the association between NP and LUTS. Materials and methods: Men scheduled for UF were recruited in two Centres. Data collected were medical history, IPSS, UF, post-void residual urine volume (PVR), 3-day frequency-volume charts (FVC). The NP index was used to assess NP with a threshold of ≥ 33%. The relationship between NP and patient’s aging was assessed. Results: 162 patients were included in the analysis. Mean age was 70.95 ± 8.04 years. The prevalence of NP was 54.9% (89/162). 110 (68%) patients reported nocturia, and among these, NP was documented in 76 (69%). Nocturia was found in 85% (76/89) of the population with NP. Total IPSS score, IPSS items #1, #2 and #7 showed a significant difference in men with NP compared with those without. Maximum flow rate and PVR did not significantly change comparing men with or without NP. Mean voiding volume (VV) of the night-time micturitions was significantly higher in men with NP compared to those without NP (532.1 ± 275.6 ml vs 175 ± 168.7 ml respectively, p < 0001), while mean VV day-time micturitions and mean VV at UF did not change between groups.Conclusions: NP had a high prevalence in men with LUTS performing UF. Aged males were more commonly affected by NP. Data demonstrated a strong relationship between NP and nocturia and increased urinary frequency while voiding symptoms were poorly related to NP.
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Sharifi, Hosein, Mohammad Bagher Minaie, Mohammad Javad Qasemzadeh, Nematollah Ataei, Mohammad Gharehbeglou, and Mojtaba Heydari. "Topical use of Matricaria recutita L (Chamomile) Oil in the Treatment of Monosymptomatic Enuresis in Children." Journal of Evidence-Based Complementary & Alternative Medicine 22, no. 1 (July 8, 2016): 12–17. http://dx.doi.org/10.1177/2156587215608989.
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Aim. To evaluate the efficacy of topical use of Matricaria recutita L oil in the treatment of enuresis in children. Methods. Eighty patients diagnosed as monosymptomatic nocturnal or daytime enuresis were allocated to receive Matricaria recutita L (chamomile) oil or placebo topically for 6 weeks in a double-blind randomized placebo-controlled trial with a parallel design. Patients were evaluated prior to and following 8 weeks of the intervention in terms of frequency of enuresis and any observed adverse events. Results. The mean frequency of enuresis at the first, second, and third 2 weeks was lower in the intervention group compared with the placebo group, and the differences were statistically significant ( P < .001, P = .03, and P < .001, respectively). There was no report of any adverse event in the study groups. Conclusion. The findings of this study showed that the topical use of (chamomile) oil can decrease the frequency of nocturia in children with monosymptomatic nocturnal or daytime enuresis.
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Juul, Kristian Vinter, Bjarke Mirner Klein, Rikard Sandström, Lars Erichsen, and Jens Peter Nørgaard. "Gender difference in antidiuretic response to desmopressin." American Journal of Physiology-Renal Physiology 300, no. 5 (May 2011): F1116—F1122. http://dx.doi.org/10.1152/ajprenal.00741.2010.
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Increased age and female gender are well-known risk factors for the development of desmopressin-induced hyponatremia. However, little focus has been on exploring gender differences in the antidiuretic response to desmopressin. Based on an exploratory analysis from three clinical trials, we report a significant gender difference in the effects of desmopressin on nocturnal urine volume that could not be explained by pharmacokinetic differences. Mean desmopressin concentration profiles were tested for covariates, and age and gender were not statistically significant and only weight was significant for log(Cmax) ( P = 0.0183) and borderline significant for log(AUC) ( P = 0.0571). The decrease in nocturnal urine volume in nocturia patients treated with desmopressin over 28 days was significantly larger for women at the lower desmopressin melt doses of 10 and 25 μg than for men. The ED50 for men was modeled to be 43.2 μg and 16.1 μg for women, with the ED50 men/women estimated to be 2.7 (1.3–8.1 95% CI), corresponding to significantly higher sensitivity to desmopressin in women. An increasing incidence of hyponatremia with increasing dose was found, and at the highest dose level of 100 μg decreases in serum sodium were approximately twofold greater in women over 50 yr of age than in men. A new dose recommendation stratified by gender is suggested in the treatment of nocturia: for men, 50- to 100-μg melt is an efficacious and safe dose, while for women a dose of 25 μg melt is recommended as efficacious with no observed incidences of hyponatremia. Areas for further research are proposed to uncover pathophysiological mechanism(s) behind these gender differences.
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Yeong, K., J. Santiapillai, B. N. Arumainayagam, P. Murray, and S. Tadtayev. "63 Nocturia—An Underappreciated “Symptom” of Obstructive Sleep Apnoea?" Age and Ageing 50, Supplement_1 (March 2021): i12—i42. http://dx.doi.org/10.1093/ageing/afab030.24.
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Abstract Nocturia (>2 per night) is the most frequent cause of disturbed sleep in older people. Poor sleep results in reduced health related QoL, and is linked to the development of cognitive impairment. Nocturia can result in an increase risk of falls and fractures, and is also an independent risk factor for mortality. The prevalence of norturia is high in the elderly, and it has been reported to be around 77.1% in elderly women and 93% in men. Historically, this bothersome symptom is thought to be mainly a result of bladder outflow obstruction due to prostatic hypertrophy or overactive bladder. More recently, nocturia has been associated witsh nocturnal polyuria (NPu) and obstructive sleep apnoea (OSA). The relationship between OSA and NPu is not fully understood but it is thought that the negative intrathoracic pressure generated by OSA causes an increase in Atrial Natriuretic Peptide (ANP) secretion, resulting in NPu. Nocturia is highly prevalent in patients with severe OSA. However, patients are usually unaware that they have sleep apnoea, and are therefore more likely to present to urology or geriatric services. It is important that OSA is not overlooked in these clinics as intervention with CPAP is highly effective in reducing symptoms. Here, we present the result of using the STOP-Bang questionnaire in 71 consecutive patients presenting to our urology service with nocturia. The average age was 73 years (range 34-88), male-to-female ratio 14:1 and median nocturia frequency of 4. 42 patients were at risk of undiagnosed sleep apnoea (median STOP-Bang Score of 5)—35 were referred for sleep studies, 4 patients declined and 3 patients were not referred. Overall, 31 out of 35 sleep studies (88.6%) demonstrated the presence of OSA; of these 23 (74.2%) confirmed moderate or severe OSA. All patients with OSA were seen and treated by the respiratory service. Overall, median nocturia frequency decreased from 4 to 1 across the whole cohort, from a combination of CPAP therapy, bladder outlet procedures and desmopressin. Conclusion At least a third of patients (32%) with bothersome nocturia have an undiagnosed clinically-significant OSA. Identification of OSA improves outcomes across the whole cohort, because nocturia in patients without OSA is more likely to respond to bladder outlet procedures and desmopressin.
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Dolby, Andrew S., John G. Temple, Laura E. Williams, Emily K. Dilger, Katrina M. Stechler, and Vanessa S. Davis. "Facultative Rest-Phase Hypothermia in Free-Ranging White-Throated Sparrows." Condor 106, no. 2 (May 1, 2004): 386–90. http://dx.doi.org/10.1093/condor/106.2.386.
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Abstract Shallow facultative rest-phase hypothermia has been reported in a number of passerine families, but few published data exist about its use by free- ranging birds. We used temperature-sensitive radio- transmitters to determine whether White-throated Sparrows (Zonotrichia albicollis) employ nocturnal hypothermia during winter. We measured skin temperatures of 24 free-ranging sparrows between 13:00 and 14:00 and between 02:00 and 03:00 for each of three days and nights per subject. The average nightly skin- temperature reduction per individual was 3.4 ± 1.0°C (SD). Skin temperature reductions ranged from 0.2°C to 7.0°C among all individuals. There was a significant negative correlation between the magnitude of skin temperature decline and nighttime ambient temperature. Additionally, we found a negative trend between depth of hypothermia and a body density index. Fase de Reposo Hipotérmica Facultativa en Individuos de Zonotrichia albicollis que se Desplazan Libremente Resumen. La fase de reposo facultativa somera ha sido mencionada para un número de familias de paseriformes, pero existen pocos datos publicados sobre su uso por parte de aves que se desplazan libremente. Usamos radio transmisores sensibles a la temperatura para determinar si Zonotrichia albicollis emplea hipotermia nocturna durante el invierno. Medimos la temperatura de la piel de 24 individuos que se desplazan libremente entre las 13:00 y 14:00 y entre las 02:00 y 03:00 durante tres días y tres noches por individuo. La reducción nocturna promedio de la temperatura de la piel por individuo fue 3.4 ± 1.0°C (DE). Las reducciones de la temperatura de la piel variaron entre 0.2°C y 7.0°C considerando todos los individuos. Hubo una correlación negativa significativa entre la disminución de la magnitud de la temperatura de la piel y la temperatura ambiental nocturna. Adicionalmente, encontramos una tendencia negativa entre la profundidad de la hipotermia y el índice de densidad corporal.
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Presicce, F., C. De Nunzio, F. Puccini, A. Melchionna, R. Lombardo, and A. Tubaro. "Patients with nocturnal polyuria presented a different night-time and daytime bladder capacity: Implication for nocturia." European Urology Supplements 16, no. 3 (March 2017): e702-e703. http://dx.doi.org/10.1016/s1569-9056(17)30465-7.
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Hashim, Hashim, Marco H. Blanker, Marcus J. Drake, Jens Christian Djurhuus, Jane Meijlink, Vikky Morris, Peter Petros, Jian Guo Wen, and Alan Wein. "International Continence Society (ICS) report on the terminology for nocturia and nocturnal lower urinary tract function." Neurourology and Urodynamics 38, no. 2 (January 15, 2019): 499–508. http://dx.doi.org/10.1002/nau.23917.
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Zotova, T. Yu, M. M. Azova, A. A. Lukanina, A. Ait Aissa, and M. L. Blagonravov. "Distribution of Polymorphic Marker of Genes of the Renin-angiotensin System RAS (AGT, AGTR1, АСЕ), ITGB3, PPARG) in Pa-tients With Essential Arterial Hypertension Depending on the Nature of the Nocturnal De-crease of BP." International Journal of Biology and Biomedical Engineering 15 (June 3, 2021): 212–18. http://dx.doi.org/10.46300/91011.2021.15.24.
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A clinical-genetic study using ABPM (24-hour BP monitoring) and Holter’s ECG methods in 49 pa-tients with essential arterial hypertension (group 1: 17 patients without sufficient nocturnal BP de-crease СI≤10%, and group 2: 32 patients with suf-ficient nocturnal BP decrease СI≥10%,) was per-formed for comparative analysis of the genotype frequencies of ACE, AGT, AGTR1, ITGB3, and PPARG. The study was conducted in order to clari-fy the pathogenetic mechanisms of the implementa-tion of different dynamics of nocturnal blood pres-sure in patients with hypertension without metabol-ic syndrome. It was found that in group 1, protec-tive genotype II of the ACE gene was more com-mon (p ≤ 0.025) than in the population data. A sig-nificant increase (p ≤ 0.025) in the frequency of the CC genotype of the AGTR1 gene responsible for the formation of insulin resistance compared to the population data was combined with a significant increase in the frequency of autonomic dysfunction in patients of group 1 - 83.4% vs. 64.5% group 2 respectively. The results obtained indicate the pos-sible pathogenetic links between genetically deter-mined insulin resistance and autonomic nervous system dysfunction and allows us to determine therapeutic approaches for correcting the noctur-nal blood pressure profile.
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Udo, Yukihiro, Masahiro Nakao, Hisashi Honjo, Osamu Ukimura, Akihiro Kawauchi, Hiroshi Kitakoji, and Tsuneharu Miki. "Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality." BJU International 107, no. 5 (August 26, 2010): 791–98. http://dx.doi.org/10.1111/j.1464-410x.2010.09581.x.
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Bovetto, S., and D. Richard. "Functional assessment of the 5-HT 1A-, 1B-, 2A/2C-, and 3-receptor subtypes on food intake and metabolic rate in rats." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 268, no. 1 (January 1, 1995): R14—R20. http://dx.doi.org/10.1152/ajpregu.1995.268.1.r14.
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The 5-hydroxytryptamine (5-HT) agonists (+/-)-8-hydroxydipropylaminotetralin hydrobromide (8-OH-DPAT), RU-24969, (+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI), and 1-phenylbiguanide were administered to male Wistar rats to assess the respective involvement of the 5-HT 1A-, 1B-, 2A/2C-, and 3-receptor subtypes in the control of food intake and metabolic rate (VO2). Four series of experiments were carried out, each series addressing the effects of four doses (including saline or dose 0) of each of the agonists selected. The drugs were intraperitoneally injected in spontaneously fed animals. Injections were performed during the first 15 min of either the diurnal or the nocturnal phases of the light-dark daily cycle. Food intake and VO2 measurements were carried out over the 12-h periods ensuing after the agonist injections. The two highest doses of the 5-HT1A-receptor agonist 8-OH-DPAT led to a quickly appearing but transient elevation of diurnal VO2. During the night, VO2 was higher when the rats were treated with 8-OH-DPAT than when they were treated with saline. There was no significant effect of 8-OH-DPAT on either diurnal or noctural food intake. The highest dose of RU-24969 induced a significant increase in diurnal VO2, whereas all doses of RU-24969 blunted the nocturnal rise in metabolic rate characteristically observed in rats kept under a daily light-dark cycle. Importantly, RU-24969 induced marked diurnal and nocturnal hypophagia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Wein, Alan J. "Re: International Continence Society (ICS) Report on the Terminology for Nocturia and Nocturnal Lower Urinary Tract Function." Journal of Urology 202, no. 4 (October 2019): 665. http://dx.doi.org/10.1097/ju.0000000000000448.
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Kamperis, Konstantinos, Soren Hagstroem, Eva Radvanska, Soren Rittig, and Jens Christian Djurhuus. "Excess diuresis and natriuresis during acute sleep deprivation in healthy adults." American Journal of Physiology-Renal Physiology 299, no. 2 (August 2010): F404—F411. http://dx.doi.org/10.1152/ajprenal.00126.2010.
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The transition from wakefulness to sleep is associated with a pronounced decline in diuresis, a necessary physiological process that allows uninterrupted sleep. The aim of this study was to assess the effect of acute sleep deprivation (SD) on urine output and renal water, sodium, and solute handling in healthy young volunteers. Twenty young adults (10 male) were recruited for two 24-h studies under standardized dietary conditions. During one of the two admissions, subjects were deprived of sleep. Urine output, electrolyte excretions, and osmolar excretions were calculated. Activated renin, angiotensin II, aldosterone, arginine vasopressin, and atrial natriuretic peptide were measured in plasma, whereas prostaglandin E2 and melatonin were measured in urine. SD markedly increased the diuresis and led to excess renal sodium excretion. The effect was more pronounced in men who shared significantly higher diuresis levels during SD compared with women. Renal water handling and arginine vasopressin levels remained unaltered during SD, but the circadian rhythm of the hormones of the renin-angiotensin-aldosterone system was significantly affected. Urinary melatonin and prostaglandin E2 excretion levels were comparable between SD and baseline night. Hemodynamic changes were characterized by the attenuation of nocturnal blood pressure dipping and an increase in creatinine clearance. Acute deprivation of sleep induces natriuresis and osmotic diuresis, leading to excess nocturnal urine production, especially in men. Hemodynamic changes during SD may, through renal and hormonal processes, be responsible for these observations. Sleep architecture disturbances should be considered in clinical settings with nocturnal polyuria such as enuresis in children and nocturia in adults.
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Taguchi, Soutarou, Hirofumi Koide, Hiroko Oiwa, Miku Hayashi, Kazuhiro Ogawa, Chihiro Ito, Koji Nakashima, et al. "Antiparkinsonian drugs as potent contributors to nocturnal sleep in patients with Parkinson’s disease." PLOS ONE 16, no. 7 (July 28, 2021): e0255274. http://dx.doi.org/10.1371/journal.pone.0255274.
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Objective To clarify whether antiparkinsonian drugs contribute to nocturnal sleep disturbances in patients with Parkinson’s disease (PD). Background Although the major antiparkinsonian drugs L-dopa and dopamine agonists (DAs) have been found to affect sleep, little is known about the effects of specific drugs on sleep in PD patients. Methods The study participants consisted of 112 PD patients (median age 72.5 years [inter-quartile range: IQR 65–79]; mean disease duration 8.44 years [standard deviation: 7.33]; median Hoehn and Yahr stage 3 [IQR 2–3.75]) taking one of three types of non-ergot extended-release DAs (rotigotine 32; pramipexole 44; ropinirole 36) with or without L-dopa (median daily total dosage of antiparkinsonian drugs 525.5 mg [IQR 376.25–658] levodopa equivalent dose [LED]). Participants were assessed using the PD Sleep Scale-2 (PDSS-2). Results For the whole PD patient cohort, the PDSS-2 sleep disturbance domain score and the scores for item 1 assessing sleep quality and item 8 assessing nocturia were positively correlated with daily total dosage of antiparkinsonian drugs and dosage of L-dopa, but not with the dosage of DAs. Sub-analysis according to DA treatment revealed that DA dosage was not correlated with item 1 or 8 score in any of the subgroups. The LED ratio of rotigotine to the total dosage of antiparkinsonian drugs was inversely correlated with the item 1 score. Conclusions These data suggest that antiparkinsonian drugs, in particular L-dopa, adversely affect nocturnal sleep in PD patients, especially in terms of sleep quality and nocturia. Thus, adjusting both the total dosage of antiparkinsonian drugs and the dose-ratio of L-dopa might be key actions for alleviating poor sleep quality in patients with PD. Among DAs, we found a clear positive correlation between the dose-ratio of rotigotine and sleep quality. Thus, partial L-dopa replacement with rotigotine could improve sleep quality in patients with PD.