Aging is associated with a marked increase in sleep complaints, and one factor causing
sleep disruption is waking to void (nocturia). Urological surveys have found that few young adults report
nocturia symptoms, but about half of those in their 60’s and nearly 80% of older age groups are
affected. Sleep surveys have found nocturia is a major cause of sleep disruption, with a majority of
older adults with sleep disruption citing the need to void as the cause of their awakening. While much
of the urological literature implies that nocturia causes sleep disruption, age-related changes in sleep depth and continuity
may make it more likely that an older adult will wake in response to a filling bladder, or that an older adult will wake for
another reason and then decide to void. There is also evidence that age-related changes in the amplitude of circadian
rhythms contribute to nocturia. There is a well-described circadian rhythm in urine output, and evidence of circadian
rhythmicity in some diuretic and anti-diuretic hormones. In this article, we describe how age-related changes in sleep
depth and continuity and age-related changes in circadian rhythm amplitude may contribute to nocturia, and how nocturia
in turn leads to sleep disruption. Better understanding of how changes in sleep and circadian rhythmicity impact nocturia
may lead to improved treatments and better quality of life for older adults.
Keywords: Aldosterone, circadian, nocturia, obstructive sleep apnea, sleep, vasopressin.
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