Purpose:
Nocturia (waking from sleep at night to void) is a common cause of sleep disruption and associated with increased comorbidity and impaired quality of life. However, its impact on mortality remains unclear. We performed a systematic review and meta-analysis to evaluate the association of nocturia with mortality, both as a prognostic and causal risk factor.
Materials and Methods:
We searched PubMed, Scopus, CINAHL and major conference abstracts up to December 31, 2018. Random effects meta-analyses addressed adjusted relative risks (RR) of mortality for people with nocturia and a meta-regression explored potential determinants of heterogeneity, including risk of bias. We applied the GRADE framework to rate the quality of evidence for nocturia as a prognostic risk factor for mortality and, separately, as a cause of mortality.
Results:
Of 5230 identified reports, 11 observational studies proved eligible. For the assessment of nocturia, ten studies used symptom questionnaires and one frequency-volume charts. Nocturia was defined as ≥2 episodes/night in six (55%), and as ≥3 episodes/night in five (45%) studies. Pooled estimates demonstrated a risk ratio of 1.27 (95% confidence interval 1.16-1.40; I 2=48%; absolute 5-year mortality difference 1.6% and 4.0% in people aged 60 and 75 years, respectively). The pooled estimates of relative risk did not differ significantly across varying age, gender, follow-up time, nocturia case definition, risk of bias, or study region. We rated the quality of evidence for nocturia as a prognostic factor as moderate and as a cause of mortality as very low.
Conclusions:
Nocturia is probably associated with an approximately 1.3-fold increased risk of death.
The same authors as the previous article performed also a systematic review and meta-analysis on the impact of nocturia on mortality. Although nocturia is a common cause of sleep disruption and associated with increased comorbidity and impaired quality of life, its impact on mortality remains unclear. These authors performed a systematic review and meta-analysis to evaluate the association of nocturia with mortality, both as a prognostic and causal risk factor.
PubMed, Scopus, CINAHL and major conference abstracts were analysed up to December 31, 2018. Random effects meta-analyses were performed to address the adjusted relative risks (RR) of mortality for individuals with nocturia and a meta-regression was used to explore potential determinants of heterogeneity, including risk of bias. They applied the GRADE framework to rate the quality of evidence for nocturia as a prognostic risk factor for mortality and, separately, as a cause of mortality.
Of 5230 identified reports, 11 observational studies proved eligible. For the assessment of nocturia, 10 studies used symptom questionnaires and 1 frequency-volume charts. Nocturia was defined as ≥2 episodes/night in six (55%), and as ≥3 episodes/night in five (45%) studies. Pooled estimates demonstrated a risk ratio of 1.27 (95% confidence interval 1.16-1.40; I2=48%; absolute 5-year mortality difference 1.6% and 4.0% in people aged 60 and 75 years, respectively). The pooled estimates of relative risk did not differ significantly across varying age, gender, follow-up time, nocturia case definition, risk of bias, or study region. Based on the existing data as studied, the quality of evidence for nocturia as a prognostic factor was rated as moderate and as a cause of mortality as very low.
The general conclusion states that nocturia is probably associated only with an approximately 1.3-fold increased risk of death.
Based on this study nocturia can be used as a prognostic factor and can be a reason for further health/morbidity analysis in individuals affected.