Nocturia

A healthy adult needs between 7-9 hours sleep per night, with babies, young children and teens needing even more to enable their growth and development. (Sleep Foundation) 

Normally, the amount of urine created at night opposed to daytime decreases, so most people can sleep the whole 6-8 hours without the need to get up and go to the toilet. (2 - US Library of Medicine). 

However, in elderly people, reduced nocturnal levels of ADH can result in water reabsorption of the renal collecting tubule, resulting in an increased volume of urine production at night increasing this need. 

In short, those that suffer from Nocturia - ‘the need to wake up at night in order to urinate’. Nocturia is a symptom of other conditions which we will elaborate on as it helps to define further this market segment and ultimate ‘market need’. Technically, Nocturia  is the requirement to void at least one or more times a night. Some studies have shown that 69% of US men and 76% of women over the age of 40 suffer from Nocturia (Sleep Foundation) 

Nocturia Suffers can be classified into three categories. Read On

A. Global Polyuria

Global Polyuria is due to a continually raised urine output over a 24 hour cycle. Causes can include;

  • Primary polydipsia - excessive fluid consumption and is associated with;
    • Diabetes Mellitus
    • Diabetes Insipidus - increased urination can be experienced with both conditions. The most common cause is primary polydipsia - usually due to an increased consumption of fluids. This may include people who;
    • Suffer from a psychiatric condition- 
    • Drink excess amounts of water/fluid during the day to maintain a healthy lifestyle
  • Medication induced - medications that increase urine production due to influence on the brain or kidneys.
    • Diuretics - Frusimide and Spironolactone
    • Anti hypertensives: Calcium Channel blockers
    • Selective Serotonin reuptake inhibitors
    • Tetracyclines
    • Lithium
    • SGLT2 inhibitors

B. Nocturnal Polyuria

  • Nocturnal Polyuria

Increased urine production at night. Causes  include;

  • Kidney disease. 
  • Heart failure  
    • It is also noted that the vast majority of heart failure patients are on diuretics, although most would be daytime prescribed. However, heart failure independent of diuretic prescription will increase night time urination.
  • Obstructive Sleep Apnoea  
    • Prevalence is higher in men and older people and prevalence runs at anywhere from 9 to 38% in adults. 
  • Consumption of natural diuretics
    • Alcohol and caffeine are natural diuretics, meaning they result in increased urine production due to their action on ADH. Drinking these beverages prior to sleep or other excessive fluid intake can lead to nocturia.
  • High sodium diets  
    • Usually indicated by a highly processed diet and usually pre packaged meals. Lower socio economic groups may be an indicator in this area.
  • Medication indued - 
    • Stimulants, alpha blockers, beta blockers, methylopa, decongestants, psychotropic medications, parkinson medications, phentoin
    • Similar to drugs that cause Global Polyuria but includes drugs that can precipitate insomnia via central nervous effects;

C. Bladder Storage Disorders

Any structural or functional pathology that affects the reservoir capacity of the bladder can increase voiding frequency. It is important to distinguish in terms of target markets down the track that Noctural polyuria is more prevalent in older people whereas bladder storage issues are more prevalent in younger people.This category may include people who suffer from;

  • Bladder outflow obstructions - 
    • The most common here being BPH (benign prostatic hyperplasia) and prostate cancer patients within the male population. 
  • Pelvic compression 
    • The most common form of pelvic compression is due to pregnancy. 
  • Other 
    • Overactive bladder syndrome, bladder cancer, Calculi, Cystitis, stroke, Parkinson’s Disease.