Abstract
PURPOSE: We examined whether nocturia could be improved by adhering to an appropriate bedtime as determined using a wearable device that measures sleep-wake activity. MATERIALS AND METHODS: We enrolled patients aged 65 years or older with nocturia at our institution and associated hospital, for whom medical therapy was either not indicated or ineffective. We conducted a prospective crossover comparative study with alternate 4-week intervention and non-intervention periods with a 2-week washout period. During the intervention, participants were instructed to go to bed at a personalized bedtime determined via the steepest descent method, using the data of bedtime and mid-wake time from an Actiwatch Spectrum (Philips Respironics). A frequency volume chart was administered before and after each period. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI). RESULTS: The analysis included 24 patients enrolled for the study. The mean age was 79.7 years. The mean bedtime changed from 21:30 to 22:11 after intervention (p < 0.01). During the intervention and non-intervention periods, the mean changes were as follows: nocturnal urinary frequency (-0.90 vs. -0.01 times, p < 0.01), nocturnal urine volume (NUV) (-105.6 vs. +4.4 mL, p = 0.04), hours to undisturbed sleep (HUS) (62.8 vs. 12.7 min, p < 0.01), NUV per hour during HUS (-28.4 vs. -0.17 mL/h, p = 0.04), and PSQI scores (-2.4 vs. 1.2, p = 0.022). CONCLUSIONS: In older patients with nocturia, going to bed at appropriate times, determined using a wearable device that measures sleep-wake activity, might potentially prolong HUS, decrease NUV, specifically NUV/h during HUS, and consequently improve nocturia and sleep quality.