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Nocturia

Common symptom in the elderly, especially men

Associated with falls, sleep disruption and impaired quality of life.

Generally associated with reduced bladder capacity, increased nocturnal urine volume, or a combination of both.

Associated with BPH, bladder detrusor instability, urinary infection or bladder tumor.

Nocturnal urine volume usually less than daytime output due to decrease in meal related fluid intake at night and increase in vasopressin (ADH) release.

Circadian ADH increase at night is blunted in the elderly, increasing nocturnal.

Nocturnal urine volume increased in diabetics, and in patients with CHF, renal diseases and hypercalcemia.

May occur in up to 50% of patients with obstructive sleep apnea, and is due to increased atrial natriuretic factor (ANF).

CPAP treatment has a 70% chance of reducing obstructive sleep apnea associated nocturia.

Mobilization of edema with recumbancy is a common cause.

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