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Review
. 2016;9(1):34-43.
doi: 10.2174/1874609809666151130220343.

Age-Related Sleep Disruption and Reduction in the Circadian Rhythm of Urine Output: Contribution to Nocturia?

Jeanne F Duffy  1 , Karine Scheuermaier, Kevin R Loughlin
Affiliations
Review

Age-Related Sleep Disruption and Reduction in the Circadian Rhythm of Urine Output: Contribution to Nocturia?

Jeanne F Duffy et al. Curr Aging Sci. 2016.

Abstract

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.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors report no potential conflicts of interest. Support for the studies presented in Figure 1 came from NIH grants R01 AG06072, P01 AG09975, M01 RR02635 and UL1 RR025758. KS was supported by NIH Fellowships T32 HL07901, F32 AG03910, and her current support is from the University of the Witwatersrand’s Faculty Research Council, and the South African Medical Research Council. JFD was supported by R01 AG044416, R01 HL093279, and P01 AG09975.

Figures

Figure 1
Figure 1
Urine output as a function of time in healthy young (black line) and older (red line) adults studied in constant conditions. Dashed vertical lines represent the time of the usual nocturnal sleep episode. Each participant remained awake, in a semi-recumbent posture, and received equal hourly aliquots of food and fluid for 40h, beginning at their usual wake time (reference clock hour = 8).
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