A Survey On The Prevalence Of Nocturia And Its Risk Factors In 14000 Young Adults

BackgroundIn 2019,the International Continence Society(ICS)updated the definition for nocturia based on the number of times urine is passed during the main sleep period where an individual wakes to pass urine and then sleeps or has the intention to sleep.According to a literature search,studies of the effects of nocturia on young adults are lacking.Epidemiological investigations of factors related to nocturia among young people studying large sample sizes are currently absent.Thus,the present study aims to determine the prevalence of nocturia,its associated risk factors and its effects on the sleep quality of young adults in China’s mainland.It is of interest to determine if nocturia is a common cause of sleep disturbances and daytime cognitive functioning in young adults and if this has any impact on academic performance.ObjectiveThe prevalence of nocturia and its risk factors in young adults in China’s mainland are investigated.MethodsA large-scale survey was conducted on 14,000 university students from 2 large universities in Henan province,China(covering students from 363 cities within 30provinces)by way of an anonymous questionnaire.The questionnaire collected information on sociodemographic characteristics,the frequency of day and night-time urination,the presence of urgency,daytime urinary incontinence,enuresis,urinary tract infection(UTI),the Pittsburgh Sleep Quality Index(PSQI)as well as the university entrance score.For the purpose of this study,pathological nocturia(PN)is defined as waking to urinate≥2 times per night.Exclusion criteria included poor health conditions hindering cooperation,history of lower urinary tract(LUT)surgery or cancer,neurogenic diseases affecting urination,urinary tract infection(UTI),and an average fluid intake(including fluid intake from food)of less than 30 ml/kg of body weight or more than 50ml/kg of body weight over 24 hours.The qualified questionnaires were collected and screened for statistical analysis.An independent sample T-test,Kruskal–Wallis test and chi-square test were used to determine differences in prevalence on the basis of gender,age group,rural household registration,enuresis,ease of waking up,history of UTI,DUI,urgency and frequency.P<0.05 was considered to indicate statistical significance.Factors related to nocturia were evaluated by logistic regression.ResultsA total of 13874 questionnaires were collected and 13104 qualified for statistical analysis.A total of 1624 young Chinese adults(12.4%)suffered from PN,including 577males and 1047 females(male:female=1:1.8).The prevalence of PN at 17,18,19,20,21,22 and 23 years of age was 10.0%,8.3%,11.5%,13.1%,15.7%,15.0%and 14.5%,respectively.The prevalence of PN seemed to increase with age,and the difference between the PN and control groups was statistically significant(t=-6.262,P<0.001).PN showed a negative correlation with the students’university entrance score(χ~2=154.418,P<0.001).Scores for sleep latency(χ~2=32.816,P<0.001),sleep efficiency(χ~2=7.788,P=0.005),sleep disturbance(χ~2=14.277,P<0.001),the use of sleeping medication(χ~2=28.197,P<0.001),and total PSQI score(χ~2=6.875,P=0.009)for the PN group were significantly higher than those of the control group.Male gender(95%CI:0.732 to 0.929),age(95%CI:1.086 to 1.171)urinary urgency(95%CI:1.714 to 2.636,1.156 to 1.571)and frequency(95%CI:1.044 to 1.650),history of UTI(95%CI:1.481 to 6.697,1.030 to1.884),and ease of waking up at night(95%CI:0.787 to 0.990)were significant risk factors associated with nocturia.ConclusionNocturia is common in 14000 young adults with 12.4%of 17-23 year old suffering from nocturia≥2x/night(PN).Increasing age within this population,male gender,history of UTI,ease of waking up,urinary urgency and frequency were associated risk factors of PN.Moreover,young adults with PN suffered from significantly more sleep problems including sleep disturbance than controls which may have negative impact on learning as suggested by lower achievements in their university entrance scores suggesting a need for more awareness and earlier active intervention for PN.