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Nocturia
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of nocturia are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2025), the European Association of Urology (EAU 2025), the European Association of Urology (EAU/EAUN 2025), the Canadian Urological Association (CUA 2022), and the European Academy of Neurology (EAN 2020).
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2
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Diagnostic investigations
History and physical examination
As per AAFP 2025 guidelines:
Obtain a complete assessment of bladder symptoms, fluid intake, sleep habits, medical history, and symptoms of obstructive sleep apnea in patients with nocturia.
B
Obtain a frequency-volume chart, including sleep and wake times, for 2 or 3 days in patients with only nighttime urinary symptoms and no obvious medical comorbidities contributing to increased urine output.
B
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Laboratory tests
Post-void residual volume
Urodynamic studies
Screening for obstructive sleep apnea
Medical management
General principles
As per AAFP 2025 guidelines:
Initiate conservative therapy and treat any contributing medical comorbidities as the initial approach for nocturia.
B
Consider initiating pharmacotherapy as an adjunct to lifestyle interventions for nocturia related to overactive bladder syndrome or BPH.
C
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Desmopressin
Anti-LUTS therapy
Diuretics
Imipramine
Vaginal estrogen
Melatonin
Nonpharmacologic interventions
Lifestyle modifications: as per EAU 2025 guidelines, discuss behavioral changes with the patient to reduce nocturnal urine volume and episodes of nocturia and improve sleep quality.
B
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Pelvic floor muscle training