Underlying Conditions of Sleep Disruption in the Age of COVID-19

Sleep disruption can be precipitated by a wide range of conditions, and prolonged sleep disruption—or insomnia—can lead to a variety of negative health effects. During the COVID-19 pandemic, stress levels have increased dramatically, and patients may be struggling with extreme cases of insomnia. But stress isn’t the only condition underlying sleeplessness.

Nocturia (frequent nighttime urination) is a common underlying condition that interrupts sleep throughout the course of the night. Globally, nocturia tends to be under-recognized by clinicians; however, the condition may improve with personalized treatment. Although nocturia is prevalent in the population and worrisome for patients and clinicians alike,¹ studies suggest that treatment can greatly improve health-related quality of life.² Yet, according to one poll, 62% of Americans do not know that this is a medical condition with potential treatment, and, perhaps more concerning, 66% of sufferers polled had not talked to a doctor about their symptoms.³

Many patients view nocturia as a natural part of aging, which may account for the sometimes very low reports of visits to clinicians—for instance, in one study focused on female Taiwanese patients, only 13% saw a clinician to discuss their nocturia.⁴ This creates an opportunity for primary care providers to step in with personalized, preventative medicine for long-term health.

Several episodes of nighttime urination are more likely to occur in certain groups without any underlying renal challenges:

• Men with enlarged prostates (and it is one of the most bothersome symptoms)^5,6
• Individuals over the age of 60 (overall prevalence is 77% in both men and women)^7,8
• People with sleep apnea⁹

However, anyone may be affected by nocturia. Although definitions vary, most of the health effects are seen in patients who are waking up two or more times a night to urinate.¹⁰ As a multifactorial condition with many potential antecedents, triggers, and mediators, nocturia presents a challenge for personalized treatment.