Prevalence of nocturia among community-dwelling adults: a population-based study in Malaysia

Abstract

Background: Nocturia is widely prevalent condition with detrimental effects on quality of life and general health. In Malaysia, there is a lack of up-to-date prevalence study on nocturia. This study aimed to investigate the prevalence of nocturia and awareness pertaining to nocturia among Malaysian adults.

Methods: A cross-sectional population-based study was conducted among Malaysian adults aged ≥ 18 years old. The data was collected by mixed mode self-administered questionnaire from May 2019 to September 2019. Nocturia was defined as one or more voids at night.

Results: There were a total of 4616 respondents with 74.5% of response rate. The overall prevalence of nocturia among Malaysian adults was found to be 57.3%. In multivariate analysis, respondents aged 31-40 (1.91 [1.52-2.40]) or > 60 years old (2.03 [1.48-2.71]), and those who presented with hypertension (2.84 [2.28-3.53]), diabetes mellitus (1.78 [1.42-2.25]), renal disease (3.58 [1.93-6.63]) or overactive bladder (1.61 [1.10-2.35]) were associated with higher prevalence of nocturia. A significantly lower disease prevalence (p < 0.05) was noted among those aged 41-50 (0.73 [0.59-0.91]), male (0.78 [0.69-0.88]) and Chinese (0.47 [0.30-0.74]) or Indian (0.34 [0.21-0.54]) ethnicities. A total of 37.3% of respondents with nocturia reported that they faced sleeping difficulty about half the time or more after waking up in the middle of night. Those who had ≥ 2 voids per night experienced significantly higher mean bother score than those who had 1 void per night (p < 0.001). Approximately half (56.7%) of all respondents were not aware that night time urination is a medical condition. Only 25.2% of respondents with nocturia had sought medical attention for their nocturia.

Conclusions: The prevalence of nocturia among Malaysian adults is high and strongly influenced by age, sex, race and comorbidities. However, the general awareness pertaining to nocturia being a health issue remains low among Malaysians. The findings also highlighted the impact of nocturia on sleep and the need for nocturia education to better address this disease.

Keywords: Awareness; Malaysia; Nocturia; Prevalence; Survey.

Fig. 1

Study protocol of subject inclusion and exclusion

Fig. 2

The prevalence of nocturia based on sex and frequency of nocturia. n = 4616. *According to the Chi-Square test, younger (18–40 years old) and older women (> 60 years old) were more commonly to have one void per night than men from the same age group (p < 0.05). Whereas middle-aged men (41–60 years old) were more likely to have two voids per night as compared to the middle-aged women (p < 0.05)

Fig. 3

Relationship between prevalence of nocturia and drinks consumption in the late evening. n = 4616. *According to the Chi-Square test, the prevalence of nocturia was significantly associated with the drink consumption in the late evening, including large volume of water, tea and coffee (p < 0.001). The prevalence of nocturia was significant among those without any drink consumption in the late evening (p < 0.001)

Fig. 4

Frequency of nocturia a among respondents with nocturia, b in different age groups. n = 2646

Fig. 5

Treatment seeking behaviour among participants with nocturia. n = 2037. a The overall treatment seeking behaviour among participants with nocturia. b The responses from those participants who had sought for treatment. c The responses from participants who had not sought for treatments