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Randomized Controlled Trial
. 2025 Feb;73(2):558-565.
doi: 10.1111/jgs.19214. Epub 2024 Oct 10.

A multisite feasibility study of integrated cognitive-behavioral treatment for co-existing nocturia and chronic insomnia

Constance H Fung  1   2 , Alison J Huang  3 , Alayne D Markland  4   5 , Michael Schembri  3 , Jennifer L Martin  1   2 , Donald L Bliwise  6 , Jing Cheng  3 , Cathy A Alessi  1   2 , Theodore M Johnson 2nd  4   7   8 , Kathryn L Burgio  4   5 , Lisa Muirhead  4   9 , Alison Neymark  10 , Erin Der-Mcleod  1 , Taressa Sergent  4   11 , Ann Chang  3 , Scott R Bauer  3   12 , Colette Spencer  1 , Andrew Guzman  1 , Camille P Vaughan  4   11
Affiliations
Randomized Controlled Trial

A multisite feasibility study of integrated cognitive-behavioral treatment for co-existing nocturia and chronic insomnia

Constance H Fung et al. J Am Geriatr Soc. 2025 Feb.

Abstract

Background: Nocturia (waking from sleep at night to void) and chronic insomnia frequently co-exist in older adults, contributing synergistically to sleep disturbance. Treatments typically target either nocturia or insomnia rather than simultaneously addressing shared mechanisms for these disorders.

Methods: We conducted a multisite feasibility study to: (1) test and refine a protocol for recruitment, randomization, and assessment of older adults with co-existing nocturia and insomnia; and (2) examine preliminary changes in outcome measures to inform a future larger, multisite clinical trial. Participants were men and women aged 60 years and older recruited from outpatient clinics, reporting an average of two or more nocturia episodes per night over the past 4 weeks and meeting diagnostic criteria for chronic insomnia disorder. Participants were randomized to receive either integrated cognitive-behavioral therapy for insomnia and nocturia or a health education control program involving five weekly visits with a trained nurse practitioner interventionist. Outcomes (e.g., nocturia episodes) were measured 1-week post-treatment and 4-month post-randomization. Descriptive statistics examined the feasibility of outcomes to guide preparations for a future efficacy trial.

Results: Of 245 adults screened, 55% were ineligible and 25% declined to participate. Sixty-one percent of 49 participants who provided informed consent were randomized. Of the 30 participants randomized (mean age = 70.6 years, 60% White), 14 were assigned to integrated cognitive-behavioral treatment and 16 to the control group. All randomized participants provided 4-month follow-up data. At 4 months, mean nightly nocturia episodes decreased by 0.9 (SD 1.0) in the integrated treatment group and by 0.2 (SD 1.2) in the control group compared with baseline.

Discussion: Findings demonstrate the feasibility of recruiting, randomizing, and collecting outcome data from older adults (predominantly male) assigned to an integrated cognitive-behavioral therapy for coexisting insomnia and nocturia or a health education control program.

Keywords: cognitive behavioral therapy; feasibility; insomnia; nocturia; older adult.

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Conflict of interest statement

AH receives royalties from Wolters Kluwer and consulting fees, travel support from the American Medical Association, and consulting fees from Rand Corporation. TJ receives royalties from Wolters Kluwer. CV had a prior consulting relationship with Becton Dickinson and Company. DB has received consulting fees from CliniLabs, Eisai, Ferring, Huxley, Idorsia, and Merck.

Figures

FIGURE 1
FIGURE 1
A flow diagram for the feasibility study is shown, including the number of participants evaluated for potential enrollment, the number excluded at telephone screening and face‐to‐face screening, the number randomized, and the number at follow‐up.
See this image and copyright information in PMC

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