This handout is for nocturia — chronic outpatient evaluation (nocturnal polyuria / reduced bladder capacity / 24-h polyuria / sleep / med / bph / chf / ckd / pregnancy / aging). Your care team identified this based on: patient reports ≥2 voids per night that wake them; ics definition of nocturia (aua oab 2019).
Other reasons your team may use this plan: nocturia causing sleep disruption / daytime fatigue / falls in elderly — symptom-driven evaluation; established bph with nocturia component — α-blocker bridge + fvc for nocturnal polyuria overlap (uro.bph.v1); established chf with nighttime supine-diuresis pattern — evening fluid restriction + diuretic timing (cardio.acute-hf.core.v1).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| Limit evening fluid / caffeine / alcohol after 6 PM; afternoon leg elevation if dependent edema; compression stockings; appropriate sleep hygiene | — | — | — | AUA OAB 2019 — behavioral first-line for nocturia (PMID 31039103;) |
| Pre-bed bladder emptying + voiding-schedule diary | — | — | — | AUA OAB 2019 |
Plan: Nocturia phenotype-specific ladder: behavioral first / med-timing adjustment / desmopressin (nocturnal polyuria ≤65) / antimuscarinic-β3 (reduced bladder capacity) / α-blocker (BPH) / CPAP (OSA) / CHF evening restriction + diuretic timing / route comorbid engines
Contact your care team if any of the following happen:
Annual re-eval; deprescribing review on diuretic / desmopressin / antimuscarinic in elderly; reassess phenotype if symptoms change (AUA OAB 2019; Beers)
Guideline: AUA OAB 2019 + amendments + NICE UI 2019 + FDA Noctiva (desmopressin) + AASM OSA + ICS / EAU nocturia + AGS Beers (deprescribing) + AHA/ACC HF 2022 (CHF nocturia)