Nocturia, Sleep Quality, and Mortality: A Systematic Review and Meta-Analysis

Purpose: Nocturia is increasingly recognized as a significant factor influencing sleep quality and potentially linked to increased mortality risk. This meta-analysis aimed to systematically review and synthesize existing research investigating the relationship between nocturia, sleep quality, and mortality, in a single framework. Materials and Methods: A comprehensive systematic search across PubMed, Embase, and the Cochrane Library was conducted from the inception of each database until April 2, 2024, yielding studies investigating the methodological qualities and the relationship between nocturia and its impact on mortality and sleep quality. Risk of Bias was assessed using ROBINSE tool and RevMan 5.4 was used to analyze the results. Results: Of the 1,450 studies subjected to screening, 33 were selected for analysis. Fourteen studies examined the association between nocturia and mortality, and 19 studies investigated impact of nocturia on sleep quality. Significant associations were found between nocturia and both mortality (pooled risk ratio: 1.78, 95% confidence interval [CI]: 1.50-2.10) and poor sleep quality (pooled odds ratio: 3.05, 95% CI: 1.89-4.93). Patients with nocturia demonstrated significantly poorer sleep quality scores compared with controls (pooled standardized mean difference: 1.01, 95% CI: 0.55-1.47). Conclusions: This meta-analysis underscores the significance of addressing nocturia as a public health concern owing to its association with poor sleep quality and increased mortality risk. It advocates for comprehensive patient care strategies for addressing nocturia, sleep quality, and mortality.