This is the first study to explore whether women with nocturia exhibited a different chronotype than those without. The aim of this study is to compare; sleep quality, chronotype, pelvic floor symptoms, quality of life and fatigue between women with and without nocturia in urinary incontinence (UI). Our hypothesis is that women with nocturia will have poorer sleep quality, a different chronotype, more severe pelvic floor symptoms, lower quality of life and higher levels of fatigue compared to women without nocturia.

This case-control study was conducted with patients routinely admitted to the outpatient gynecology clinics. The sample size was calculated using G*Power, which determined that 102 participants were required (51 for each group) to achieve 80% power with a 0.05 Type I error level. Women aged 18 and older diagnosed with UI were included. The presence of nocturia was determined based on self-reported. The type of incontinence, sleep quality, chronotype, pelvic floor symptoms, quality of life and fatigue were assessed using the 3 Incontinence Questionnaire, the Pittsburgh Sleep Quality Index, the Morning and Evening Questionnaire, the Global Pelvic Floor Bother Questionnaire, the CONTILIFE questionnaire and the Fatigue Severity Scale, respectively. Statistical analysis was performed using SPSS (ver. 25). Descriptive statistics were presented as mean±standard deviation. Chi-square test was used to compare categorical variables while Mann-Whitney U test was used to compare continuous variables with non-normal distribution. Independent t test was used to analyze continuous variables with normal distribution.

A total of 169 individuals were invited. Exclusions: 1 with sleep disorder, 2 with neurological disease, 1 with kidney disease, 19 with diabetes, 5 on hormone therapy, 1 with a recent urinary tract infection, 2 with recent pelvic surgery, 2 with cancer, 7 using sleeping pills, 10 on antidepressants, 2 with UI medications and 15 who did not volunteer. A total of 102 patients were included, with 51 in the nocturia group (n=28 with stress urinary incontinence (SUI), n=22 with urge, n=1 with mixed) in the non-nocturia group (n=31 with SUI, n=12 with urge, n=4 with mixed, n=4 with other). The mean age was 47.25±12.12 years (min=21, max=85) and 45.59±13.05 years (min=20, max=80) in the nocturia and non-nocturia groups, respectively. The nocturia group had a body mass index (BMI) of 28.96±4.17, while the non-nocturia group had a BMI of 27.40±4.28. The duration of symptoms of UI was 42.09±49.86 and 57.02±75.65 months in the nocturia and non-nocturia groups, respectively. The number of gravida was also comparable between the groups 2.76±1.76, 2.69±1.73 in the nocturia and non-nocturia groups, respectively. The age, BMI, duration of symptoms and number of gravida were similar between the groups (p=0.224, p=0.66, p=0.535, p=0.861 respectively). There was no significant difference chronotype (p=0.815) between the groups. However, significant differences were observed in sleep quality (p=0.025), pelvic floor symptoms (p=0.002), quality of life (p=0.034) and fatigue (p=0.017).

The two groups were comparable in terms of age, BMI and symptom duration. Pelvic floor symptoms were significantly more severe in the nocturia group. Although chronotype remained comparable across the groups, nocturia was associated with significantly poorer sleep quality. Furthermore, both quality of life and fatigue levels were significantly worse in the nocturia group.

In clinical practice, the effects of nocturia should undoubtedly be considered, as it significantly impacts sleep, pelvic floor health and overall well-being. Therefore, it is crucial for healthcare providers to address nocturia comprehensively, considering its multifactorial influence on patient health. Early identification and management of nocturia may improve not only sleep and pelvic floor function but also the overall quality of life for patients with UI.