To evaluate lifestyle modification achieved through a structured self-check sheet-based behavioral therapy program and its association with changes in nighttime frequency in patients with nocturia.
We analyzed 218 patients from 14 institutions aged ≥40 years who completed a 4-week behavioral therapy program. Eight lifestyle habits were assessed before the intervention, and behavioral change was defined as executing a behavioral item on ≥14 of 28 days. Outcomes included (1) the association between the number of behavioral items successfully adopted and the change in nighttime frequency, (2) the association between adoption of each behavioral item and (3) changes in estimated salt intake.
Greater reductions in nighttime frequency were associated with a higher number of behavioral items adopted, with the greatest reduction observed in those who adopted four to five items (-1.1 episodes), and showed significant differences among groups (P = .03). In multivariable regression, positive changes in nighttime frequency (indicating greater improvement) were independently associated with regular mealtimes (β = 0.739, P = .030) and evening exercise (β = 0.328, P = .028). Salt intake significantly decreased only in patients who newly adopted salt-reduction behavior (9.4 → 8.6 g/day, P = .01).
Behavioral therapy using a simple, time-efficient self-check sheet is associated with improvement in nighttime frequency with a minimal burden on patients. Greater adherence is associated with greater improvement, and specific behaviors, particularly regular mealtimes and evening exercise, show independent associations with symptom improvement.
Urology. 2026 Feb 11 [Epub ahead of print]
Yuki Kyoda, Atsushi Wanifuchi, Ippei Muranaka, Manabu Okada, Toshiki Kenuka, Takeshi Maehana, Junya Abe, Kosuke Shibamori, Shuichi Kato, Azusa Yamana, Hiroki Horita, Makoto Nakamura, Koji Ichihara, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Urology, Hokkaido Prefectural Haboro Hospital, Haboro, Japan; Department of Urology, Rumoi Municipal Hospital, Rumoi, Japan. Electronic address: ., Department of Urology, Kushiro Red Cross Hospital, Kushiro, Japan., Department of Urology, Hokkaido Social Work Association Obihiro Hospital, Obihiro, Japan., Department of Urology, Hokkaido Medical Center, Sapporo, Japan., Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan., Department of Urology, NTT-East Sapporo Hospital, Sapporo, Japan., Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan., Department of Urology, Muroran City General Hospital, Muroran, Japan., Department of Urology, Saiseikai Otaru Hospital, Otaru, Japan., Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan., Department of Urology, Sapporo Central Hospital, Sapporo, Japan., Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Urology, Yakumo General Hospital, Yakumo, Japan., Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.