News

For lazy guys who can get away with it! (Tongue in cheek……..)

Getting up to pee at night is a real bummer. It wakes you up and can really disturb your sleep and that of your partner if you`re lucky enough to have one. By the way, you`re not alone!

There’s a medical term for getting up to pee at night, `nocturia` and it affects 1 in 3 people over the age of 30 and 50% of over 55 year olds. It can`t be avoided due to hormonal and physiological changes in the bladder as we age, sad news is it`ll just get worse as we get older. Millions just accept it as a part of the ageing process but it can have a major negative impact on your life so medical osteopath Robin Shepherd has invented a modern day chamber pot for use by able bodied people in the comfort of their bedroom.

Ok, so there might be a perceived yuk factor here, peeing alongside your bedside, smell, noise, `going back to the dark ages`? You could be right, but Shepherd has thought this through and designed something that looks like an Ikea vase, captures odour, reduces sound, and best of all if it`s knocked over it doesn’t spill! It`ll take 2 full bladders safely and go on to take up to 5 full bladders and remain incredibly stable like a ships decanter. There’s even a removable glow in the dark band so you can find it easily without switching on the light. Next morning simply empty, rinse and you`re ready for another good nights sleep.

The convenience is huge, no more tricky trips to the loo, risking injury, waking up your partner and most importantly fully waking up yourself. Better sleep, better health equals better life.

So if you`re lazy, compromised, or simply want to invest in a better nights sleep (and can get away with peeing in the bedroom), then the Handi-P could be your new best friend.

Shepherd has a female version waiting in the wings with a `fanny funnel` as well as a camouflage model for camping and a smaller one the `Kiddie-P` for kids on the move.

The effect of nocturia on sleep

If you want to understand fully the rationale behind the Handi-P, why it was created and how it might help, take a look at the paper below. It`s one of the most comprehensive pieces of research into the highly detrimental effects of nocturia on the sufferer, their family and society.

Nocturia is by far the biggest cause of sleep disruption and all the potential dangers that entails. If the Handi-p can help reduce those dangers it’ll be worth the journey.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137590/

Lack of sleep costs the UK £40 billion a year study finds.

Bosses should consider providing nap rooms for employees and not expect them to answer emails after hours, according to a new report into the effects of sleep deprivation on productivity.

Workers who don’t turn up because they are exhausted or ill through lack of sleep – or those who do come to work but are tired and sluggish – cost the UK $50 billion (£40 billion) a year, found the study. Continue reading “Lack of sleep costs the UK £40 billion a year study finds.”

Tips for helping women deal with night time urination

For many, it first happens with a pregnancy. We can’t seem to get through the night without visiting the bathroom at various inconvenient hours. And as we get older, we may again feel like slaves to our needy bladders.

The good news is that if your bladder is waking you up at night at various times to urinate, or what scientists call “nocturia,” there are small but effective changes you can make for better sleep.

It’s also important to talk to your doctor because frequent urination can be more than just a nuisance — it can also be a sign of an underlying medical condition.

Tips for dealing with night time urination:

•Keep a voiding diary. Monitor your drinking and your urine output. Take note of whether you are urinating too much around the clock, or just at night. If you’re urinating more than eight times in 24 hours, that’s too much. A lot depends on your age. And if you’re between age 65-70 and going more than twice a night, you should make an appointment with your doctor. Also, see a doctor if you are getting up more than once a night if you are between age 60-65, and more than three times each night if you are age 70 or older. While your bladder’s capacity does not necessarily decrease with age, the prevalence of overactive bladder increases with age.
•Limit your intake of fluids two hours before bedtime. Drinking too close to bedtime can cause the need to urinate at night. And alcohol and caffeine — bladder stimulants — should be limited all day long. Cut back to just one alcoholic beverage, or none at all, and decrease your current caffeine intake.
•Check for sleep apnea. During deep sleep, our bodies produce antidiuretic hormone (ADH). This allows us to retain more fluid overnight. People with sleep apnea do not get into the deep stages of sleep, so their bodies don’t make enough of this hormone. In addition, the drops in oxygen levels during apnea episodes trigger the kidneys to excrete more water. In this case, treating sleep apnea should take care of the problem.
•Exercise, and wear support hose for swelling in your feet or legs. If you experience swelling in your feet or legs, you’ll probably wake more often overnight to urinate. That’s because the fluid pooling in your extremities during the day will be reabsorbed into your system once you lie down with your feet at the level of your heart. Then the fluid will head to your kidneys to be processed. To help with this issue, exercise and wear support hose to try to get that fluid processed before bedtime.
•Elevate your legs. In the late afternoon, if you prop up your legs for an hour at the level of your heart, this can help you urinate during the day (rather than at night).

Some of it is part of aging:

It’s true that as we age, our bodies make less of a hormone that allows us to retain fluids, so our bladders fill more rapidly. Our bladders are also able to hold less urine as we get older.

Between these two factors, women beyond age 60 should expect to wake to use the bathroom at least once each night. But even so, these tips can help minimize the nightly washroom excursions for women of any age.

The Cost of Nocturia in Europe

Hypothesis / aims of study
Nocturia is common and can have a profoundly negative effect on those living with the condition, mainly due to its impact on sleep. Nocturia is the leading cause of sleep disruption in adults aged ≥55 years, but the consequence of poor sleep as a result of nocturia is often overlooked. Poor sleep leads to deficits in daily functioning, productivity and overall quality of life (QoL). The sleep fragmentation experienced by people with nocturia, especially when difficulties falling back to sleep are encountered, might help to explain the wide-ranging negative impact of the condition.
Since nocturia is believed to be an inevitable part of the aging process and not a serious medical condition, it is often regarded as a trivial ‘QoL problem’ which does not require treatment. It is therefore important to conduct a cost-of-illness calculation to investigate the economic consequences of nocturia. If there is significant cost to society caused by nocturia, the disease is no longer only relevant for the affected individual/family – it becomes a wider societal concern. This may impact upon the perception of nocturia and be of relevance in consideration of whether proactive treatment or ‘watchful waiting’ is the most appropriate strategy.
US data show that failing to treat nocturia leads to a large economic burden on society; however, these results cannot be translated to Europe as healthcare systems are very different in the USA and in Europe. Therefore, the aim of this study was to establish the cost implications of failing to treat nocturia in a European context. Reduced work productivity and increased falls are the two main sources of cost associated with nocturia which require consideration when calculating the economic burden of the condition.

Study design, materials and methods
Based on the Epidemiology of LUTS (EpiLUTS) data, ≥12.9% of men and 15% of women experience severe nocturia (≥3 voids/night) at least ‘often’. European data on working hours and average salaries were obtained from EUROstat.
The impact of nocturia on work productivity was calculated using published data from population surveys of both absenteeism and productivity in professionally active adults with nocturia compared with controls. The work productivity and activity impairment questionnaire was used (1). The net impairment of 9.19% (0% = maximum productivity; 100% = total loss of work productivity) was based on subjects who had ≥1 void/night in the population survey; however, to ensure a modest estimate, this level of impairment was attributed to those who had ≥3 voids/night in this study.
To assess the impact of nocturia on falls we estimated the proportional population risk from a study on hip fractures in elderly (≥65 years) nocturia patients, showing a prevalence of 1.38% and 1.52% per year for men and women, respectively (2). This was applied to the estimated EU mean cost of hospitalization for a hip fracture (8500 €) (3) to establish the total cost attributable to nocturia.

Results
Based on prevalence rates from the EpiLUTS study, approximately 7 million men and 8 million women aged between 40 and 65 years have ≥3 voids/night in Europe (defined as EU-15: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden and the UK).
Table 1 shows the estimated loss of productivity per year for men and women living with severe nocturia based on a reduction in work productivity of 9.19%. In total, nocturia costs approximately €29 billion per year.
Of the 24 million men and 33 million women ≥65 living in EU-15, approximately 3 million men and 5 million women suffer from ≥3 voids/night (severe nocturia) according to the EpiLUTS data. Applying the proportional population risk of breaking the hip due to severe nocturia (≥3 voids/night) approximately 43,000 men and 76,000 women per year will break a hip in EU-15 due to nocturia (see Table 2). The estimated total cost of hospitalization for hip fractures due to severe nocturia per year in EU-15 is approximately €1 billion.

Interpretation of results
It is difficult to conduct a cost of illness study in Europe because the European countries are very different. However, it is still interesting to compare the cost of nocturia in Europe with that in the USA. Since it was necessary to use many average values in our calculations, we have been as conservative as possible with the values incorporated into the model. Prevalence data used were for individuals with ≥3 voids/night (severe nocturia only). Although the prevalence rate (12.9% of men and 15% of women) is based on a sample of individuals aged 40–99 years and includes people above working age, it is still lower than in most other epidemiology studies. In addition, only hip fracture data were used for falls. These numbers are more reliable because a hip fracture must be treated in hospital and there are studies correlating nocturia and hip fractures. The current study, therefore, presents a conservative estimate because all other types of falls are not included. Lastly, the estimate is based upon data from the EU-15 countries only, since these have a more similar price level than some of the wider European Union countries (eg Bulgaria), and the average values therefore do not cover extreme outliers.

Concluding message
These findings demonstrate that nocturia represents a very significant economic burden for EU-15 society, especially due to a decrease in productivity. This cost estimate challenges preconceived notions about nocturia that it should not be treated because it is a natural part of the aging process. The costs associated with nocturia indicate that whether or not nocturia is treated is not just a matter of relevance for the QoL of affected individuals, but is a wider societal concern.
Table 1: Economic burden of nocturia in Europe due to loss of work productivity in patient <65 (average European wage based on full-time employees in ‘industry and services’ with ≥10 employees).
Men
Women
Average wage per hour
€14.1
€10.9
Productivity loss per person
180 hours
143 hours
Value of total lost productivity in EU per year
€17,753,966,984
€10,918,327,646
Table 2: Economic burden of nocturia in Europe due to hip fractures in nocturia patients ≥65.
Men
Women
Mean cost of total hospitalization cost due to hip fracture
€ 8500
€ 8500
Number of nocturia patients (≥3 voids/night) suffering hip fracture
43,103
75,931
Total cost of hip fractures due to nocturia per year
€366,371,964
€645,409,339

Frequent Urination at Night Linked to Raised Death Risk

People who wake up frequently during the night to urinate are at an increased risk of death even after accounting for chronic conditions that are known to cause the problem, two new studies show.

The findings, scheduled to be presented Sunday at the American Urological Association’s annual meeting in San Francisco, suggest that frequent urination at night, or nocturia, is a predictor of mortality in adults of all ages rather than just the elderly, and that other unrecognized medical conditions may be contributing factors.

In the first study, researchers at the New England Research Institutes in Watertown, Mass., examined the health records of nearly 16,000 men and women aged 20 and older, and found that those who woke up to urinate two or more times a night had a higher risk of mortality than those who made less than two nighttime bathroom trips. The association between nocturia and mortality remained even after adjusting for coexisting conditions, such as diabetes and cardiovascular disease, and was stronger in those aged 20 to 64 than it was in those aged 65 and older.

“In the younger age group, those who reported having nocturia had roughly twice the risk of mortality as those without, while in the older age group nocturia increased the risk in the range of 20 to 30 percent,” said study author Varant Kupelian, a research assistant at the New England Research Institutes.

Kupelian and colleagues examined records from the Third National Health and Nutrition Examination Survey (NHANES III) conducted between 1988 and 1994, as well as death certificate data in the National Death Index through Dec. 31, 2000. In the study group of 15,988 men and women, the prevalence of nocturia was 15.5 percent among men and roughly 21 percent among women, and increased rapidly with age.

Kupelian said the greater risk of mortality in younger adults “suggests that nocturia may be a marker or warning sign for subclinical disease or for the impending development of chronic disease.” He added that the higher mortality risk in older adults may also be partly due to falls and fractures that occur when people get up to go to the bathroom in the middle of the night.

The second study, by researchers at Tohoku University School of Medicine in Sendai, Japan, examined a group of elderly residents living in an urban district of north Japan and resulted in findings similar to the U.S. study. After conducting extensive health assessments of 788 men and women aged 70 and older, and then tracking mortality data on them for five years, Dr. Haruo Nakagawa and colleagues found a significantly increased risk of mortality associated with frequency of nighttime urination, even after adjusting for several factors that could contribute to mortality. They also found that the more times a person got up to urinate at night, the higher the risk of mortality.

“Both of these studies are showing a connection between nocturia and mortality, and now the next step is to try to identify what the underlying factors are that are causing this association,” said Dr. Tomas L. Griebling, vice chair of the department of urology at the University of Kansas School of Medicine in Kansas City.

In the meantime, said Griebling, the message for patients is “don’t be alarmed if you’re getting up two or three times a night. It doesn’t mean you’re going to die. But it is something you should tell your health care provider about, because it may be due to an underlying health condition.”