Waking at night to void is known as nocturia. It is a common condition that affects both men and women and is one of the most bothersome of lower urinary tract symptoms (LUTS). It is defined by the International. Continence Society (ICS) as ‘waking at night to void, with each void preceded and followed by sleep’. It is often perceived as a symptom of an underlying disease which, however, is not always true.

Nocturia has a profound impact on a patient’s health, quality of life, and economic condition. It is often perceived as a symptom of an organic disease, but the pathophysiology of nocturia is now well-understood, and it is considered as a disease itself. It is classified based on four different pathophysiologic mechanisms (24-hour polyuria, nocturnal polyuria, reduced bladder capacity, and sleep disorders). The association of nocturia with impaired quality of life, cardiovascular morbidity, and all-cause mortality is well established.

Various pharmacological agents are available, of which desmopressin is considered safe and effective in both short- and long-term studies for the treatment of nocturia in men and women, including the elderly. Combining desmopressin with other agents provides an effective treatment option for nocturia in patients with lower urinary tract symptoms, benign prostatic hypertrophy, or overactive bladder syndrome.

There is a need for a “nocturia clinic”, which is a comprehensive diagnostic and management center for patients with nocturia. This set-up may help bring about a positive change in the underreported and undertreated status of nocturia and bring relief to sufferers of nocturia.

Therefore nocturia though perceived as a symptom of many disorders; it itself has defined pathophysiology and needs treatment.