275 - Circadian Rhythm Disturbances in Nocturia and Nocturnal Polyuria: A Systematic Review
Bibliographic record
Abstract
Background Nocturia is a common symptom among adults and is often associated with disrupted sleep and diminished quality of life. In many cases, it is driven by nocturnal polyuria, an imbalance in nighttime urine production. Emerging evidence suggests that circadian rhythm disturbances, which regulate hormone secretion, renal function, and blood pressure, may play a role in this altered diuresis. This systematic review evaluated the contribution of circadian dysregulation to the pathophysiology of two distinct nocturnal voiding patterns: nocturia (defined by voiding frequency) and nocturnal polyuria (defined by urine production volume). Methods We systematically searched PubMed, Embase, and CINAHL for studies examining circadian factors, such as melatonin, vasopressin, natriuretic peptides, or nocturnal blood pressure patterns, in relation to nocturia or nocturnal polyuria. Eligible studies included adult populations, with no publication date restrictions. Studies addressing nocturnal polyuria and nocturia were analyzed separately to reflect distinct underlying mechanisms. Two reviewers independently screened articles, extracted data, and assessed study quality using the Newcastle–Ottawa Scale. Studies were categorized based on use of the clinical threshold for nocturia (≥2 voids per main sleep period), nocturnal polyuria, or subgroup analyses. Results Fourteen studies met inclusion criteria. Across diverse populations and methodologies, circadian dysregulation was consistently linked to altered nocturnal urine production. Common findings included reduced nighttime melatonin and vasopressin levels, elevated natriuretic peptide secretion, and diminished nocturnal blood pressure dipping. These abnormalities were observed in older adults, patients with obstructive sleep apnea, and individuals with neurological conditions. Several studies also reported a blunting of normal diurnal variation in sodium excretion and urine concentration. Conclusions These findings underscore the importance of incorporating circadian rhythm assessment into the clinical evaluation of nocturnal urinary complaints.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.011 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".