Assessing the burden of nocturia in the workplace: The associations between nocturnal voiding, subjective well-being, work engagement and productivity.

Aims: Nocturia (getting up at night to urinate, where each urination being followed by sleep or intention to sleep) is a bothersome symptom with potentially negative consequences for individual health and daytime functioning. This study assessed the burden of nocturia in the workplace by investigating associations between nocturia and subjective well-being, work engagement and productivity.Methods: Using large-scale international workplace survey data, the associations between nocturia, subjective well-being (SWB), work engagement (Utrecht Work Engagement Scale, UWES-9) and productivity (Work Productivity and Impairment Index, WPAI) were assessed. Bivariate and multivariate regression analysis was used with adjustment for a large set of confounding factors, including sleep duration and sleep quality.Results: Across a study sample of 92,129 observations, aged 18 to 70, an average of 10% of the survey population reported ≥2 nocturnal voids (generally considered clinically significant nocturia), with prevalence of nocturia increasing with age. Individuals with nocturia reported a 35.7% (p < 0.001) higher relative sleep disturbance score and were 10.5 percentage points (p < 0.001) more likely to report short sleep. Adjusted for covariates, nocturia was associated with a 3.5% (p < 0.001) lower relative SWB score and a 2% (p < 0.001) lower relative UWES-9 work engagement score. Nocturia was associated with a 3.9 percentage points (p < 0.001) higher work impairment due to absenteeism and presenteeism (WPAI). Adjusting additionally for sleep disturbance and sleep duration reduced the magnitude of the estimated effects, suggesting a key role for poor sleep in explaining the relationship between nocturia and the outcomes (SWB, UWES-9, WPAI) assessed.Conclusions: A key contribution of this study is the assessment of the association between nocturia and a range of work performance outcomes in a sizeable study using validated instruments to measure work engagement and productivity. The study highlights the importance of taking sleep into account when assessing the relationship between nocturia and associated outcomes.

Journal of medical economics. 2020 May 12 [Epub ahead of print]

Marco Hafner, Fredrik L Andersson, Teodor Burtea, Christian van Stolk, Michael Whitmore, Erez Yerushalmi, Wendy M Troxel

RAND Europe, Cambridge, United Kingdom., International PharmaScience Center, Ferring Pharmaceuticals A/S, Copenhagen, Denmark., Ferring International Center S.A., Saint-Prex, Switzerland., Birmingham City University, Birmingham, United Kingdom., RAND Corporation, Pittsburgh, United States.