The COVID-19 impact on nocturia epidemiology: a national health survey analysis

INTRODUCTION: The COVID-19 pandemic has significantly impacted disease burdens, yet updated nocturia epidemiological data remain limited. This study characterized age-sex-race disparities in nocturia prevalence and evaluated pandemic-related temporal changes. METHODS: Using NHANES data (2017-2023), this cross-sectional study included 10,946 adults (≥ 20 years). Primary outcomes were nocturia prevalence (≥ 1 and ≥ 2 nightly episodes). Analyses incorporated sampling weights and multivariable logistic regression. RESULTS: Overall weighted prevalence reached 71.9% for nocturia (≥ 1 time/night) and 31.2% for clinical nocturia (≥ 2 times/night). Post-pandemic surge was significant: nocturia increased from 70.0% to 75.3% (P = 0.002) and clinical nocturia from 28.5 to 36.0% (P < 0.001) (2017-2020 vs. 2021-2023). Young males showed the steepest clinical nocturia escalation (11.6-24.1%, P = 0.001), while middle-aged females experienced significant increases in overall nocturia (70.2-77.1%, P = 0.054). Racial disparities widened post-pandemic, with Hispanic populations demonstrating a 43.5% increase in clinical nocturia (26.9-38.6%, P < 0.001). Multivariable regression confirmed obesity as an independent risk factor (OR = 1.312, 95% CI 1.119-1.539, P = 0.002). Obesity-related exacerbation intensified during the pandemic: obese males experienced a 38.9% surge in nocturia (54.5-75.7%, P = 0.005) and 201% increase in clinical nocturia (10.4-31.3%, P = 0.007). CONCLUSIONS: Nocturia prevalence escalated markedly post-pandemic, disproportionately affecting young and obese males. Targeted interventions addressing metabolic health and socioeconomic disparities are urgently needed.