Multi-center Trial to Improve Nocturia and Sleep in Older Adults

The Multi-center Trial to Improve Nocturia and Sleep in Older Adults (MINT) study is a randomized trial to determine and assess the efficacy of integrated treatment of coexisting nocturia and insomnia, as well as explore the effects of this treatment on quality of life.

Inclusion Criteria: * Age ≥ 60 years * Average of ≥ 2 episodes per night of nocturia on the International Consultation on Incontinence Questionnaire-Overactive Bladder Module (ICIQ-OAB) questionnaire * Insomnia Severity Index \> 7 * Able to attend weekly study visits Exclusion Criteria: * Prior cognitive behavioral therapy for insomnia * Presence of bipolar disorder * Significant cognitive impairment as measured by a score \< 20 on the Mini-Mental State Exam * Sleep disturbance better explained by another sleep disorder such as restless legs syndrome, narcolepsy, insufficient sleep syndrome, or circadian rhythm sleep-wake disorders * Untreated sleep-disordered breathing (respiratory event index ≥ 15 plus • Epworth Sleepiness Scale \> 10 or respiratory event index \> 30. Note that participants with treated sleep-disordered breathing will not be excluded) * Current urinary tract infection or hematuria * Unstable doses or recent changes in bladder medication * New or recently discontinued insomnia medication within past month * Previous or current intensive behavioral therapy for insomnia or urinary symptoms, * Unstable health conditions expected to result in death or hospitalization within 3 months, as assessed by overall study PIs or Site PI. * Unstable medical conditions that could contribute to nocturia or insomnia such as poorly controlled heart failure as evidenced on physical examination, poorly controlled diabetes mellitus with either hemoglobin A1c of ≥ 9.0, or chronic kidney disease (stage 4 or 5) or a potential to initiate dialysis in 3 months * Unstable psychiatric conditions (e.g., psychosis, active alcohol/substance abuse based on history and medical records) * Unstable housing situation * Evidence of significant urinary retention as measured by a residual bladder volume of ≥ 200 mL by bladder ultrasound with 15 minutes of voiding * Genitourinary cancer undergoing active treatment * Pelvic or colon surgery within 6 months of enrollment or onabotulinum toxin therapy for urinary symptoms within 6 months of enrollment