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Comment & Response
October 2019

An Elderly Bias, Nocturia, and Adverse Effects of Sedative-Hypnotic Medication—Reply

Author Affiliations
  • 1Division of General Internal Medicine, Sinai Health System, Toronto, Ontario, Canada
  • 2Institute of Health Policy, Management and Evaluation, Toronto, Ontario, Canada
  • 3Centre for Quality and Patient Safety, University of Toronto, Toronto, Ontario, Canada
  • 4Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
  • 5Department of Quality, New York Health and Hospitals, New York
  • 6Lown Institute, Brookline, Massachusetts
  • 7Division of Pulmonary, Critical Care, and Sleep Medicine, Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2019;179(10):1444-1445. doi:10.1001/jamainternmed.2019.4033

In Reply We thank Bliwise for his comments on our article1 and for highlighting the role of nocturia in disordered sleep. Routinely in hospital settings, diuretics such as furosemide may be unnecessarily dosed in the late evening (known as q 12 hours, or 9 am and 9 pm), contributing to nocturia, interrupted sleep, and increasing the risk of falls. Unnecessary continuous intravenous maintenance fluids that are not reassessed may also contribute and are important to address.

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