OBJECTIVES: To examine changes in nocturia from a multicomponent behavioral training program or drug therapy in older women with urge or mixed (urge-predominant) urinary incontinence. DESIGN: A secondary analysis of data from a prospective, randomized clinical trial. SETTING: Parent trial was an outpatient research protocol in Alabama. PARTICIPANTS: One hundred ninety-seven women (aged 55-92) with incontinence and urodynamic evidence of bladder dysfunction. At baseline, 131 women (66% of participants) had nocturia. INTERVENTION: In the parent study, participants received behavioral training, including four sessions of biofeedback-assisted pelvic floor muscle exercises, drug treatment (oxybutynin IR titrated from 2.5 mg per day to 5.0 mg three times a day), or placebo. MEASUREMENTS: Participant-completed bladder diaries were used to calculate changes in nocturia. RESULTS: Behavioral training reduced nocturia by a median 0.50 episodes per night and was significantly more effective than drug treatment (median reduction = 0.30 episodes; P =.02) and placebo (median reduction = 0.00 episodes; P < .001). Also, drug treatment was more effective than control (P = .007). CONCLUSION: Both behavioral training and drug treatment reduced nocturia more than placebo, but behavioral training was the most effective. © 2005 by the American Geriatrics Society.