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Nocturia, Other Lower Urinary Tract Symptoms and Sleep Dysfunction in a Community-Dwelling Cohort of Men - 28/10/16

Doi : 10.1016/j.urology.2016.06.022 
Sean A. Martin a, * , Sarah L. Appleton b, Robert J. Adams b, Anne W. Taylor c, Peter G. Catcheside d, Andrew Vakulin d, e, R. Douglas McEvoy d, Nick A. Antic d, Gary A. Wittert a
a Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, SA, Australia 
b The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA, Australia 
c Population Research and Outcome Studies, University of Adelaide, Adelaide, SA, Australia 
d Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia 
e The NHMRC Centres of Research Excellence, CIRUS and NEUROSLEEP, Woolcock Institute of Medical Research, Central Clinical School, University of Sydney, NSW, Australia 

*Address correspondence to: Sean A. Martin, Ph.D., South Australian Health & Medical Research Institute (SAHMRI), Freemasons Foundation Centre for Men's Health, University of Adelaide, Lv 7 (Men's Health), North Terrace, Adelaide, SA 5005, Australia.South Australian Health & Medical Research Institute (SAHMRI)Freemasons Foundation Centre for Men's HealthUniversity of AdelaideLv 7 (Men's Health)North TerraceAdelaideSA5005Australia

Abstract

Objectives

To examine the influence of obstructive sleep apnea (OSA) on nocturia, controlling for their shared co-morbidities, in a population of community-based middle aged to elderly men.

Methods

Participants were drawn from a randomly selected, community-dwelling cohort of men in Adelaide, Australia. Seven hundred and eight men (mean: 60.7 [41.6-88.2] years) who had polysomnography recordings, complete lower urinary tract symptoms (LUTS) measures (International Prostate Symptom Score), without prostate or bladder cancer and/or surgery, and no prior OSA diagnosis were selected. Nocturia was defined as ≥2 voids per main sleep. Unadjusted and multi-adjusted regression models of nocturia were combined with OSA, wake after sleep onset, total sleep period, excessive daytime sleepiness (EDS), and sleep quality (SQ) data, together with socio-demographic, and health-related factors.

Results

Men with nocturia were found to have higher levels of OSA (32.2% [n = 65]), wake after sleep onset time (97.2 ± 52.9 minutes), sleep period (467.3 ± 58.4 minutes), EDS (18.2% [n = 37]), and poorer SQ (54.3% [n = 108]). Multiple-adjusted models showed nocturia was positively associated with OSA (odds ratio:1.64, 95% confidence interval [1.03,2.55]), EDS (1.72 [1.01,2.93]), and poorer SQ (1.65 [1.10,2.48]). Including other storage and voiding LUTS attenuated the effect of OSA and strengthened the association with EDS (2.44 [1.45,4.10] and 2.24 [1.19,4.22]), whereas voiding LUTS also strengthened the association with poorer SQ (2.61 [1.63,4.17]). Men with increasing nocturic frequency spent less time in N2 and rapid eye movement stage sleep.

Conclusion

Nocturia is strongly associated with OSA in community-based men. Nocturia also reduces sleep efficiency/SQ, N2, and rapid eye movement sleep time, while increasing EDS. Other LUTS increase EDS through non-OSA means.

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 Financial Disclosure: SA and RA received research funding from the ResMed Foundation. PC received grants from Philips Respironics and AirLiquide Healthcare outside the submitted work. DM received research funding from the ResMed Foundation, Philips Respironics, Fisher and Paykel, equipment donations from ResMed, and Philips Respironics outside the submitted work. NA received research funding, and equipment donations from Philips Respironics and equipment donations and lecture fees or payment for development of educational presentations from ResMed outside the submitted work. GW received research funding from Bayer Schering, Eli Lilly, ResMed Foundation, and Lawley Pharmaceuticals; and also received speaking fees from Bayer Schering, Novo Nordisk, Sanofi, AstraZeneca, I-Nova, and Elsevier outside the submitted work. The remaining authors declare that they have no relevant financial interests.


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Vol 97

P. 219-226 - novembre 2016 Retour au numéro
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