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Monaghan TF, Wein AJ, Lazar JM, Bliwise DL. Melatonin for nocturia: Lessons learned from the sleep literature. Neurourol Urodyn 2024. [PMID: 38837267 DOI: 10.1002/nau.25517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Thomas F Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Alan J Wein
- Department of Urology, Desai Sethi Urology Institute, University of Miami Health System, Miami, Florida, USA
| | - Jason M Lazar
- Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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Verbakel I, Bou Kheir G, de Rijk M, Dhondt K, Bliwise D, Pauwaert K, Monaghan T, Hervé F, Vogelaers D, Mariman A, Everaert K. Is the insomnia phenotype the common denominator in LUTS during transition periods? An expert NOPIA research group review. Neurourol Urodyn 2024; 43:1134-1146. [PMID: 38289321 DOI: 10.1002/nau.25372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024]
Abstract
AIMS As people age, sleep stages and characteristics transition over time, but sleep deficits can profoundly impact health and cognitive functioning. Chronic sleep deprivation is linked to impaired attention and productivity, weakened immunity, increased risk of cardiovascular disease, obesity, and mental health disorders. Insomnia, obstructive sleep apnea syndrome, hormonal changes, nocturia, neurological disorders, and life events interfere with sleep patterns and some are linked to lower urinary tract symptoms (LUTS). This NOPIA symposium on Lifelong LUTS aimed to analyze the literature on associations between sleep and LUTS, generate ideas for future research, and explore whether there is support for the concept of lifelong LUTS in relation to changes in sleep throughout the lifespan. METHODS An international panel of experts took part in an online meeting addressing the role of lifelong LUTS in relationship to sleep and the brain organized by the NOPIA research group. The manuscript summarizes existing literature, hypotheses, future research ideas, and clinical recommendations. RESULTS Insomnia, sleep fragmentation, hyperarousal, and sensory processing disorders emerged as potential factors in the relationship between sleep and LUTS. Insomnia is often a persistent factor and may have been the initial symptom; however, it is often unrecognized and/or unaddressed in healthcare settings. By recognizing insomnia as a primary driver of various health issues, including nocturia, transitional care aims to address root causes and underlying problems earlier to initiate appropriate treatment. CONCLUSIONS A multidisciplinary approach with collaboration between healthcare professionals from various disciplines, such as urology, sleep medicine, gynecology, pediatrics, and geriatrics, is needed and should include validated measurements such as the insomnia severity index and sleep and voiding diaries. Ensuring ongoing follow-up and monitoring through transitional care is crucial for individuals with persistent sleep problems and LUTS, allowing issues that arise or fluctuate over the lifespan to be addressed.
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Affiliation(s)
- Irina Verbakel
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - George Bou Kheir
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Mathijs de Rijk
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Karlien Dhondt
- Department of Child and Adolescent Psychiatry, Pediatric Sleep Center, Ghent University Hospital, Ghent, Belgium
| | - Don Bliwise
- Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kim Pauwaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Thomas Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - François Hervé
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Dirk Vogelaers
- Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
- Department of General Internal Medicine, AZ Delta, Roeselare, Belgium
| | - An Mariman
- Center for Integrative Medicine, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
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Wu Y, Wang W, Wang Y, Zhao Y, You D, Zhang W, Xia J, Gu Y, Qian Q, Hong Y, Sun G. Association of sleep traits with benign prostatic hyperplasia in middle-aged and elderly men: A prospective analysis in UK Biobank. Geriatr Gerontol Int 2024. [PMID: 38764254 DOI: 10.1111/ggi.14897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/14/2024] [Accepted: 05/04/2024] [Indexed: 05/21/2024]
Abstract
AIMS The association of sleep traits (insomnia, sleep duration, chronotype, daytime sleepiness, and snoring) with benign prostatic hyperplasia (BPH) is unclear. This research aimed to examine the effects of sleep traits on BPH risk. METHODS A total of 170 241 men aged 38 to 73 years from UK Biobank were included. An overall healthy sleep score was created based on five sleep traits. A Cox regression model was utilized to compute adjusted hazard ratios (HRs) and population attributable fractions (PAFs) with 95% confidence intervals (CIs) for BPH risk in relation to sleep traits. RESULTS During a median of 12.0 years follow-up, 13 026 incident BPH cases occurred. We observed that sleep duration (7-8 h/d; HR 0.95; 95% CI 0.92-0.99), no frequent insomnia (HR 0.71; 95% CI 0.69-0.74), and no frequent daytime sleepiness (HR 0.86; 95% CI 0.79-0.93) were significantly related to reduced BPH risk. Each one-point increment of the healthy sleep score was related to a decreased BPH risk, with an adjusted HR of 0.90 (95% CI 0.89-0.92). The multivariable-adjusted HR in men adopting five versus zero to one low-risk sleep traits was 0.68 (95% CI 0.61-0.75) for BPH risk. Estimates of the PAF indicated that 9.1% (95% CI 5.8-12.5%) of BPH cases would be prevented if all individuals had adopted all five low-risk sleep traits, assuming causality. CONCLUSIONS Our study indicates an association between a healthy sleep pattern and a lower risk of BPH, emphasizing the importance of adhering to such patterns for potentially reducing BPH risk. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Yougen Wu
- National Institute of Clinical Research, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Wei Wang
- Department of Urology, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yang Wang
- Department of Urology, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dongfang You
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wei Zhang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Ju Xia
- National Institute of Clinical Research, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yuting Gu
- National Institute of Clinical Research, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Qingqing Qian
- Department of Pharmacy, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yang Hong
- Department of Osteology, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Guangchun Sun
- National Institute of Clinical Research, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
- Department of Pharmacy, Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
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Cavanaugh D, Urbanucci A, Mohamed NE, Tewari AK, Figueiro M, Kyprianou N. Link between circadian rhythm and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). Prostate 2024; 84:417-425. [PMID: 38193363 PMCID: PMC10922447 DOI: 10.1002/pros.24656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is the most common urologic disease in aging males, affecting 50% of men over 50 and up to 80% of men over 80 years old. Its negative impact on health-related quality of life implores further investigation into its risk factors and strategies for effective management. Although the exact molecular mechanisms underlying pathophysiological onset of BPH are poorly defined, the current hypothesized contributors to BPH and lower urinary tract symptoms (LUTS) include aging, inflammation, metabolic syndrome, and hormonal changes. These processes are indirectly influenced by circadian rhythm disruption. In this article, we review the recent evidence on the potential association of light changes/circadian rhythm disruption and the onset of BPH and impact on treatment. METHODS A narrative literature review was conducted using PubMed and Google Scholar to identify supporting evidence. The articles referenced ranged from 1975 to 2023. RESULTS A clear relationship between BPH/LUTS and circadian rhythm disruption is yet to be established. However, common mediators influence both diseases, including proinflammatory states, metabolic syndrome, and hormonal regulation that can be asserted to circadian disruption. Some studies have identified a possible relationship between general LUTS and sleep disturbance, but little research has been done on the medical management of these diseases and how circadian rhythm disruption further affects treatment outcomes. CONCLUSIONS There is evidence to implicate a relationship between BPH/LUTS and circadian rhythm disruptions. However, there is scarce literature on potential specific link in medical management of the disease and treatment outcomes with circadian rhythm disruption. Further study is warranted to provide BPH patients with insights into circadian rhythm directed appropriate interventions.
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Affiliation(s)
- Dana Cavanaugh
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
| | - Alfonso Urbanucci
- Prostate Cancer Research Center, Faculty of Medicine and Health Technology and FiCanMid, Tampere University, Tampere, Finland
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
| | - Ashutosh K. Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
| | - Mariana Figueiro
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
- Light and Health Research Center, Department of Population Health Science and Policy, Mount Sinai Health, New York, NY, USA
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of medicine at Mount Sinai, New York, NY, USA
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Smith AR, Mansfield SA, Bradley CS, Kenton KS, Helmuth ME, Cameron AP, Kirkali Z, Emi Bretschneider C, Andreev V, Sarma A, Lane G, Collins SA, Cella D, Henry Lai H, Harte SE, Griffith JW. Relationships Between Urinary and Nonurinary Symptoms in Treatment-Seeking Women in LURN. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:123-131. [PMID: 37428882 PMCID: PMC10751379 DOI: 10.1097/spv.0000000000001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
IMPORTANCE Physical health and psychological health represent modifiable factors in the causal pathway of lower urinary tract symptoms (LUTS). OBJECTIVES Understand the relationship between physical and psychological factors and LUTS over time. STUDY DESIGN Adult women enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network observational cohort study completed the LUTS Tool and Pelvic Floor Distress Inventory, including urinary (Urinary Distress Inventory), prolapse (Pelvic Organ Prolapse Distress Inventory), and colorectal anal (Colorectal-Anal Distress Inventory) subscales at baseline, 3 months, and 12 months. Physical functioning, depression, and sleep disturbance were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires; relationships were assessed using multivariable linear mixed models. RESULTS Of 545 women enrolled, 472 had follow-up. Median age was 57 years; 61% and 78% reported stress urinary incontinence and overactive bladder, respectively; and 81% reported obstructive symptoms. The PROMIS depression scores were positively associated with all urinary outcomes (range, 2.5- to 4.8-unit increase per 10-unit increase in depression score; P < 0.01 for all). Higher sleep disturbance scores were associated with higher urgency, obstruction, LUTS Total Severity, Urinary Distress Inventory, and Pelvic Floor Distress Inventory (1.9- to 3.4-point increase per 10-unit increase, all P < 0.02). Better physical functioning was associated with less severe urinary symptoms except stress urinary incontinence (2.3- to 5.2-point decrease per 10-unit increase, all P < 0.01). All symptoms decreased over time; however, no association was detected between baseline PROMIS scores and trajectories of LUTS over time. CONCLUSIONS Nonurologic factors demonstrated small to medium cross-sectional associations with urinary symptom domains, but no significant association was detected with changes in LUTS. Further work is needed to determine whether interventions targeting nonurologic factors reduce LUTS in women.
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Affiliation(s)
| | | | | | | | | | | | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | | | | | | | - Sarah A. Collins
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - David Cella
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - H. Henry Lai
- Washington University in St. Louis, St. Louis, MO
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
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Boroda JU, De Leon B, Khosla L, Chobufo MD, Rahman SN, Lazar JM, Weiss JP, Monaghan TF. Application of the Sleep C.A.L.M. Tool for Assessing Nocturia in a Large Nationally Representative Cohort. Int Neurourol J 2024; 28:55-61. [PMID: 38461857 DOI: 10.5213/inj.2346258.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/26/2023] [Indexed: 03/12/2024] Open
Abstract
PURPOSE Nocturia significantly impacts patients' quality of life but remains insufficiently evaluated and treated. The "Sleep C.A.L.M." system categorizes the factors thought to collectively reflect most underlying causes of nocturia (Sleep disorders, Comorbidities, Actions [i.e., modifiable patient behaviors such as excess fluid intake], Lower urinary tract dysfunction, and Medications). The purpose of this study was to assess the association of nocturia with the Sleep C.A.L.M. categories using a nationally representative dataset. METHODS Retrospective analysis of the National Health and Nutrition Examination Survey from 2013/14-2017/18 cycles was conducted. Pertinent questionnaire, laboratory, dietary, and physical examination data were used to ascertain the presence of Sleep C.A.L.M. categories in adults ≥20 years of age. Nocturia was defined as ≥2 nighttime voids. RESULTS A total of 12,274 included subjects were included (51.6% female; median age, 49.0 years [interquartile range, 34.0-62.0 years]; 27.6% nocturia). Among subjects with nocturia, the prevalence of 0, ≥1, and ≥2 Sleep C.A.L.M. categories was 3.5% (95% confidence interval [CI], 2.8%-4.4%), 96.5% (95% CI, 95.6%-97.2%), and 81.2% (95% CI, 78.9%-83.3%), respectively. Compared to those with 0-1 Sleep C.A.L.M. categories, the adjusted odds of nocturia in subjects with 2, 3, and 4-5 Sleep C. A.L.M. categories were 1.77 (95% CI, 1.43-2.21), 2.33 (1.89-2.87), and 3.49 (2.81-4.35), respectively (P<0.001). Similar trends were observed for most age and sex subgroups. When assessed individually, each of the 5 Sleep C.A.L.M. categories were independently associated with greater odds of nocturia, which likewise persisted across multiple age and sex subgroups. CONCLUSION Sleep C.A.L.M. burden is associated with increased odds of nocturia in a dose-dependent fashion, and potentially a relevant means by which to organize the underlying etiologies for nocturia among community-dwelling adults.
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Affiliation(s)
- Joseph U Boroda
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Benjamin De Leon
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Lakshay Khosla
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Muchi D Chobufo
- Department of Medicine, Division of Cardiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Syed N Rahman
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | - Jason M Lazar
- Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Thomas F Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Fornaro M, Caiazza C, De Simone G, Rossano F, de Bartolomeis A. Insomnia and related mental health conditions: Essential neurobiological underpinnings towards reduced polypharmacy utilization rates. Sleep Med 2024; 113:198-214. [PMID: 38043331 DOI: 10.1016/j.sleep.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
Insomnia represents a significant public health burden, with a 10% prevalence in the general population. Reduced sleep affects social and working functioning, productivity, and patient's quality of life, leading to a total of $100 billion per year in direct and indirect healthcare costs. Primary insomnia is unrelated to any other mental or medical illness; secondary insomnia co-occurs with other underlying medical, iatrogenic, or mental conditions. Epidemiological studies found a 40-50% comorbidity prevalence between insomnia and psychiatric disorders, suggesting a high relevance of mental health in insomniacs. Sleep disturbances also worsen the outcomes of several psychiatric disorders, leading to more severe psychopathology and incomplete remission, plausibly contributing to treatment-resistant conditions. Insomnia and psychiatric disorder coexistence can lead to polypharmacy, namely, the concurrent use of two or more medications in the same patient, regardless of their purpose or rationale. Polypharmacy increases the risk of using unnecessary drugs, the likelihood of drug interactions and adverse events, and reduces the patient's compliance due to regimen complexity. The workup of insomnia must consider the patient's sleep habits and inquire about any medical and mental concurrent conditions that must be handled to allow insomnia to be remitted adequately. Monotherapy or limited polypharmacy should be preferred, especially in case of multiple comorbidities, promoting multipurpose molecules with sedative properties and with bedtime administration. Also, non-pharmacological interventions for insomnia, such as sleep hygiene, relaxation training and Cognitive Behavioral Therapy may be useful in secondary insomnia to confront behaviors and thoughts contributing to insomnia and help optimizing the pharmacotherapy. However, insomnia therapy should always be patient-tailored, considering drug indications, contraindications, and pharmacokinetics, besides insomnia phenotype, clinical picture, patient preferences, and side effect profile.
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Affiliation(s)
- Michele Fornaro
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Claudio Caiazza
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy.
| | - Giuseppe De Simone
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine of Naples Federico II, Naples, Italy
| | - Flavia Rossano
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Andrea de Bartolomeis
- Clinical Section of Psychiatry and Psychology, Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine of Naples Federico II, Naples, Italy
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Chen T, Zhan X, Xiao S, Fu B. U-shaped association between sleep duration and urgency urinary incontinence in women: a cross-sectional study. World J Urol 2023; 41:2429-2435. [PMID: 37522906 DOI: 10.1007/s00345-023-04537-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND To investigate the association between sleep duration and urgency urinary incontinence (UUI) among adult women. METHODS Cross-sectional data were retrieved from the 2005-2014 National Health and Nutrition Examination Survey. To explore the association between sleep duration and urgency urinary incontinence, multivariable logistic regression and restricted cubic spline (RCS) regression analysis was carried out. RESULTS Among 9204 adult women, the weighted urinary incontinence prevalence was 31% for urgency urinary incontinence (UUI). The fully adjusted multivariable model revealed that participants with short (< 7 h) or long (> 9 h) sleep duration were more likely to report UUI compared to participants with normal (7-9 h) sleep duration (OR 1.20, 95% CI 1.03-1.40, p = 0.02, OR 1.40, 95% CI 1.11-1.76, p = 0.005, respectively). Subgroup analysis showed no significant interaction. Furthermore, additional analysis demonstrated a U-shaped correlation between sleep duration and incident UUI. CONCLUSION The non-linear association exists between sleep duration and urgency urinary incontinence. Compared with insufficient or excessive sleep, normal sleep duration is related to lower prevalence of urgency urinary incontinence. Future prospective longitudinal studies should be conducted to further investigate and determine the degree of the association between sleep time and urgent urinary incontinence.
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Affiliation(s)
- Tao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiangpeng Zhan
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shucai Xiao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
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Ma K, Dong Q. Association between sleep quality and benign prostate hyperplasia among middle-aged and older men in India. BMC Public Health 2023; 23:1147. [PMID: 37316942 DOI: 10.1186/s12889-023-15972-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The association between sleep quality and benign prostate hyperplasia (BPH) has rarely been studied. The aim of this study was to examine the relationship between sleep quality and BPH among middle-aged and older men in India. METHODS This study used data from men over 45 years old in Wave 1 (2017-2018) of the Longitudinal Aging Study in India (LASI). Benign prostate hyperplasia was self-reported, and sleep symptoms were assessed using five questions modified from the Jenkins Sleep Scale. A total of 30,909 male participants were finally included. Multivariate logistic regression analysis, subgroup analysis, and interaction tests were performed. RESULTS Total 453 (1.49%) men reported benign prostatic hyperplasia and have higher sleep quality score (9.25 ± 3.89 vs. 8.13 ± 3.46). The results revealed that the sleep quality score and risk of benign prostatic hyperplasia were significantly correlated after adjusting for all confounding factors (OR:1.057, 95% CI: 1.031-1.084, p < 0.001]. After dividing people into four groups based on the quartile of sleep quality scores, compared with the first quartile group, the third quartile group was 1.32 times, and the fourth quartile group was 1.615 times more likely to develop benign prostate hyperplasia. A significant interaction effect of alcohol consumption was observed. (p for interaction < 0.05). CONCLUSION Worse sleep quality was significantly associated with a higher incidence of benign prostatic hyperplasia among middle-aged and older Indian men. A further prospective study is needed to clarify this association and explore potential mechanisms.
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Affiliation(s)
- Kai Ma
- Department of Urology, institution of Urology, West China Hospital of Sichuan University, Chengdu, 610000, Sichuan Province, China
| | - Qiang Dong
- Department of Urology, institution of Urology, West China Hospital of Sichuan University, Chengdu, 610000, Sichuan Province, China.
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Negoro H, Setoh K, Fukunaga A, Kawaguchi T, Funada S, Yoshino T, Yoshimura K, Mathis BJ, Tabara Y, Matsuda F, Ogawa O, Kobayashi T. Risk analyses of nocturia on incident poor sleep and vice versa: the Nagahama study. Sci Rep 2023; 13:9495. [PMID: 37302997 DOI: 10.1038/s41598-023-36707-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023] Open
Abstract
Cross-sectional relationships between nocturia and sleep problems have been well evaluated but the risk association for each incidence is scarcely reported. This analysis included 8076 participants of the Nagahama study in Japan (median age 57, 31.0% male) and associations between nocturia and self-reported, sleep-related problems (poor sleep) were evaluated cross-sectionally. Causal effects on each new-onset case were analyzed longitudinally after 5 years. Three models were applied: univariable analysis, adjustment for basic variables (i.e., demographic and lifestyle variables) and full adjustment for basic and clinical variables. The overall prevalences of poor sleep and nocturia were 18.6% and 15.5%, while poor sleep was positively associated with nocturia (OR = 1.85, p < 0.001) and vice versa (OR = 1.90, p < 0.001). Among 6579 good sleep participants, 18.5% developed poor sleep. Baseline nocturia was positively associated with this incident poor sleep (OR = 1.49, p < 0.001, full adjustment). Among 6824 non-nocturia participants, the nocturia incidence was 11.3%. Baseline poor sleep was positively associated with this incident nocturia (OR = 1.26, p = 0.026); such associations were significant only in women (OR = 1.44, p = 0.004) and under-50-year-old groups (OR = 2.82, p < 0.001), after full adjustment. Nocturia and poor sleep associate with each other. Baseline nocturia can induce new-onset poor sleep while baseline poor sleep may induce new-onset nocturia only in women.
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Affiliation(s)
- Hiromitsu Negoro
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-Ku, Shizuoka, Japan
| | - Arinobu Fukunaga
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Funada
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Yoshino
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Yoshimura
- Department of Urology, Shizuoka General Hospital, Shizuoka, Japan
| | - Bryan J Mathis
- International Medical Center, University of Tsukuba Affiliated Hospital, Ibaraki, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-Ku, Shizuoka, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takashi Kobayashi
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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11
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Leng S, Jin Y, Vitiello MV, Zhang Y, Ren R, Lu L, Shi J, Tang X. Self-reported insomnia symptoms are associated with urinary incontinence among older Indian adults: evidence from the Longitudinal Ageing Study in India (LASI). BMC Public Health 2023; 23:552. [PMID: 36959651 PMCID: PMC10037814 DOI: 10.1186/s12889-023-15472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/20/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Insomnia and urinary incontinence (UI) are both diseases burdening older adults. However, the association between them has not been well elucidated. The purpose of this study is to assess the correlation between insomnia symptoms and UI in a large community-dwelling sample of older Indian adults. METHODS Data were from Wave 1 (2017-2018) of the Longitudinal Ageing Study of India (LASI). Male and female participants aged ≥ 60 years who provided complete information on insomnia symptoms, UI, stress UI (SUI), and covariates were included. Insomnia symptoms were identified by a report of: trouble falling asleep, waking up at night, or waking too early, ≥ 5 times/week. UI was defined by self-reported diagnosis. SUI was identified by self-report of involuntary urine leakage when sneezing, coughing, laughing, or lifting weights. Multivariable logistic regression analyses evaluated the associations between insomnia symptoms and UI and SUI. Stratified linear regression evaluated for interactions in prespecified subgroups. RESULTS Twenty-six thousand eight hundred twenty-one LASI participants met entry criteria. 2979 (11.11%) reported insomnia symptoms, 976 (3.64%) UI, and 2726 (10.16%) SUI. After full adjustment, insomnia symptoms were associated with both UI and SUI among males (OR 1.53; 95%CI 1.20-1.96 and OR 1.51; 95%CI 1.25-1.83) and females (OR 1.53; 95% CI 1.21-1.92 and OR 1.50; 95% CI 1.31-1.73). A significant interaction effect by age was observed between insomnia symptoms and SUI among both males (p = 0.048) and females (p = 0.042). CONCLUSIONS Insomnia symptoms were associated with UI and with SUI in both male and female older Indian adults. Further prospective study is called for to better characterize these associations and to explore underlying mechanisms.
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Affiliation(s)
- Siqi Leng
- Sleep Medicine Center, Department of Urology, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Yuming Jin
- Sleep Medicine Center, Department of Urology, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Ye Zhang
- Sleep Medicine Center, Department of Urology, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Rong Ren
- Sleep Medicine Center, Department of Urology, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Lin Lu
- National Institute On Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China
| | - Jie Shi
- National Institute On Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Urology, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China.
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12
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Hafner M, Yerushalmi E, Andersson FL, Burtea T. Partially different? The importance of general equilibrium in health economic evaluations: An application to nocturia. HEALTH ECONOMICS 2023; 32:654-674. [PMID: 36424887 PMCID: PMC10100343 DOI: 10.1002/hec.4638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Both the human capital approach and the friction cost approach are frequently used to quantify the productivity costs associated with illness, disability or death in health economic evaluations. In this paper we argue that these approaches have one major, but common shortcoming: they only capture partial equilibrium (PE) effects and therefore underestimate the true potential productivity costs associated with health conditions. They neglect the sizable, indirect, ripple effects in the economy captured by general equilibrium (GE) models. To demonstrate our point, we compare a traditional PE with a GE approach for the application to nocturia, a condition characterized by the need to frequently wake up at night to urinate. Nocturia is associated with substantial impairment of daytime functioning and work productivity. We employ large-scale United Kingdom (UK) employer-employee survey data to estimate the prevalence and productivity loss. These estimates are then used as shared inputs to drive both approaches. We find that the traditional PE approach underestimates the annual productivity cost of clinically relevant nocturia by around 16%. We propose a generalized GE/PE multiplier to approximate the GE effect for other health conditions. Our findings stress the importance of accounting for sizable GE effects when conducting health economic evaluations.
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Affiliation(s)
| | - Erez Yerushalmi
- Birmingham City Business SchoolBirmingham City UniversityBirminghamUK
| | | | - Teodor Burtea
- Ferring International Center SASaint‐PrexSwitzerland
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Abstract
Despite sleep's fundamental role in maintaining and improving physical and mental health, many people get less than the recommended amount of sleep or suffer from sleeping disorders. This review highlights sleep's instrumental biological functions, various sleep problems, and sleep hygiene and lifestyle interventions that can help improve sleep quality. Quality sleep allows for improved cardiovascular health, mental health, cognition, memory consolidation, immunity, reproductive health, and hormone regulation. Sleep disorders, such as insomnia, sleep apnea, and circadian-rhythm-disorders, or disrupted sleep from lifestyle choices, environmental conditions, or other medical issues can lead to significant morbidity and can contribute to or exacerbate medical and psychiatric conditions. The best treatment for long-term sleep improvement is proper sleep hygiene through behavior and sleep habit modification. Recommendations to improve sleep include achieving 7 to 9 h of sleep, maintaining a consistent sleep/wake schedule, a regular bedtime routine, engaging in regular exercise, and adopting a contemplative practice. In addition, avoiding many substances late in the day can help improve sleep. Caffeine, alcohol, heavy meals, and light exposure later in the day are associated with fragmented poor-quality sleep. These sleep hygiene practices can promote better quality and duration of sleep, with corresponding health benefits.
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14
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Aucar N, Fagalde I, Zanella A, Capalbo O, Aroca-Martinez G, Favre G, Musso CG. Nocturia: its characteristics, diagnostic algorithm and treatment. Int Urol Nephrol 2023; 55:107-114. [PMID: 35945304 DOI: 10.1007/s11255-022-03317-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 07/25/2022] [Indexed: 01/05/2023]
Abstract
Nocturia is the complaint that an individual has to wake up at night one or more times to urinate. It is a frequent condition among older adults and entails detrimental effects with regard to sleeping, sexual activity, comfort, depression, mental function and vitality. It is clinically important to distinguish it from global polyuria, defined as a urinary rate ≥ 125 ml/h (3000 ml/day), as well as from nocturnal polyuria, which is an abnormally large volume of urine during sleep associated with a decreased daytime urine production. A Frequency Volume Chart (FVC), overnight water deprivation test with renal concentrating capacity test, and the nocturnal bladder capacity index are some of the methods that help establish the underlying pathology of this condition and hence define an adequate treatment plan.
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Affiliation(s)
- Nahir Aucar
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ines Fagalde
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Akemi Zanella
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Olivia Capalbo
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Gustavo Aroca-Martinez
- Universidad del Norte, Barranquilla, Colombia.,Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla, Colombia
| | - Gabriel Favre
- Urology Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos G Musso
- Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. .,Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla, Colombia.
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15
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de Sá-Caputo D, Seixas A, Taiar R, Van der Zee EA, Bernardo-Filho M. Editorial: Non-pharmacological interventions in healthy and pathological aging: Facts and perspectives. Front Aging Neurosci 2023; 15:1191281. [PMID: 37143692 PMCID: PMC10151739 DOI: 10.3389/fnagi.2023.1191281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
- Danúbia de Sá-Caputo
- Laboratório de Vibrações Mecânicas e Práticas Integrativas (LAVIMPI), Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes and Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Danúbia de Sá-Caputo
| | - Adérito Seixas
- Escola Superior de Saúde Fernando Pessoa, Fundação Fernando Pessoa, Porto, Portugal
| | - Redha Taiar
- MATériaux et Ingénierie Mécanique (MATIM), Université de Reims Champagne- Ardenne, Reims, France
| | - Eddy A. Van der Zee
- Department of Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, Netherlands
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas (LAVIMPI), Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes and Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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DE Nunzio C, Nacchia A, Lombardo R, Brassetti A, Sica A, Baldassarri V, Guarnotta G, Al Salhi Y, Tuderti G, Li Marzi V, Finazzi Agrò E, Pastore A, Carbone A, Simone G, Tubaro A. Effect of vacation on urinary symptoms in health care workers: an Italian multicenter study. Minerva Urol Nephrol 2022; 74:755-760. [PMID: 33781024 DOI: 10.23736/s2724-6051.21.04274-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Aim of our study was to assess the impact of vacation on urinary symptoms in health care workers. METHODS Between March 2018 to October 2019 a survey was carried out by enrolling health care system workers in three centers. Demographic and clinical characteristics of health care workers (i.e. age, smoking status, medical history) were collected. Lower urinary tract symptoms (LUTS) and work related quality of life were assessed before and after vacation with validated questionnaires: Overactive Bladder Questionnaire Short Form (OABq-sf), International Prostate Symptom Score (IPSS), Work-related Quality of Life (WRQOL) and SF-36 questionnaires. As well, night shift workers (NSWs), defined as working at least one time a week from 8 pm to 8 am, were compared to traditional workers (TWs). RESULTS A total of 236 participants (118 males and 118 females) with a median of 41 (32/49 IQR) years old were included in the survey. Healthcare workers presented after vacation an improvement in LUTS, in work related quality of life and overall health. Overall, 89 (37%) were NSWs and 147 (62%) subjects were TWs. NSWs reported a significant higher median OABq Total Score and IPSS than TWs: respectively, 27 (IQR 23-34) vs. 20 (IQR 19-24) P=0.01, 2 (0/6) vs. 0 (0/2) (P<0.01). No significative differences were found for WRQOL and SF36, respectively 66 (IQR 59/77) vs. 67 (IQR 61/82) (P<0.29) and 98 (97/101) vs. 98 (97/100) (P<0.79). CONCLUSIONS NSWs present worst urinary symptoms when compared to TWs. Vacation has a beneficial effect, particularly in NSWs, on urinary symptoms and work-related quality of life.
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Affiliation(s)
| | | | | | - Aldo Brassetti
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Angela Sica
- Department of Urology, Sant'Andrea Hospital, Rome, Italy
| | | | | | - Yazan Al Salhi
- Department of Urology, Traumatological Orthopedic Surgical Institute, Latina, Italy
| | - Gabriele Tuderti
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Li Marzi
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | | | - Antonio Pastore
- Department of Urology, Traumatological Orthopedic Surgical Institute, Latina, Italy
| | - Antonio Carbone
- Department of Urology, Traumatological Orthopedic Surgical Institute, Latina, Italy
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Rome, Italy
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18
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Li CH, Chung MH, Liao CH, Su CC, Lin YK, Liao YM. Urinary Incontinence and Sleep Quality in Older Women with Type 2 Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15642. [PMID: 36497716 PMCID: PMC9739322 DOI: 10.3390/ijerph192315642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Urinary incontinence (UI) and poor sleep negatively affect health-related quality of life (HRQoL). This study explored the UI-related factors and the relationships between UI, sleep quality, and HRQoL. METHODS This cross-sectional study collected data from 237 women with type 2 diabetes. Multivariate logistic regression was conducted to identify the factors associated with UI. One-way analysis of variance was used to compare the mean sleep quality and HRQoL scores of women without UI and those who experienced UI of varying severities. Correlation coefficients were estimated, and multivariate linear regression was conducted to examine the relationships between UI severity, sleep quality, and HRQoL. RESULTS Of the 237 women, 115 (48.52%) experienced UI and 139 (58.65%) were poor sleepers. The three factors associated with UI were advanced age, a higher body mass index, and a history of vaginal delivery. Significant associations between UI severity and sleep quality and between sleep quality and HRQoL were revealed. UI severity and night-time voiding frequency were both associated with sleep quality. CONCLUSIONS One factor associated with UI (body mass index) is modifiable. UI severity is associated with sleep quality as the possible influence of night-time voiding frequency on sleep quality has been considered.
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Affiliation(s)
- Chia-Hui Li
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City 110, Taiwan, Republic of China (R.O.C.)
- Department of Surgery, Cardinal Tien Hospital, New Taipei City 231, Taiwan, Republic of China (R.O.C.)
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City 110, Taiwan, Republic of China (R.O.C.)
| | - Chun-Hou Liao
- Department of Surgery, Cardinal Tien Hospital, New Taipei City 231, Taiwan, Republic of China (R.O.C.)
- Department of Urology, Cardinal Tien Hospital, New Taipei City 231, Taiwan, Republic of China (R.O.C.)
- College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan, Republic of China (R.O.C.)
| | - Ching-Chieh Su
- Department of Endocrinology, Cardinal Tien Hospital, New Taipei City 231, Taiwan, Republic of China (R.O.C.)
- Dr. Su Diabetes Clinic, New Taipei City 231, Taiwan, Republic of China (R.O.C.)
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 333, Taiwan, Republic of China (R.O.C.)
| | - Yuan-Mei Liao
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei City 112, Taiwan, Republic of China (R.O.C.)
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Li Y, Zhou X, Qiu S, Cai B, Wang S, Chen L, Hu D, Jiang Z, Wang M, Xiong X, Jin K, Wei Q, Yang L, Ma L. Association of sleep quality with lower urinary tract symptoms/benign prostatic hyperplasia among men in China: A cross-sectional study. Front Aging Neurosci 2022; 14:938407. [PMID: 36353690 PMCID: PMC9637838 DOI: 10.3389/fnagi.2022.938407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective As the population aged, voiding dysfunction has been steadily rising among males during the past decade. Increasing evidence showed that sleep disorders are associated with an increasing risk of various diseases, but the association between sleep disorders and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) among Chinese males have not been well characterized. Materials and methods We conducted a cross-sectional analysis of data from West China Natural Population Cohort Study (WCNPCS) 2019-2021. Sleep quality was assessed by Pittsburgh sleep quality index (PSQI) in Chinese version. LUTS/BPH as a dependent variable of a binary variable, assessed by a self-reported questionnaire. Multivariate logistic regression analysis were performed to evaluate the correlation between sleep disorders and the risk of LUTS/BPH after adjusting for confounding factors. Results 11,824 eligible Chinese men participated in this cross-sectional survey. In multivariate logistic regression analysis, after adjusting for confounding variables, global PSQI score (OR: 1.257, 1.119-1.411, p < 0.001) and its six compounds (Subjective sleep quality: OR: 1.376, 1.004-1.886, p = 0.048; Sleep latency: OR: 0.656, 0.557-0.773, p < 0.001; Sleep duration: OR: 1.441, 1.189-1.745, p < 0.001; Habitual sleep efficiency: OR: 1.369, 1.193-1.570, p < 0.001; Daytime dysfunction: OR: 1.702, 1.278-2.267, p < 0.001) except the use of sleep drug subgroup were significantly positively correlated with LUTS/BPH prevalence. Significant interaction effects were observed in age subgroups (age-young group: age < 51; age-middle group: 51 ≤ age ≤ 61; age-older group: age > 61) (P < 0.05). Among older participants, sleep disorders were more significantly associated with the risk of LUTS/BPH. Conclusion There was a significant association between poor sleep quality and increased prevalence of LUTS/BPH, especially among the elderly male population, suggesting an important role of healthy sleep in reducing prostate disease burden.
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Affiliation(s)
- Yifan Li
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China,West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Shi Qiu
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Boyu Cai
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Sheng Wang
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Clinical Research, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Hu
- Department of Clinical Research, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongyuan Jiang
- Department of Clinical Research, West China Hospital, Sichuan University, Chengdu, China
| | - Mingda Wang
- Department of Clinical Research, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyu Xiong
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Kun Jin
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology, Institute of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, West China Hospital of Sichuan University, Chengdu, China,*Correspondence: Lu Yang,
| | - Li Ma
- Institute of Hospital Management of West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China,The First People’s Hospital of Longquanyi District, Chengdu, China,Li Ma,
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Zheng C, Ge Y, Chen X, Shao W, Wang G, Zhang B, Zhang W. Association between sleep status and lower urinary tract symptoms among men aged 40 or older in Zhengzhou. Sleep Biol Rhythms 2022; 20:337-344. [PMID: 38469426 PMCID: PMC10900034 DOI: 10.1007/s41105-022-00373-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
A cross-sectional study based on the community was conducted to explore the association between sleep status and LUTS among middle and old-aged men. Male residents in Zhengzhou aged 40 or older were recruited. Participants received the Pittsburgh Sleep Quality Index questionnaire and the International Prostate Symptom Score questionnaire to evaluate sleep status and the severity of lower urinary tract symptoms (LUTS), respectively. Logistic regression analyses and linear regression analyses were performed to evaluate the relationship between sleep quality and sleep duration and LUTS. A total of 5785 participants were enrolled. Multivariable analyses showed a positive relationship between sleep quality and LUTS (β 0.716, 95% CI 0.647-0.784), and poor sleepers were significantly associated with moderate or severe LUTS (OR 2.486, 95% CI 2.095-2.950). U-shaped dose-response relationship revealed that sleeping less than 5.8 h/day and more than 7.9 h/day was related to moderate or severe LUTS and more than 7.9 h/day of sleep duration was associated with poor voiding and storage symptoms (P for nonlinearity < 0.001). Similar relationship was observed between sleep status and nocturia. It showed a significantly positive relationship between sleep quality and LUTS. U-shaped dose-response relationships between sleep duration and LUTS were observed.
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Affiliation(s)
- Caifang Zheng
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Yongchao Ge
- Department of Urology, The Third People’s Hospital of Zhengzhou, Zhengzhou, 450000 Henan China
| | - Xiaorui Chen
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Weihao Shao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Gaili Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Bowen Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
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Xin Q, Yuan RK, Zitting KM, Wang W, Purcell SM, Vujovic N, Ronda JM, Quan SF, Williams JS, Buxton OM, Duffy JF, Czeisler CA. Impact of chronic sleep restriction on sleep continuity, sleep structure, and neurobehavioral performance. Sleep 2022; 45:6537622. [PMID: 35218665 PMCID: PMC9272266 DOI: 10.1093/sleep/zsac046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic sleep restriction (CSR) has been associated with adverse effects including cognitive impairment and increased risk of diabetes and cardiovascular disease. Yet, sleep restriction therapy is an essential component of most behavioral treatments for insomnia. Moreover, little is known about the impact of CSR on sleep continuity and structure in healthy people whose need for sleep is satiated. We investigated the impact of CSR on sleep continuity and structure in nine healthy participants. They had 4 nights of sleep extension, 2 nights of post-extension sleep, 21 nights of CSR (5/5.6-hour time-in-bed), and 9 nights of recovery sleep. Compared to postextension sleep, during CSR sleep duration was reduced by 95.4 ± 21.2 min per night, Slow-Wave Activity was significantly increased, and sleep was more consolidated. During recovery, sleep duration was increased by 103.3 ± 23.8 min compared to CSR, and the CSR-induced increase in Slow-Wave Activity persisted, particularly after the 5-hour exposure. Yet, we found that sustained vigilant attention was not fully recovered even after nine nights of recovery sleep. Our results suggest that CSR improves traditional metrics of sleep quality and may have a persistent impact on sleep depth, which is consistent with the reported benefits on sleep continuity and structure of sleep restriction therapy. However, these improvements in traditional metrics of sleep quality were associated with deterioration rather than improvement in neurobehavioral performance, demonstrating that sleep duration should be included in assessments of sleep quality. These results have implications for the long-term use of sleep restriction in the behavioral treatment of insomnia. Clinical Trial Registration: Impact of Chronic Circadian Disruption vs. Chronic Sleep Restriction on Metabolism (https://clinicaltrials.gov/ct2/show/; #NCT02171273).
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Affiliation(s)
- Qilong Xin
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Robin K Yuan
- Corresponding author. Robin K. Yuan, RF386D, Division of Sleep and Circadian Disorders, 221 Longwood Avenue, Boston, MA 02115, USA.
| | - Kirsi-Marja Zitting
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Wei Wang
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Shaun M Purcell
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Nina Vujovic
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Joseph M Ronda
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Stuart F Quan
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Jonathan S Williams
- Department of Medicine, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park PA 16802, USA
| | - Jeanne F Duffy
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Charles A Czeisler
- Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA,Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
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22
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Vaughan CP, Markland AD, Huang AJ, Alessi CA, Guzman A, Martin JL, Bliwise DL, Johnson II TM, Burgio KL, Fung CH. Considerations for integrated cognitive behavioural treatment for older adults with coexisting nocturia and insomnia. Age Ageing 2022; 51:6527735. [PMID: 35165690 PMCID: PMC8844541 DOI: 10.1093/ageing/afac024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Indexed: 11/14/2022] Open
Abstract
Nocturia and chronic insomnia disorder are common conditions that frequently coexist in older adults. Existing medication treatments for each condition have risks, particularly in older adults. While treatment guidelines recommend starting with behavioural therapy for each condition, no existing program simultaneously addresses nocturia and insomnia. Existing behavioural interventions for nocturia or insomnia contain concordant and discordant components. An expert panel (including geriatricians with sleep or nocturia research expertise, sleep psychologists and a behavioural psychologist) was convened to combine and reconcile elements of behavioural treatment for each condition. Concordant treatment recommendations involve using situational self-management strategies such as urge suppression or techniques to influence homeostatic drive for sleep. Fluid modification such as avoiding alcohol and evening caffeine and regular self-monitoring through a daily diary is also appropriate for both conditions. The expert panel resolved discordant recommendations by eliminating overnight completion of voiding diaries (which can interfere with sleep) and discouraging routine overnight voiding (a stimulus control strategy). The final product is an integrated cognitive behavioural treatment that is delivered by advanced practice providers weekly over 5 weeks. This integrated program addresses the common scenario of coexisting nocturia and chronic insomnia disorder.
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Affiliation(s)
- Camille P Vaughan
- Address correspondence to: Camille P. Vaughan, 1841 Clifton Road, NE, Room 533, Atlanta, GA 30329, USA. Tel: 404 728 6902.
| | - Alayne D Markland
- Dept of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL & Atlanta, GA, USA,Dept of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alison J Huang
- Dept of Medicine, University of California, San Francisco, CA 94115, USA
| | - Cathy A Alessi
- Dept of Medicine, University of California, Los Angeles, CA 90095, USA,Geriatric Research, Education, and Clinical Center; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Andrew Guzman
- Dept of Medicine, University of California, Los Angeles, CA 90095, USA,Geriatric Research, Education, and Clinical Center; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Jennifer L Martin
- Dept of Medicine, University of California, Los Angeles, CA 90095, USA,Geriatric Research, Education, and Clinical Center; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Donald L Bliwise
- Sleep Program, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Theodore M Johnson II
- Dept of Medicine, Division of Geriatrics & Gerontology, Emory University, Atlanta, GA 30329, USA,Dept of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL & Atlanta, GA, USA,Dept of Medicine, Division of General Internal Medicine, Emory University, Atlanta, GA 30329, USA,Dept of Family and Preventive Medicine, Emory University, Atlanta, GA 30329, USA
| | - Kathryn L Burgio
- Dept of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL & Atlanta, GA, USA,Dept of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Constance H Fung
- Dept of Medicine, University of California, Los Angeles, CA 90095, USA,Geriatric Research, Education, and Clinical Center; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
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23
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Zhang W, Cao G, Sun Y, Wu F, Wang Q, Xu T, Hu H, Xu K. Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in middle-aged and older Chinese individuals: Results from the China Health and Retirement Longitudinal Study. J Affect Disord 2022; 296:660-666. [PMID: 34565588 DOI: 10.1016/j.jad.2021.09.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Male lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is common and may increase the risk of depressive symptoms. This study aimed to investigate the associated factors of LUTS/BPH and its association with depressive symptoms in middle-aged and older Chinese men. METHODS This study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A total number of 8,586 men aged ≥45 years were included in this study. Participants answered positively to whether they have ever been diagnosed with a prostate illness (excluding prostatic cancer) were defined as LUTS/BPH individuals. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Multivariate logistic analyses were applied to explore the associated factors of LUTS/BPH, association between LUTS/BPH and depressive symptoms, and risk factors of depressive symptoms according to LUTS/BPH status. RESULTS The weighted overall prevalence of LUTS/BPH was 13.1% in Chinese men aged ≥45 years. The prevalence of depressive symptoms was 29.1% in LUTS/BPH individuals and 22.9% in non-LUTS/BPH individuals. Depressive symptoms and LUTS/BPH shared some same risk factors, which were education, living regions, annual household consumption, sleep duration and multimorbidity. The results from logistic models showed that education, sleep duration and multimorbidity were significantly and independently associated with depression of LUTS/BPH individuals (P<0.001). CONCLUSIONS Prevalence of depressive symptoms in LUTS/BPH population was higher than in non-LUTS/BPH population. Education, sleep duration and multimorbidity were associated with the onset of depressive symptoms in LUTS/BPH individuals (P<0.001).
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Affiliation(s)
- Weiyu Zhang
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 100191 Beijing, China; Medical Informatics Center, Peking University, 100191 Beijing, China
| | - Yiran Sun
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Feng Wu
- Institute for Disease Control and Prevention, Chinese PLA, 100071 Beijing, China
| | - Qi Wang
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Hao Hu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China.
| | - Kexin Xu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China.
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24
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Smith L, Shin JI, Ghayda RA, Hijaz A, Sheyn D, Pope R, Hong SH, Kim SE, Ilie PC, Carrie AM, Ippoliti S, Soysal P, Barnett Y, Pizzol D, Koyanagi A. Physical multimorbidity and incident urinary incontinence among community-dwelling adults aged ≥50 years: findings from a prospective analysis of the Irish Longitudinal Study on Ageing. Age Ageing 2021; 50:2038-2046. [PMID: 34279551 DOI: 10.1093/ageing/afab151] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are no prospective studies on the association between multimorbidity and urinary incontinence (UI), while mediators in this association are unknown. Thus, we aimed to (i) investigate the longitudinal association between multimorbidity and UI in a large sample of Irish adults aged ≥50 years and (ii) investigate to what extent physical activity, polypharmacy, cognitive function, sleep problems, handgrip strength and disability mediate the association. METHODS Data on 5,946 adults aged ≥50 years old from the Irish Longitudinal Study on Aging were analysed. The baseline survey was conducted between 2009 and 2011 and follow-up after 2 years was conducted. Information on self-reported occurrence of UI in the past 12 months and lifetime diagnosis of 14 chronic conditions were obtained. Multivariable logistic regression and mediation analysis were conducted. RESULTS After adjustment for potential confounders, compared to having no chronic conditions at baseline, having three (odds ratio [OR] = 1.79; 95% confidence interval [CI] = 1.30-2.48) and four or more (OR = 1.86; 95% CI = 1.32-2.60), chronic conditions were significantly associated with incident UI. Mediation analysis showed that polypharmacy, sleep problems and disability explained 22.7, 17.8 and 14.7% of the association between multimorbidity (i.e. two or more chronic conditions) and incident UI, respectively. CONCLUSION A greater number of chronic conditions at baseline were associated with a higher risk for incident UI at 2-year follow-up among adults aged ≥50 years in Ireland. Considering the effects of different medications on UI and improving sleep quality and disability among people aged ≥50 years with multimorbidity may reduce the incidence of UI.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ramy Abou Ghayda
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Adonis Hijaz
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David Sheyn
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rachel Pope
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sun Hwi Hong
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sung Eun Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Petre Cristian Ilie
- Queen Elizabeth Hospital King’s Lynn Foundation Trust, King’s Lynn PE30 4ET, UK
| | - Anne Marie Carrie
- Queen Elizabeth Hospital King’s Lynn Foundation Trust, King’s Lynn PE30 4ET, UK
| | - Simona Ippoliti
- Queen Elizabeth Hospital King’s Lynn Foundation Trust, King’s Lynn PE30 4ET, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Yvonne Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain
- ICREA, 08010 Barcelona, Spain
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25
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Kim JK, Lee YG, Han K, Han JH. Obesity, metabolic health, and urological disorders in adults: a nationwide population-based study. Sci Rep 2021; 11:8687. [PMID: 33888807 PMCID: PMC8062508 DOI: 10.1038/s41598-021-88165-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/30/2021] [Indexed: 12/25/2022] Open
Abstract
We evaluate the risks of various urological disorders that require treatments according to obesity and metabolic health status using a nationwide dataset of the Korean population. 3,969,788 patients who had undergone health examinations were enrolled. Participants were classified as “obese” (O) or “non-obese” (NO) using a BMI cut-off of 25 kg/m2. People who developed ≥ 1 metabolic disease component in the index year were considered “metabolically unhealthy” (MU), while those with none were considered “metabolically healthy” (MH). There were classified into the MHNO, MUNO, MHO, and MUO group. In BPH, chronic renal disease, neurogenic bladder, any medication related to voiding dysfunction, alpha-blocker, and antidiuretics, age and gender-adjusted hazard ratio (HR) was highest in MUO, but higher in MUNO than in MHO. In stress incontinence, prostate surgery, and 5alpha-reductase, HR increased in the order of MUNO, MHO, and MUO. In prostatitis, anti-incontinence surgery, and cystocele repair, HR was higher in MHO than MUNO and MUO. In cystitis, cystostomy, and anticholinergics, HR was higher in MUNO and MUO than MHO. In conclusion, obesity and metabolic health were individually or collaboratively involved in urological disorders related to voiding dysfunction. Metabolic healthy obesity needs to be distinguished in the diagnosis and treatment of urological disorders.
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Affiliation(s)
- Jong Keun Kim
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea
| | - Young Goo Lee
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-Ro, Dongjak-gu, Seoul, 06978, Republic of Korea
| | - Jun Hyun Han
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea.
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26
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Trotti LM, Bliwise DL, Keating GL, Rye DB, Hu WT. Cerebrospinal Fluid Hypocretin and Nightmares in Dementia Syndromes. Dement Geriatr Cogn Dis Extra 2021; 11:19-25. [PMID: 33790936 PMCID: PMC7989783 DOI: 10.1159/000509585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023] Open
Abstract
Background/Aims Hypocretin promotes wakefulness and modulates REM sleep. Alterations in the hypocretin system are increasingly implicated in dementia. We evaluated relationships among hypocretin, dementia biomarkers, and sleep symptoms in elderly participants, most of whom had dementia. Methods One-hundred twenty-six adults (mean age 66.2 ± 8.4 years) were recruited from the Emory Cognitive Clinic. Diagnoses were Alzheimer disease (AD; n = 60), frontotemporal dementia (FTD; n = 21), and dementia with Lewy bodies (DLB; n = 20). We also included cognitively normal controls (n = 25). Participants and/or caregivers completed sleep questionnaires and lumbar puncture was performed for cerebrospinal fluid (CSF) assessments. Results Except for sleepiness (worst in DLB) and nocturia (worse in DLB and FTD) sleep symptoms did not differ by diagnosis. CSF hypocretin concentrations were available for 87 participants and normal in 70, intermediate in 16, and low in 1. Hypocretin levels did not differ by diagnosis. Hypocretin levels correlated with CSF total τ levels only in men (r = 0.34; p = 0.02). Lower hypocretin levels were related to frequency of nightmares (203.9 ± 29.8 pg/mL in those with frequent nightmares vs. 240.4 ± 46.1 pg/mL in those without; p = 0.05) and vivid dreams (209.1 ± 28.3 vs. 239.5 ± 47.8 pg/mL; p = 0.014). Cholinesterase inhibitor use was not associated with nightmares or vivid dreaming. Conclusion Hypocretin levels did not distinguish between dementia syndromes. Disturbing dreams in dementia patients may be related to lower hypocretin concentrations in CSF.
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Affiliation(s)
- Lynn Marie Trotti
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Glenda L Keating
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David B Rye
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.,Emory Sleep Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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27
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Um YH, Oh JH, Kim TW, Seo HJ, Kim SM, Chung JS, Jeong JH, Hong SC. Nocturia and Sleep: Focus on Common Comorbidities and Their Association with Obstructive Sleep Apnea. SLEEP MEDICINE RESEARCH 2020. [DOI: 10.17241/smr.2020.00731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Hafner M, Andersson FL, Burtea T, van Stolk C, Whitmore M, Yerushalmi E, Troxel WM. Assessing the burden of nocturia in the workplace: the associations between nocturnal voiding, subjective well-being, work engagement and productivity. J Med Econ 2020; 23:994-1003. [PMID: 32397770 DOI: 10.1080/13696998.2020.1767631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: Nocturia (getting up at night to urinate, where each urination being followed by sleep or intention to sleep) is a bothersome symptom with potentially negative consequences for individual health and daytime functioning. This study assessed the burden of nocturia in the workplace by investigating associations between nocturia and subjective well-being (SWB), work engagement and productivity.Methods: Using large-scale international workplace survey data, the associations between nocturia, SWB, work engagement (Utrecht Work Engagement Scale, UWES-9) and productivity (Work Productivity and Activity Impairment, WPAI) were assessed. Bivariate and multivariate regression analysis was used with adjustment for a large set of confounding factors, including sleep duration and sleep quality.Results: Across a study sample of 92,129 observations, aged 18-70, an average of 10% of the survey population reported ≥2 nocturnal voids (generally considered clinically significant nocturia), with prevalence of nocturia increasing with age. Individuals with nocturia reported a 35.7% (p < .001) higher relative sleep disturbance score and were 10.5 percentage points (pp) (p < .001) more likely to report short sleep. Adjusted for covariates, nocturia was associated with a 3.5% (p < .001) lower relative SWB score and a 2% (p < .001) lower relative UWES-9 work engagement score. Nocturia was associated with a 3.9 pp (p < .001) higher work impairment due to absenteeism and presenteeism (WPAI). Adjusting additionally for sleep disturbance and sleep duration reduced the magnitude of the estimated effects, suggesting a key role for poor sleep in explaining the relationship between nocturia and the outcomes (SWB, UWES-9, WPAI) assessed.Conclusions: A key contribution of this study is the assessment of the association between nocturia and a range of work performance outcomes in a sizeable study using validated instruments to measure work engagement and productivity. The study highlights the importance of taking sleep into account when assessing the relationship between nocturia and associated outcomes.
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Affiliation(s)
| | - Fredrik L Andersson
- International PharmaScience Center, Ferring Pharmaceuticals A/S, Copenhagen, Denmark
| | - Teodor Burtea
- Ferring International Center S.A., Saint-Prex, Switzerland
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29
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DE Nunzio C, Nacchia A, Cicione A, Sica A, Baldassarri V, Voglino O, Mancini E, Guarnotta G, Trucchi A, Tubaro A. Night shift workers refer higher urinary symptoms with an impairment quality of life: a single cohort study. Minerva Urol Nephrol 2020; 73:831-835. [PMID: 32284530 DOI: 10.23736/s2724-6051.20.03735-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of the present study is to assess the impact of night shift work (NSW) on urinary symptoms. METHODS Between March 2018 to October 2018, we evaluated a group of National Health care system workers. Urinary symptoms and quality of life were measured by Overactive Bladder Questionnaire Short Form (OABq-sf). Clinical variables (i.e. age, smoking status, medical history) were collected and analyzed according to be NS workers (NSWs) from subjects working at least one time from 8 pm to 8 am or from traditional workers (TWs). Univariate and multivariate analysis was performed to identify predictive variables of worse OAB outcomes (OABq-sf>30, OABq-SB≥12, OABq HRQL≥18). RESULTS A total of 136 participants (68 males and 68 females) were included in the study. On OABq-sf, total score, symptoms bother (OABq-SB) and health related quality of life (OABq-HRQL) domains were significantly (P<0.05) higher in NSWs group, respectively: 31 (IQR 26-35) vs. 19 (IQR 19-20); 11 (IQR 10-13) vs. 6 (IQR 6-7); 19 (IQR 16-22) vs. 13 (13-14). Finally, seven NSWs (10.6%) referred nocturia respect to only one (1%) TWs, (P=0.02). On multivariate analysis NSW was an independent predictor of OABq-sf>30 units (OR:30; CI: 9-111, P=0.001), OABq-SB ≥12 units (OR:16, CI: 6-43, P=0.001) and OABq HRQL≥18 units (OR:20, CI: 6-70, P=0.001). CONCLUSIONS Night shift workers presented worst OAB Score and poor QL when compared to similar traditional workers. Long-term data on NSWs patients are also needed to further clarify this relationship.
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Affiliation(s)
- Cosimo DE Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy -
| | - Antonio Nacchia
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonio Cicione
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Angela Sica
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Valeria Baldassarri
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Olivia Voglino
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Elisa Mancini
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Giorgio Guarnotta
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Alberto Trucchi
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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30
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Kulakaç N, Sayılan AA. Determining the quality of life and the sleep quality in patients with benign prostate hyperplasia. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2019. [DOI: 10.1111/ijun.12215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nurşen Kulakaç
- Department of NursingGümüşhane University Faculty of Health Sciences Gümüşhane Turkey
| | - Aylin Aydın Sayılan
- Department of NursingKırklareli University Vocational School of Health Sciences Kırklareli Turkey
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31
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Bliwise DL. An Elderly Bias, Nocturia, and Adverse Effects of Sedative-Hypnotic Medication. JAMA Intern Med 2019; 179:1444. [PMID: 31589262 DOI: 10.1001/jamainternmed.2019.4593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Donald L Bliwise
- Sleep Center, Emory University School of Medicine, Atlanta, Georgia
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Monaghan TF, Bliwise DL, Suss NR, Epstein MR, Wu ZD, Michelson KP, Agudelo CW, Robins DJ, Wagg A, Weiss JP. Overnight Urge Perception in Nocturia Is Independent of Depression, PTSD, or Anxiety in a Male Veterans Administration Population. J Clin Sleep Med 2019; 15:615-621. [PMID: 30952224 DOI: 10.5664/jcsm.7726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/09/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The goal of this study was to compare the urge perception associated with nocturnal voiding at the time of voiding in individuals with and without depression, posttraumatic stress disorder (PTSD), or anxiety diagnoses to test the hypothesis that patients with such diagnoses are more likely to experience insomnia-driven convenience voiding during the sleep period. METHODS A database of voiding diaries with urge perception grades (UPGs) from 429 adult males seeking treatment for nocturia at a Veterans Affairs-based urology clinic was analyzed. The UPG categorizes perception for urinating from 0 (out of convenience) to 4 (desperate urge). Diaries completed by males age 18 years and older showing ≥ 2 nocturnal voids were included. Those included (n = 178) were divided into two cohorts based on the presence (n = 62) or absence (n = 116) of one or more previously established mental health diagnoses (depression, PTSD, or anxiety). The chi-square test was used to determine significance between groups. RESULTS Patients with a mental health diagnosis were more likely to report convenience voiding compared to those without depression, PTSD, or anxiety (14.5% versus 0.8%, P < .01). However, most voids in both groups were associated with the perception of urinary urgency. There were no differences in urinary volumes or hourly rates of urine production between the groups. CONCLUSIONS A relatively small subset of urology patients experience nocturnal voiding because they are awake for reasons other than the urge to void. Mental health factors had a substantial, albeit minimal, effect. Most nocturia reflects urgency to urinate rather than voiding by convenience.
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Affiliation(s)
- Thomas F Monaghan
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Nicholas R Suss
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Matthew R Epstein
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Zhan D Wu
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Kyle P Michelson
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | | | - Dennis J Robins
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Adrian Wagg
- Department of Geriatric Medicine, University of Alberta, Edmonton, Canada
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York.,Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
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Sigalos JT, Kohn TP, Cartagenova L, Dao Z, Gondokusumo JC, Santiago J, Kohn JR, Pickett SM, Pastuszak AW, Lipshultz LI. Shift Workers With Shift Work Disorder Have Worse Lower Urinary Tract Symptoms. Urology 2019; 128:66-70. [PMID: 30817957 DOI: 10.1016/j.urology.2019.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To examine the association between shift work or shift work disorder (SWD) and lower urinary tract symptoms (LUTS). Nonstandard shift workers are defined as those working shifts outside of a normal 7 AM-6 PM work day. METHODS Men presenting to a single andrology clinic between July 2014 and June 2017 completed questionnaires that included questions about work schedules, shift work status, SWD[1][1], personal well-being via the Patient Health Questionnaire-9, and LUTS (International Prostate Symptom Score [IPSS]). Men who had previously undergone prostate surgery were excluded. Shift work and SWD on IPSS was assessed via multivariate linear regression. RESULTS Of the 2571 men who completed all questionnaires, 619 (24.1%) reported working nonstandard shifts in the past month. Of these, 196 (31.7%) had high risk of SWD as determined by a questionnaire. When controlling for age, medications, surgical intervention for benign prostatic hyperplasia, comorbidities, and testosterone (T) levels, nonstandard shift work overall was not associated with worse LUTS (P = .82). However, nonstandard shift workers at high risk for SWD had IPSS scores that were clinically significantly higher (3.74 points ± 0.57 standard error) than nonstandard shift workers without SWD (P <.0001). CONCLUSION Nonstandard shift workers at high risk for SWD have worse LUTS than those without SWD. However, no association between nonstandard shift work and LUTS was found.
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Affiliation(s)
| | - Taylor P Kohn
- John's Hopkins Brady Urological Institute, Baltimore, MD
| | | | | | | | | | - Jaden R Kohn
- John's Hopkins Department of Obstetrics and Gynecology, Baltimore, MD
| | | | - Alexander W Pastuszak
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT.
| | - Larry I Lipshultz
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX; Scott Department of Urology, Baylor College of Medicine, Houston, TX
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Bliwise DL, Howard LE, Moreira DM, Andriole GL, Hopp ML, Freedland SJ. Nocturia and associated mortality: observational data from the REDUCE trial. Prostate Cancer Prostatic Dis 2018; 22:77-83. [DOI: 10.1038/s41391-018-0090-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/27/2018] [Accepted: 08/02/2018] [Indexed: 12/28/2022]
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Jones HJ, Zak R, Lee KA. Sleep Disturbances in Midlife Women at the Cusp of the Menopausal Transition. J Clin Sleep Med 2018; 14:1127-1133. [PMID: 29991421 DOI: 10.5664/jcsm.7208] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/14/2018] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES To compare causes of sleep disturbance and to compare self-reported sleep duration among groups of late premenopausal women and early perimenopausal women. METHODS In a longitudinal study of a community-based sample of healthy women 40 to 50 years of age, menstrual cycle and symptom data were collected every 2 months; anthropometric measures, a urine sample for follicle stimulating hormone (FSH), and the Pittsburgh Sleep Quality Index (PSQI) measures were collected every 6 months. RESULTS At 12 to 18 months, 206 women remained premenopausal and 69 women became perimenopausal. Poor sleep quality (PSQI score > 5) was experienced by 42% of the total cohort. Awakening to use the bathroom was the most frequent reason (81%) for sleep disturbance in the entire cohort, followed by feeling too hot (26%). However, premenopausal women were significantly more likely to awaken to use the bathroom than perimenopausal women (P = .047), and perimenopausal women were more likely than premenopausal women to awaken because of feeling too hot (P = .002). Women in early perimenopause reported shorter sleep duration (P = .007) and worse sleep quality (P = .05) than premenopausal women of similar age. CONCLUSIONS Sleep disturbance is a significant issue for midlife women regardless of age or reproductive stage. Identification of salient factors that disrupt sleep, such as nocturia prior to menopausal transition or feeling too hot early in menopausal transition, will provide direction for developing tailored intervention strategies to improve sleep and quality of life. COMMENTARY A commentary on this article appears in this issue on page 1095.
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Affiliation(s)
- Holly J Jones
- College of Nursing, University of Cincinnati, Cincinnati, Ohio
| | - Rochelle Zak
- Sleep Disorders Center, University of California, San Francisco, California
| | - Kathryn A Lee
- Department of Family Health Care Nursing, University of California, San Francisco, California
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Doyle-McClam M, Shahid MH, Sethi JM, Koo P. Nocturia in Women With Obstructive Sleep Apnea. Am J Lifestyle Med 2018; 15:260-268. [PMID: 34025318 DOI: 10.1177/1559827618782657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/27/2018] [Accepted: 05/23/2018] [Indexed: 12/21/2022] Open
Abstract
Obstructive sleep apnea (OSA) is underdiagnosed in women compared with men. Women have a tendency to underreport or present with atypical symptoms such as behavior changes, insomnia, fatigue, and depression. Nocturia, waking up from sleep 2 times or more to void, has been shown to be associated with OSA, but it is not an included symptom in commonly used screening questionnaires in primary provider offices. About 50% of patients with OSA have nocturia, and treatment of OSA improves it. Recognition of nocturia as a relevant symptom of OSA is important for primary providers to provide timely referral for the diagnosis of OSA.
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Affiliation(s)
- Megan Doyle-McClam
- University of Tennessee College of Medicine Chattanooga, Erlanger Baroness Hospital, Chattanooga, Tennessee
| | - Muhammad H Shahid
- University of Tennessee College of Medicine Chattanooga, Erlanger Baroness Hospital, Chattanooga, Tennessee
| | - Jigme M Sethi
- University of Tennessee College of Medicine Chattanooga, Erlanger Baroness Hospital, Chattanooga, Tennessee
| | - Patrick Koo
- University of Tennessee College of Medicine Chattanooga, Erlanger Baroness Hospital, Chattanooga, Tennessee
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Vaughan CP, Markland AD, Smith PP, Burgio KL, Kuchel GA. Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Urinary Incontinence in Older Adults: A Translational Research Agenda for a Complex Geriatric Syndrome. J Am Geriatr Soc 2018; 66:773-782. [PMID: 29205261 PMCID: PMC5906179 DOI: 10.1111/jgs.15157] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its ninth Bedside-to-Bench research conference, entitled "Urinary Incontinence in the Older Adult: A Translational Research Agenda for a Complex Geriatric Syndrome," October 16 to 18, 2016, in Bethesda, Maryland. As part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm disturbance, and urinary incontinence-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these conditions. The conference provided a forum for discussing current epidemiology, basic science, and clinical and translational research on urinary incontinence in older adults; for identifying gaps in knowledge; and for developing a research agenda to inform future investigative efforts. The conference also promoted networking involving emerging researchers and thought leaders in the field of incontinence, aging, and other fields of research, as well as National Institutes of Health program personnel.
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Affiliation(s)
- Camille P Vaughan
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Birmingham/Atlanta, Atlanta, Georgia, Birmingham, Alabama
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
| | - Alayne D Markland
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Birmingham/Atlanta, Atlanta, Georgia, Birmingham, Alabama
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Phillip P Smith
- Division of Urology, University of Connecticut Health Center, Farmington, Connecticut
- UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
| | - Kathryn L Burgio
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Birmingham/Atlanta, Atlanta, Georgia, Birmingham, Alabama
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - George A Kuchel
- UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
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Fung CH, Vaughan CP, Markland AD, Huang AJ, Mitchell MN, Bliwise DL, Ancoli-Israel S, Redline S, Alessi CA, Stone K. Nocturia is Associated with Poor Sleep Quality Among Older Women in the Study of Osteoporotic Fractures. J Am Geriatr Soc 2017; 65:2502-2509. [PMID: 28914959 DOI: 10.1111/jgs.15027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES (1) To examine relationships between frequency of nocturia and self-reported sleep quality and objective sleep measures in older women, and (2) to estimate the amount of variation in sleep measures that is specifically attributable to frequency of nocturia. DESIGN AND SETTING Secondary, cross sectional analysis of the multicenter prospective cohort Study of Osteoporotic Fractures (SOF). PARTICIPANTS Community-dwelling women aged ≥80 years. MEASUREMENTS Frequency of nocturia in the previous 12 months, Pittsburgh Sleep Quality Index sleep quality subscale, and actigraphy-measured wake after sleep onset (WASO) and total sleep time (TST). RESULTS Of 1,520 participants, 25% (n = 392) reported their nocturia frequency was 3-4 times/night and an additional 60% (n = 917) reported their nocturia frequency was 1-2 times/night. More frequent nocturia was associated with poor sleep quality (3-4/night: 26.8% reported fairly bad or very bad sleep quality; 1-2/night: 14.7%; 0/night: 7.7%; P < .001) and longer WASO (3-4/night: 89.8 minutes; 1-2/night: 70.6; 0/night: 55.5; P < .001). In nested regression models, a nocturia frequency of 3-4/night quadrupled the odds of poor sleep quality (odds ratio: 4.26 [95% CI 1.65, 11.01]; P = .003) and was associated with a 37-minute worsening in WASO (95% CI 26.0, 49.0; P < .001). Frequency of nocturia explained an additional 6% variation in WASO, above and beyond demographic, medical/psychiatric conditions, and medication factors (∆R2 = 0.06). CONCLUSIONS Nocturia is common among octogenarian and nonagenarian women and is independently associated with poor sleep quality and longer wake time at night. Interventions that improve nocturia may be useful in improving sleep quality and wake time at night.
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Affiliation(s)
- Constance H Fung
- Department of Veterans Affairs Greater, Los Angeles Geriatric Research, Education, and Clinical Center, Los Angeles, California.,Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Camille P Vaughan
- Department of Veterans Affairs Birmingham, Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama.,Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia
| | - Alayne D Markland
- Department of Veterans Affairs Birmingham, Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama.,Department of Medicine, Division of Geriatrics, Gerontology and Palliative Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alison J Huang
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Michael N Mitchell
- Department of Veterans Affairs Greater, Los Angeles Geriatric Research, Education, and Clinical Center, Los Angeles, California
| | - Donald L Bliwise
- Sleep Program, Emory University School of Medicine, Atlanta, Georgia
| | - Sonia Ancoli-Israel
- Departments of Psychiatry and Medicine, University of California, San Diego, La Jolla, California
| | - Susan Redline
- Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Cathy A Alessi
- Department of Veterans Affairs Greater, Los Angeles Geriatric Research, Education, and Clinical Center, Los Angeles, California.,Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Katie Stone
- California Pacific Medical Center, San Francisco, California
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Branche BL, Howard LE, Moreira DM, Roehrborn C, Castro-Santamaria R, Andriole GL, Hopp ML, Freedland SJ. Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE. J Urol 2017; 199:536-542. [PMID: 28870861 DOI: 10.1016/j.juro.2017.08.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE Although lower urinary tract symptoms and sleep problems often develop together, to our knowledge it is unknown whether sleep disturbances are linked to lower urinary tract symptoms development and progression. As measured by the 6-item MOS-Sleep (Medical Outcomes Study Sleep Scale) survey we examined the relationship between sleep problems, and the development and progression of lower urinary tract symptoms in the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study. MATERIALS AND METHODS REDUCE was a randomized trial testing prostate cancer chemoprevention with dutasteride in men with prostate specific antigen 2.5 to 10 ng/ml and a negative biopsy. At baseline men completed MOS-Sleep and a scaled average was used to calculate the sleep score. Men were followed for 4 years and I-PSS (International Prostate Symptom Score) was completed at baseline and every 6 months. Asymptomatic men had I-PSS less than 8 while symptomatic men had I-PSS 8 or greater. In the placebo arm of 2,588 men not receiving α-blockers or 5α-reductase inhibitors at baseline we tested the association between sleep problems and lower urinary tract symptom development and progression using Cox models. RESULTS During followup lower urinary tract symptoms developed in 209 of 1,452 asymptomatic men (14%) and 580 of 1,136 (51%) with lower urinary tract symptoms demonstrated progression. On multivariable analysis higher sleep scores were suggestively associated with increased lower urinary tract symptoms in asymptomatic men (quartile 4 vs 1 HR 1.41, 95% CI 0.92-2.17, p = 0.12) and with lower urinary tract symptom progression in symptomatic men (per 10 points of sleep score HR 1.06, 95% CI 1.01-1.12, p = 0.029). CONCLUSIONS Among men with lower urinary tract symptoms worse sleep scores were associated with the progression of lower urinary tract symptoms and among asymptomatic men worse sleep scores were suggestively associated with the development of lower urinary tract symptoms. If confirmed, these data suggest that sleep problems may precede such symptoms. Whether treating sleep problems would improve lower urinary tract symptoms requires further testing.
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Affiliation(s)
- Brandee L Branche
- Surgery Section, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Lauren E Howard
- Surgery Section, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
| | | | - Claus Roehrborn
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ramiro Castro-Santamaria
- Metabolic Pathways and Cardiovascular R&D Unit, GlaxoSmithKline, Inc., King of Prussia, Pennsylvania
| | - Gerald L Andriole
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Martin L Hopp
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Stephen J Freedland
- Surgery Section, Durham Veterans Affairs Medical Center, Durham, North Carolina; Cedars-Sinai Medical Center, Los Angeles, California.
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Sleep Disturbance and Fatigue Are Associated With More Severe Urinary Incontinence and Overactive Bladder Symptoms. Urology 2017; 109:67-73. [PMID: 28826875 DOI: 10.1016/j.urology.2017.07.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/20/2017] [Accepted: 07/28/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the relationship between sleep disturbance, fatigue, and urinary incontinence (UI) and overactive bladder (OAB) symptoms among patients with OAB. METHODS Patients who were diagnosed with OAB and age-matched control subjects without OAB were enrolled. Sleep disturbance and fatigue symptoms were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. UI and OAB symptoms were assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI), the International Consultation on Incontinence Questionnaire-Overactive Bladder (ICIQ-OAB), the Overactive Bladder Questionnaire (OAB-q), the Urogenital Distress Inventory Short Form (UDI-6), and the Incontinence Impact Questionnaire Short Form (IIQ-7). Psychosocial health (depression, anxiety, and perceived stress level) was also assessed. RESULTS Patients with OAB reported a significantly greater sleep disturbance compared with controls (PROMIS 8b T-scores: 54.3 ± 10.3 vs 43.8 ± 9.2). Patients with OAB also reported a significantly greater fatigue compared with controls (PROMIS 7a T-scores: 54.7 ± 9.6 vs 46.0 ± 6.4). After adjusting for nocturia, the differences in sleep disturbance between OAB and controls became insignificant (P = .21), whereas the differences in fatigue between OAB and controls remained significant (P = .014). Among patients with OAB, there were positive correlations between sleep disturbance and the severity of OAB symptoms (ICIQ-OAB), poorer health-related quality of life (OAB-q QOL), the severity of UI symptoms (ICIQ-UI), greater incontinence impact (IIQ-7), and urinary bother (UDI-6). Positive correlations were also observed between fatigue and worse UI and OAB symptoms and quality of life. Both sleep disturbance and fatigue were associated with poor psychosocial health (depression, anxiety, and higher stress level) among patients with OAB. CONCLUSION Sleep disturbance and fatigue are present in substantial percentages of patients with OAB. Among patients with OAB, sleep disturbance and fatigue were associated with more severe UI and OAB symptoms, worse health-related quality of life, and poorer psychosocial health.
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Denys MA, Anding R, Tubaro A, Abrams P, Everaert K. Lower urinary tract symptoms and metabolic disorders: ICI-RS 2014. Neurourol Urodyn 2016; 35:278-82. [PMID: 26872568 DOI: 10.1002/nau.22765] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 02/23/2015] [Indexed: 12/12/2022]
Abstract
AIMS To investigate the link between lower urinary tract symptoms (LUTS) and metabolic disorders. MATERIALS AND METHODS This report results from presentations and subsequent discussions about LUTS and metabolic disorders at the International Consultation on Incontinence Research Society (ICI-RS) in Bristol, 2014. RESULTS There are common pathophysiological determinants for the onset of LUTS and the metabolic syndrome (MetS). Both conditions are multifactorial, related to disorders in circadian rhythms and share common risk factors. As in men with erectile dysfunction, these potentially modifiable lifestyle factors may be novel targets to prevent and treat LUTS. The link between LUTS and metabolic disorders is discussed by using sleep, urine production and bladder function as underlying mechanisms that need to be further explored during future research. CONCLUSION Recent findings indicate a bidirectional relationship between LUTS and the MetS. Future research has to explore underlying mechanisms to explain this relationship, in order to develop new preventive and therapeutic recommendations, such as weight loss and increasing physical activity. The second stage is to determine the effect of these new treatment approaches on the severity of LUTS and each of the components of the MetS.
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Affiliation(s)
| | - Ralf Anding
- Department of Neuro-Urology, University Hospital, Bonn, Germany
| | - Andrea Tubaro
- Department of Urology Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Paul Abrams
- Department of Urology, Bristol Urological Institute, Bristol, United Kingdom
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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42
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Fung CH, Vitiello MV, Alessi CA, Kuchel GA. Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Sleep, Circadian Rhythms, and Aging: New Avenues for Improving Brain Health, Physical Health, and Functioning. J Am Geriatr Soc 2016; 64:e238-e247. [PMID: 27858974 PMCID: PMC5173456 DOI: 10.1111/jgs.14493] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its eighth Bedside-to-Bench research conference, entitled "Sleep, Circadian Rhythms, and Aging: New Avenues for Improving Brain Health, Physical Health and Functioning," October 4 to 6, 2015, in Bethesda, Maryland. Part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm (SCR) disturbance, and voiding dysfunction-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these three geriatric syndromes. The conference provided a forum for discussing current sleep, circadian rhythm, and aging research; identifying gaps in knowledge; and developing a research agenda to inform future investigative efforts. The conference also promoted networking among developing researchers, leaders in the field of SCR and aging, and National Institutes of Health program personnel.
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Affiliation(s)
- Constance H Fung
- Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Michael V Vitiello
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Cathy A Alessi
- Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - George A Kuchel
- Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
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Nocturia, Other Lower Urinary Tract Symptoms and Sleep Dysfunction in a Community-Dwelling Cohort of Men. Urology 2016; 97:219-226. [DOI: 10.1016/j.urology.2016.06.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/01/2016] [Accepted: 06/14/2016] [Indexed: 11/20/2022]
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Scovell JM, Pastuszak AW, Slawin J, Badal J, Link RE, Lipshultz LI. Impaired Sleep Quality is Associated With More Significant Lower Urinary Tract Symptoms in Male Shift Workers. Urology 2016; 99:197-202. [PMID: 27639796 DOI: 10.1016/j.urology.2016.05.076] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 05/16/2016] [Accepted: 05/31/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the association between sleep quality and severity of lower urinary tract symptoms (LUTS) in men working nonstandard shifts, a population at risk of poor sleep quality. METHODS Men who presented to a single andrology clinic between July and October 2014 and worked nonstandard shifts completed the International Prostate Symptom Score (IPSS) and responded to questions regarding their work habits, sleep quality, and physical or cognitive function. We assessed the relationship between age, sleep quality, physical or cognitive function, and severity of LUTS. RESULTS A total of 228 men with a mean ± standard deviation age of 41.8 ± 5.7 (range 21-76) years reported working nonstandard shifts, with the majority working these shifts for more than 1 year (81%). Men with difficulties falling asleep reported more severe LUTS than men who did not have difficulty falling asleep (IPSS score 9 vs 6, P <.001). Men who reported difficulty staying asleep or falling back asleep after awakening also reported more severe LUTS (IPSS scores 6 vs 13, P = .004; 5 vs 13, P <.001, respectively). Men with a decreased sense of well-being or decreased physical or cognitive function also reported more severe LUTS (IPSS score 6 vs 9, P <.0010; 6 vs 10, P = .016, respectively). All findings were independent of subject age. CONCLUSION Men working nonstandard shifts who have difficulty falling asleep, staying asleep, and falling back asleep report more severe LUTS than men without similar sleep difficulties. Men with a decreased sense of well-being or decreased physical or cognitive function also report worse LUTS. These findings implicate sleep quality as a possible risk factor for LUTS symptom severity.
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Affiliation(s)
- Jason M Scovell
- Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX
| | - Alexander W Pastuszak
- Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX.
| | - Jeremy Slawin
- Department of Urology, NYU Langone Medical, New York, NY
| | | | - Richard E Link
- Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX
| | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX
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Abstract
Nocturia is an extremely common condition that has major sequelae for affected patients. Through disruption of sleep, nocturia impairs quality of life and worsens health outcomes, and is associated with a variety of morbidities including diabetes, coronary artery disease, obstructive sleep apnoea, obesity, metabolic syndrome, and depression. Unsurprisingly, several studies have also linked nocturia with reduced survival. Nocturia is not simply a consequence of lower urinary tract disease; rather, it is a multifactorial disorder that is often a manifestation of an underlying renal or systemic disease. Through the use of the frequency volume chart, clinicians can accurately quantify nocturia and determine its aetiology. Evaluation of quality of life and sleep using simple measures is essential in order to assess the impact of nocturia on a patient. Numerous treatment options for nocturia exist, but most are associated with minor benefit or lack sufficient evidence supporting their use. By systematically analysing an individual's causes of nocturia, clinicians can design appropriate treatment strategies to most effectively treat this condition.
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Affiliation(s)
- Hasan Dani
- Department of Urology, SUNY Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, New York 11226, USA
| | - Ashanda Esdaille
- Department of Urology, SUNY Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, New York 11226, USA
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, New York 11226, USA
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Kaplan SA. Re: Analyzing why Men Seek Treatment for Lower Urinary Tract Symptoms and Factors Associated with Nonimprovement. J Urol 2016; 195:1546. [DOI: 10.1016/j.juro.2016.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pesonen JS, Cartwright R, Mangera A, Santti H, Griebling TL, Pryalukhin AE, Riikonen J, Tähtinen RM, Agarwal A, Tsui JF, Vaughan CP, Markland AD, Johnson TM, Fonsell-Annala R, Khoo C, Tammela TLJ, Aoki Y, Auvinen A, Heels-Ansdell D, Guyatt GH, Tikkinen KAO. Incidence and Remission of Nocturia: A Systematic Review and Meta-analysis. Eur Urol 2016; 70:372-81. [PMID: 26905787 DOI: 10.1016/j.eururo.2016.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
Abstract
CONTEXT Although vital for decision-making about management, the natural history of nocturia remains uncertain. A systematic review would clarify the issue, but because natural history reviews are uncommon it would require methodological innovations. OBJECTIVE To estimate the incidence and remission of nocturia, and refine methods for meta-analyses assessing natural history. EVIDENCE ACQUISITION We conducted a comprehensive search of PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases and abstracts of major urologic meetings as far as August 31, 2015. Random effects meta-analyses addressed incidence/remission rates of nocturia; meta-regression explored potential determinants of heterogeneity. Studies were categorized as either low or high risk of bias using a novel instrument specifically designed for longitudinal symptom studies aimed at the general population. EVIDENCE SYNTHESIS Of 4165 potentially relevant reports, 16 proved eligible. Pooled estimates from 13 studies (114 964 person-years of follow-up) demonstrated that annual incidence was strongly associated with age: 0.4% (0-0.8%) for adults aged < 40 yr; 2.8% (1.9-3.7%) for adults aged 40-59 yr; and 11.5% (9.1-14.0%) for adults aged ≥ 60 yr. Of those with nocturia, each year 12.1% (9.5-14.7%) experienced remission. CONCLUSIONS The available evidence suggests that nocturia onset is strongly associated with age, with much higher rates in those over 60 yr; remission occurs in approximately 12% each year. These estimates can aid with management decisions and counseling related to nocturia. PATIENT SUMMARY We reviewed all previous studies of progression of night-time urination (nocturia). We found that in any given year 0.4% of adults aged < 40 yr, 3% of adults aged 40-59 yr, and 12% of adults aged ≥ 60 yr will develop nocturia, while overall 12% of those with nocturia will improve. These findings may be helpful in making decisions about coping with or treating nocturia.
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Affiliation(s)
- Jori S Pesonen
- Department of Urology, Päijät-Häme Central Hospital, Lahti, Finland; Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Rufus Cartwright
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK; Department of Urogynaecology, Imperial College London, London, UK
| | - Altaf Mangera
- Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK
| | - Henrikki Santti
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tomas L Griebling
- Department of Urology, University of Kansas and The Landon Center On Aging, Kansas City, KS, USA
| | - Alexey E Pryalukhin
- North-Western State Medical University named after I.I. Mechnikov, Department of Urology, Saint Petersburg, Russia; Department of Pathology, Saarland University Medical Center, Homburg, Germany
| | - Jarno Riikonen
- Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Riikka M Tähtinen
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Johnson F Tsui
- Department of Urology, Lenox Hill Hospital, New York, NY, USA
| | - Camille P Vaughan
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA
| | - Alayne D Markland
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA
| | - Theodore M Johnson
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA, USA
| | | | - Charlie Khoo
- Department of Urology, Royal Free Hospital, London, UK
| | - Teuvo L J Tammela
- Department of Urology, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland
| | - Yoshitaka Aoki
- Department of Urology, University of Fukui, Faculty of Medical Sciences, Fukui, Japan
| | - Anssi Auvinen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Diane Heels-Ansdell
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Gordon H Guyatt
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Kari A O Tikkinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
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Vaughan CP, Bliwise DL, Johnson TM. Editorial comment. Urology 2015; 85:646-7. [PMID: 25733280 DOI: 10.1016/j.urology.2014.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Camille P Vaughan
- Department of Veterans Affairs Medical Center, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, GA; Emory University School of Medicine, Atlanta, GA
| | | | - Theodore M Johnson
- Department of Veterans Affairs Medical Center, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, GA; Emory University School of Medicine, Atlanta, GA
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Wei JT. How Much Worse Will My Voiding Symptoms Get over Time? J Urol 2014; 191:15-6. [DOI: 10.1016/j.juro.2013.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- John T. Wei
- Department of Urology, University of Michigan, Ann Arbor, Michigan
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