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Lambert C, Maria JD, Denys P, Even A, Welniarz A, Hartley S, Prigent H, Leotard A, Joussain C. Nocturia and obstructive sleep apnea in spinal cord injured patients - a cohort study. World J Urol 2024; 42:519. [PMID: 39259389 DOI: 10.1007/s00345-024-05190-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/20/2024] [Indexed: 09/13/2024] Open
Abstract
PURPOSE To describe the prevalence of nocturia and obstructive sleep apnea (OSA) in a cohort of spinal cord injury (SCI) patients and to describe their association. Additionally, to assess clinical and urodynamic data explaining nocturia and to evaluate the effect of OSA management with continuous positive airway pressure (CPAP). METHOD Retrospective analysis of data from patients with SCI followed in a tertiary care rehabilitation center with a specialized sleep and neuro-urology units. All adult SCI patients who underwent urodynamic assessment before polysomnography (PSG) between 2015 and 2023 were eligible. Subjective (nocturia) and objective data (urodynamic data, polysomnography, CPAP built-in software) were collated from the Handisom database (database register no. 20200224113128) and the medical records of SCI patients. Statistical testing used Mann-Whitney test for non-parametric variables, Fisher's exact test for contingency analysis and the Spearman correlation test to assess correlations. A p-value < 0.05 was considered significant. Statistical analyses were performed using GraphPad Prism v9. RESULTS 173 patients (131 males, 42 females) were included. The majority of patients were paraplegic (n = 111 (64,2%)) and had complete lesions (n = 75 (43,4%)). A total of 100 patients had nocturia (57,5%). The prevalence of OSA (Apnea Hypopnea Index (AHI) ≥ 15/h) in the studied population was 61,9%. No correlation was found between nocturia and OSA. A significant difference was observed between patients with and without nocturia in terms of the presence of neurogenic detrusor overactivity (p = 0,049), volume at the first detrusor contraction (p = 0,004) and the bladder functional capacity (p < 0,001). CONCLUSION Nocturia and OSA are highly prevalent in patients with SCI, but no statistical association was found between these two disorders. A prospective study focusing on nocturnal polyuria will be needed to assess the impact of OSA on lower urinary tract symptoms in SCI patients.
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Affiliation(s)
- C Lambert
- Service de Médecine Physique et Réadaptation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - J Di Maria
- Service de Physiologie et d'Explorations Fonctionnelles, GHU Paris Saclay, AP-HP, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, Garches, 92380, France
| | - P Denys
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - A Even
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - A Welniarz
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - S Hartley
- Service de Physiologie et d'Explorations Fonctionnelles, GHU Paris Saclay, AP-HP, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, Garches, 92380, France
| | - H Prigent
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - A Leotard
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - Charles Joussain
- GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France.
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France.
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Abushamma F, Zidan E, Douglass ZE, Jaber A, Nazzal Z, Hamdan ZI, Ktaifan M, Hashim H. Lower urinary tract symptoms among male patients on hemodialysis: Prospective and multi-central cross-sectional study. SAGE Open Med 2024; 12:20503121241263302. [PMID: 39092156 PMCID: PMC11292685 DOI: 10.1177/20503121241263302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/31/2024] [Indexed: 08/04/2024] Open
Abstract
Background Lower urinary tract symptoms are common and can significantly impact quality of life, especially in men with co-morbidities and end-stage renal disease. The presence of lower urinary tract symptoms affect the quality of life of patients on hemodialysis. Objectives The purpose of this study is assessing the presence and severity of lower urinary tract symptoms among male patients on hemodialysis. Factors that may exacerbate lower urinary tract symptoms were assessed and studied. The impact of lower urinary tract symptoms on quality of life was also identified. Methods A prospective, multi-central, and cross-sectional study of male patients on hemodialysis was conducted. Demographics, clinical data, and core lower urinary tract symptoms score questionnaire were all collected. A correlation has been made between all variables. Results One hundred forty-five patients were enrolled. Eighty-seven percent of hemodialysis patients had at least one storage symptom, and 85% had at least one voiding symptom. The prevalence of storage symptoms (frequency, nocturia, urgency, and urgency incontinence) was found to be 3%, 70%, 44%, and 12%, respectively. The voiding symptoms were mainly weak stream, straining, and incomplete emptying, which were found in 60%, 43%, and 36%, respectively. Fifteen percent of the cohort had a negatively significant impact on their quality of life. The absence of voiding symptoms was statistically linked to a better quality of life (p < 0.05). Hemodialysis patients who are over 60 years old, smokers, or obese were found to be significantly more likely to report storage symptoms (18%, 9%, and 79%, respectively; p < 0.05). Bladder pain was significantly correlated to the dialysis duration of more than 24 months (p < 0.05). Conclusion Storage and voiding lower urinary tract symptoms are common among hemodialysis male patients with a minor impact on their quality of life. Age, smoking, and obesity are major risks of exaggerating such symptoms.
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Affiliation(s)
- Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Department of Urology, An-Najah National University Hospital, Nablus, Palestine
| | - Enas Zidan
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zainab E Douglass
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Anas Jaber
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zaher Nazzal
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zakaria I Hamdan
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Department of Nephrology, An-Najah National University Hospital, Nablus, Palestine
| | - Mahfouz Ktaifan
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Hashim Hashim
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
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Rameshkumar S, Arizmendi BJ, Salwen-Deremer JK. The role of arousal in maintaining the relationship between insomnia and gastrointestinal conditions. Transl Gastroenterol Hepatol 2024; 9:41. [PMID: 39091658 PMCID: PMC11292074 DOI: 10.21037/tgh-23-126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/30/2024] [Indexed: 08/04/2024] Open
Abstract
The relationship between gastrointestinal (GI) conditions and sleep disturbance has been well established. With a higher-than-average prevalence of sleep disturbance in individuals with GI conditions, it is imperative to better understand the maintaining factors driving this comorbidity. Although there are separate, ongoing investigations into both the biological mechanisms and interventions for the sleep and GI relationship, there is a considerable need to further specify common and mutually influential pathways. In our review, we highlight arousal as both a unifying feature of insomnia and various GI conditions as well as a possible mechanism for action for the bidirectional relationship. This review aims to summarize the relationship between arousal, insomnia, and GI conditions, specifically examining sources of arousal across four broad domains: psychosocial factors, physical health factors, daily living factors, and sociocultural factors. Online databases, including PubMed, PsychInfo, and Google Scholar, were searched for full-text English language articles focused on patients with insomnia and/or GI conditions and involving mental health, physical comorbidities, and social factors. Understanding the nature of this bidirectional relationship between sleep and GI through the lens of arousal as a common mechanism will lend itself to using a multidisciplinary approach to treatment and care.
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Affiliation(s)
| | - Brian J. Arizmendi
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Jessica K. Salwen-Deremer
- Department of Psychiatry & Center for Digestive Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Liu J, Richmond RC, Anderson EL, Bowden J, Barry CJS, Dashti HS, Daghlas IS, Lane JM, Kyle SD, Vetter C, Morrison CL, Jones SE, Wood AR, Frayling TM, Wright AK, Carr MJ, Anderson SG, Emsley RA, Ray DW, Weedon MN, Saxena R, Rutter MK, Lawlor DA. The role of accelerometer-derived sleep traits on glycated haemoglobin and glucose levels: a Mendelian randomization study. Sci Rep 2024; 14:14962. [PMID: 38942746 PMCID: PMC11213880 DOI: 10.1038/s41598-024-58007-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 03/25/2024] [Indexed: 06/30/2024] Open
Abstract
Self-reported shorter/longer sleep duration, insomnia, and evening preference are associated with hyperglycaemia in observational analyses, with similar observations in small studies using accelerometer-derived sleep traits. Mendelian randomization (MR) studies support an effect of self-reported insomnia, but not others, on glycated haemoglobin (HbA1c). To explore potential effects, we used MR methods to assess effects of accelerometer-derived sleep traits (duration, mid-point least active 5-h, mid-point most active 10-h, sleep fragmentation, and efficiency) on HbA1c/glucose in European adults from the UK Biobank (UKB) (n = 73,797) and the MAGIC consortium (n = 146,806). Cross-trait linkage disequilibrium score regression was applied to determine genetic correlations across accelerometer-derived, self-reported sleep traits, and HbA1c/glucose. We found no causal effect of any accelerometer-derived sleep trait on HbA1c or glucose. Similar MR results for self-reported sleep traits in the UKB sub-sample with accelerometer-derived measures suggested our results were not explained by selection bias. Phenotypic and genetic correlation analyses suggested complex relationships between self-reported and accelerometer-derived traits indicating that they may reflect different types of exposure. These findings suggested accelerometer-derived sleep traits do not affect HbA1c. Accelerometer-derived measures of sleep duration and quality might not simply be 'objective' measures of self-reported sleep duration and insomnia, but rather captured different sleep characteristics.
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Affiliation(s)
- Junxi Liu
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- Nuffield Department of Population Health, Oxford Population Health, University of Oxford, Oxford, UK.
| | - Rebecca C Richmond
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma L Anderson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Division of Psychiatry, University College of London, London, UK
| | - Jack Bowden
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- College of Medicine and Health, The University of Exeter, Exeter, UK
| | - Ciarrah-Jane S Barry
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hassan S Dashti
- Centre for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Iyas S Daghlas
- Centre for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jacqueline M Lane
- Centre for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Simon D Kyle
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Claire L Morrison
- Department of Psychology & Neuroscience and Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Samuel E Jones
- Institute for Molecular Medicine Finland, University of Helsinki, Uusimaa, Finland
| | - Andrew R Wood
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - Timothy M Frayling
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - Alison K Wright
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Matthew J Carr
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Simon G Anderson
- George Alleyne Chronic Disease Research Centre, Caribbean Institute of Health Research, University of the West Indies, Kingston, Jamaica
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Richard A Emsley
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - David W Ray
- Oxford Centre for Diabetes, Endocrinology and Metabolism, and Oxford Kavli Centre for Nanoscience Discovery, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, and NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, UK
| | - Richa Saxena
- Centre for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martin K Rutter
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and The University of Bristol, Bristol, UK
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Jia Y, Ca J, Yang F, Dong X, Zhou L, Long H. Association between family income to poverty ratio and nocturia in adults aged 20 years and older: A study from NHANES 2005-2010. PLoS One 2024; 19:e0303927. [PMID: 38768158 PMCID: PMC11104595 DOI: 10.1371/journal.pone.0303927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Nocturia, the most common lower urinary tract symptom (LUTS), significantly impacts socioeconomic factors and individuals' quality of life and is closely related to many diseases. This study utilized data from NHANES 2005-2010 to explore the relationship between family income to poverty ratio (PIR) and the presence of nocturia symptoms in adults aged 20 or older in the United States. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) in 2005-2010, including 6,662 adults aged 20 or older, were utilized for this cross-sectional study. The baseline data was used to display the distribution of each characteristic visually. Multiple linear regression and smooth curve fitting were used to study the linear and non-linear correlations between PIR and nocturia. Subgroup analysis and interaction tests were conducted to examine the stability of intergroup relationships. RESULTS Out of the 6,662 adult participants aged 20 or older, 1,300 households were categorized as living in poverty, 3,671 households had a moderate income, and 1,691 households were classified as affluent. Among these participants, 3,139 individuals experienced nocturia, representing 47.12% of the total, while 3,523 individuals were nocturia-free, constituting 52.88% of the total population. After adjusting for all other covariates, it was found that PIR was significantly negatively correlated with nocturia (OR: 0.875, 95%CI: 0.836-0.916 P<0.0001). This trend persisted when PIR was divided into three groups (PIR <1, PIR 1-4, PIR > 4) or quartiles. There was a non-linear negative correlation between PIR and nocturia. CONCLUSION Our findings indicated that lower PlR was associated with a higher risk of nocturia in adults aged 20 or older in the United States. These findings highlight the importance of considering socioeconomic factors in preventing and managing nocturia. Nonetheless, further exploration of the causal nexus between these factors was precluded due to the constraints of a cross-sectional design.
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Affiliation(s)
- Yangtao Jia
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Jiacheng Ca
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Fangzheng Yang
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Xinke Dong
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Libin Zhou
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
| | - Huimin Long
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, 315040, People’s Republic of China
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Brown A, Ferguson L, Castillo J, Nguyen HXT, Ervin C, Whishaw DM, Bower W. Determinants of Bladder Care at Night in a Subacute Ward for Aged Patients: An Observational Study. J Wound Ostomy Continence Nurs 2024; 51:146-151. [PMID: 38215216 DOI: 10.1097/won.0000000000001057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
PURPOSE The purpose of this study was to evaluate how bladder care at night correlates to patients' mobility status. DESIGN This was an observational study. SUBJECTS AND SETTING The sample comprises 63 aged care subacute patients who were observed over 3 consecutive nights in an inpatient subacute aged care ward located in Melbourne, Australia. Half of the participants were female; their mean age was 82.0 (standard deviation 8.2) years. Data were collected from December 2020 to March 2021. METHODS Outcome variables included demographic and pertinent clinical characteristics, type and timing of toileting and/or bladder care provided, and mobility classification. Descriptive statistics were used to summarize the frequency of nocturnal bladder care provided each night and as a mean over the 3 nights. The relationship between the type of care units provided and other variables was explored using a 1-way analysis of variance; values ≤.05 were deemed statistically significant. RESULTS Findings indicate that 27% (n = 17), 41% (n = 26), and 48% (n = 30) of participants required assistance to move in bed, sit up in bed, and stand from sitting, respectively. Care episodes for both incontinence and assistance with voiding were significantly associated with functional mobility in bed ( F = 5.52, P < .001; F = 2.14, P = .02) and with ambulation independence ( F = 3.52, P = .001; F = 2.04, P = .03) but not with age or ambulation distance. CONCLUSIONS Care provided for urinary incontinence during the night was related to the need for physical support of ambulation and poor mobility in bed. Targeted input from a multidisciplinary team is warranted to facilitate change of practice at night.
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Affiliation(s)
- Adelle Brown
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Laura Ferguson
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Jasper Castillo
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Huong Xuan Thi Nguyen
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Claire Ervin
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - David Michael Whishaw
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Wendy Bower
- Adelle Brown, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Laura Ferguson, BPT(Hons), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, Parkville, Australia
- Jasper Castillo, BSN, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Huong Xuan Thi Nguyen, FRACP, MBBS, BiomedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Memory Loss and Dementia Support Service, Merri Health, and Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, Australia
- Claire Ervin, RN, MNurs (Urology), GradDipNurse (Comm Health), Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- David Michael Whishaw, FRACP, MBBS, BMedSci, Department of Medicine and Aged Care, Royal Melbourne Hospital, Parkville, Australia
- Wendy Bower, FACP, PhD, Grad Dip Epid & Biostat, BAppSc (Physio), Physiotherapy Department, Department of Allied Health, Royal Melbourne Hospital, and Department of Medicine and Aged Care, Royal Melbourne Hospital, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, and Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
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7
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Chen M, He W, Cai S, Chen Z, Ye H, Jin Z, Lv X. Association of nocturia with cardiovascular and all-cause mortality: a prospective cohort study with up to 31 years of follow-up. Front Public Health 2023; 11:1292362. [PMID: 38186694 PMCID: PMC10768185 DOI: 10.3389/fpubh.2023.1292362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Background Nocturia is a highly prevalent and under-considered condition and impacts the quality of life for many individuals. The long-term impact of nocturnal voiding on mortality, especially mortality from cardiovascular disease, remains unknown. The current study aimed to evaluate the relationship of nocturnal voiding episodes with cardiovascular and all-cause mortality among adults in the United States. Methods This is a prospective cohort study of a nationally representative sample of 13,862 U.S. adults aged 20 years or older who participated in the National Health and Nutrition Examination Survey III (1988-1994). Nighttime urination frequency was reported during an in-house interview. All-cause and cause-specific mortality were ascertained by linking to National Death Index mortality data through December 31, 2019. The associations of nocturia with cardiovascular and all-cause mortality were estimated using weighted Cox proportional hazards regression models. Results Throughout a median follow-up of 26.7 years, 5,029 deaths were reported, comprising 1,720 deaths from cardiovascular disease. In the fully adjusted model, participants who reported once, twice, and three or more times nocturnal voiding episodes have a higher risk of cardiovascular mortality (HR1, 1.22 [95% CI, 0.997-1.49], HR2, 1.47 [95% CI, 1.13-1.91], and HR ≥ 3, 1.96 [95% CI, 1.52-2.53]) as well as all-cause mortality (HR1, 1.12 [95% CI, 0.90-1.39], HR2, 1.54 [95% CI, 1.23-1.93], and HR ≥ 3, 2.48 [95% CI, 1.81-3.40]), compared to those without nocturia, and heart disease-specific mortality (HR1, 1.33 [95% CI, 1.08-1.64], HR2, 1.62 [95% CI, 1.25-2.10], and HR≥3, 2.07 [95% CI, 1.61-2.67]). Nevertheless, there was no significant relationship between the number of nocturia episode changes and stroke-specific mortality. Conclusion Nocturia was associated with a significantly augmented risk of overall and heart disease-specific mortality in a dosage-dependent manner. Early recognition and taking precautions may benefit individuals with nocturia by promoting quality of life and cardiac health.
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Affiliation(s)
- Min Chen
- Wuhan University of Science and Technology Medical College, Wuhan, China
| | - Wangan He
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Shaoqian Cai
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Zhi Chen
- Wuhan University of Science and Technology Medical College, Wuhan, China
| | - Huarong Ye
- China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Zhigang Jin
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Xuexiang Lv
- Department of Cardiology, China Resources and Wisco General Hospital, Wuhan University of Science and Technology, Wuhan, China
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8
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Jung JY, Oh CM, Kim E, Park SK. Dietary sodium intake and its relation to sleep duration, sleep quality and nocturnal urination in working-aged Korean adults. NUTR BULL 2023; 48:365-375. [PMID: 37458133 DOI: 10.1111/nbu.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/13/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Both sodium intake and sleep have an important effect on cardiovascular health. However, few studies have looked at the association between sodium intake and sleep. Therefore, we analysed the association of sodium intake with sleep quality, sleep duration and nocturnal urination. The data for the present study were obtained from the Kangbuk Samsung Health Study. Study participants were 156 696 working-aged Korean adults (average age 38.0 years ±8.0 in men and 36.0 years ±8.1 in women). They were categorised into five groups by quintile of sodium intake, measured by food frequency questionnaire. Poor sleep quality and short sleep duration were determined by Pittsburgh Sleep Quality Index >5, and sleep duration <7 h, respectively. Nocturnal urination was defined as awakening to urinate more than three times a week. Multivariable adjusted logistic regression analysis was used in calculating the odds ratio (OR) and 95% confidence interval (CI) for poor sleep quality, short sleep duration and nocturnal urination (adjusted OR [95% CI]) across five study groups. In all study participants, increased sodium intake was significantly associated with poor sleep quality (quintile 1: reference, quintile 2: 1.07 [1.04-1.11], quintile 3: 1.12 [1.08-1.16], quintile 4: 1.15 [1.11-1.19] and quintile 5: 1.13 [1.09-1.18]). This pattern of relationship was similarly observed in association of sodium intake with short sleep duration (p for trend <0.001) and nocturnal urination (p for trend <0.001). In gender subgroup analysis, increased sodium intake had a significant association with poor sleep quality and short sleep duration in men and with poor sleep quality and nocturnal urination in women. In conclusion, high sodium intake is associated with an increased likelihood of poor sleep quality, short sleep duration and nocturnal urination.
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Affiliation(s)
- Ju Young Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Eugene Kim
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Keun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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9
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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: 1] [Impact Index Per Article: 1.0] [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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10
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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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11
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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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12
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Verbakel I, Maenhout T, Petrovic M, Weiss J, Van Laecke E, Delanghe J, Everaert K. Laying the foundation for enhancing safety of desmopressin in older people: Validation of capillary blood sodium levels. Neurourol Urodyn 2023; 42:303-308. [PMID: 36321798 DOI: 10.1002/nau.25084] [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: 06/10/2022] [Revised: 09/22/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE We aim to make desmopressin a safe treatment option for (older) patients at risk for hyponatremia, by introducing a new way of sodium monitoring. The goal is to reduce the risk of hyponatremia, enhance patient safety and ultimately introduce self-monitoring of sodium levels. The first step in the aforementioned is to validate capillary sodium. MATERIALS AND METHODS 100 randomly selected patients admitted to the urology department received a single finger prick to collect capillary blood (250 µl) in a lithium-heparin tube. Each patient acted as its own control for the capillary and venous blood sample. Venous and capillary plasma sodium were analyzed by indirect ion-selective electrode measurement. The primary outcome was the agreement between capillary and venous sodium measurements, measured by the intra-class correlation coefficient (ICC). RESULTS One hundred paired blood samples were obtained of which four were excluded. There was no significant statistical difference observed between venous and capillary sodium (-0.23 mmol/L, p = 0.374). The ICC for single measures between capillary and venous sodium was 0.82 (95% confidence interval 0.75-0.88). Inter-method differences analyzed by a Bland-Altman plot and a Passing-Bablock regression did not reveal a statistically significant difference between both groups. CONCLUSIONS We demonstrated that venous and capillary sodium levels are interchangeable, taken into account the inter- and intravariability between analyses. We provided the first step towards a simple and safe solution for frequent sodium monitoring through a minimal invasive capillary blood collection. The results are of direct clinical relevance to safely use desmopressin in (older) patients at risk.
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Affiliation(s)
- Irina Verbakel
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | | | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | - Jeffrey Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Erik Van Laecke
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Clinical Laboratory, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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13
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Kovacic J, Dhar A, Shepherd A, Chung A. A rude awakening: management of nocturia in men. TRENDS IN UROLOGY & MEN'S HEALTH 2022. [DOI: 10.1002/tre.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- James Kovacic
- Royal North Shore Hospital Sydney Australia
- North Shore Urology Research Group Sydney Australia
| | - Ankur Dhar
- Royal North Shore Hospital Sydney Australia
- North Shore Urology Research Group Sydney Australia
| | - Andrew Shepherd
- Royal North Shore Hospital Sydney Australia
- Adelaide Medical School University of Adelaide Australia
| | - Amanda Chung
- Royal North Shore Hospital Sydney Australia
- North Shore Urology Research Group Sydney Australia
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14
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Yuen JWM, Wong IYP, Chiu PKF, Teoh JYC, Chan CK, Yee CH, Ng CF. Predictive Values of Nocturia and Its Voiding Frequency on the Aging Males' Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11632. [PMID: 36141927 PMCID: PMC9517266 DOI: 10.3390/ijerph191811632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The link between nocturia and aging male symptoms (AMS) has not been scientifically established. This study aimed to measure the degree of severity of AMS that impacts health-related quality of life (HRQoL) in adult males living with nocturia and to determine the predictive values of nocturnal factors on AMS. METHODS This is an extended analysis of new data collected by using the Hong Kong Traditional AMS (HK-AMS) scale and the Cantonese version of the Pittsburgh Sleep Quality Index (PSQI) in a recently published cross-sectional population-based survey. RESULTS Of the 781 respondents that completed the set of questionnaires, 68% and 61% of men living with nocturia reported clinically significant (at moderate-to-severe levels) somato-vegetative and sexual AMS; the prevalence and severity were increased with advancing nighttime voiding frequency. Age, the Global PSQI score, certain metabolic diseases, the nocturia-specific QoL (NQoL) score and bedtime voiding frequency were found to be significant predictive factors for composite somato-vegetative and sexual AMS. CONCLUSIONS The current findings suggested the inclusion of nocturia when measuring male-specific HRQoL related to aging.
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Affiliation(s)
- John Wai-Man Yuen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Ivy Yuen-Ping Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Peter Ka-Fung Chiu
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Kwok Chan
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Hang Yee
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Fai Ng
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
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15
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Chen SH, Chin WC, Huang YS, Chuech LS, Lin CM, Lee CP, Lin HL, Tang I, Yeh TC. The effect of electromagnetic field on sleep of patients with nocturia. Medicine (Baltimore) 2022; 101:e29129. [PMID: 35960119 PMCID: PMC9371528 DOI: 10.1097/md.0000000000029129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Accumulated studies revealed that electromagnetic field can affect human brain and sleep. We explored the effectiveness of electromagnetic field [Schumann resonance (SR)] on nocturia symptoms, quality of life, and sleep in patients with nocturia. METHODS This is a randomized, open-label, and active-controlled study, in which 35 participants were randomized into 2 groups. Group A received oxybutynin and the SR device for 12 weeks, while the active-control group received only the medication. We followed these patients every 4 weeks with a number of questionnaires, including the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS) for sleep, the American Urological Association Symptom Score (AUASS) for nocturia symptoms, and the Nocturia-Quality-of-Life-questionnaire (N-QOL) for quality of life. Descriptive statistics, pair t-tests, Chi-squared tests, and repeated measures were applied for data analysis. RESULTS No significant difference was found in the demographic data between the 2 groups. The AUASS, N-QOL, PSQI, and ESS total scores were significantly improved in the SR-sleep-device group (P < .001, P = .005, P < .001, P = .001) after treatment, but no significant change was found in the active-control group. Several variables of AUASS in the SR-sleep-device group were significantly improved, especially streaming and sleeping (both P = .001), and subjective sleep quality and sleep efficiency also demonstrated significant improvement (both P < .001). CONCLUSIONS Our study revealed that electromagnetic field (SR) as an add-on can improve not only sleep and quality of life but also nocturia symptoms in patients with nocturia. These findings suggest that SR can be effective for sleep disturbance secondary to physical disease, which can be a new application of the electromagnetic field.
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Affiliation(s)
- Shin-Hong Chen
- Division of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Wei-Chih Chin
- Division of Pediatric Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Shu Huang
- Division of Pediatric Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Yu-Shu Huang, MD, PhD, Department of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, 5 Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan (e-mail: )
| | | | - Chang-Min Lin
- Division of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Chin-Pang Lee
- Division of Pediatric Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Huang-Li Lin
- Division of Pediatric Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I Tang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Chun Yeh
- Division of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
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16
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Ikeda Y, Morita E, Muroi K, Arai Y, Ikeda T, Takahashi T, Shiraki N, Doki S, Hori D, Oi Y, Sasahara S, Ishihara A, Matsumoto S, Yanagisawa M, Satoh M, Matsuzaki I. Relationships between sleep efficiency and lifestyle evaluated by objective sleep assessment: SLeep Epidemiology Project at University of Tsukuba. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:554-569. [PMID: 36237889 PMCID: PMC9529619 DOI: 10.18999/nagjms.84.3.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022]
Abstract
Objectively measured sleep efficiency has recently been shown to be associated with health problems. Although several factors have previously been reported to be associated with sleep efficiency, most of these studies were conducted on older or younger adults, and the factors associated with sleep efficiency in healthy workers remain unknown. The aim of this study was to investigate the relationship between sleep efficiency and lifestyle factors using sleep measurement data recorded by an activity meter worn by workers. In total, 693 workers (male, 43.6%; mean age, 42.7 ± 11.3 years) were recruited from five offices in 2017. Sleep was measured over the period of 1 week by actigraphy. Workers' attributes, lifestyle habits, and occupational stress were identified using a questionnaire, and the association of sleep efficiency with lifestyle, occupational stress, and attributes was explored by logistic regression analysis. A logistic regression analysis using attributes and occupational stress as adjustment variables revealed that "longer sleeping hours on weekends than on weekdays" [odds ratios (OR), 0.66; 95% confidence interval (CI), 0.47-0.94], "water ingestion at bedtime" [OR, 2.09; 95% CI, 1.28-3.41], and "smartphone use at bedtime" [OR, 1.90; 95% CI, 1.28-2.83] were associated with decreased sleep efficiency. This study found that lifestyle habits were associated with sleep efficiency among workers. It is necessary to verify whether intervention in these lifestyle habits would contribute to the improvement of sleep efficiency in future studies.
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Affiliation(s)
- Yu Ikeda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Emi Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,Forestry and Forest Products Research Institute, Forest Research and Management Organization, Tsukuba, Japan
| | - Kei Muroi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yo Arai
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiko Ikeda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tsukasa Takahashi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nagisa Shiraki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Shotaro Doki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Daisuke Hori
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuichi Oi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shin‐ichiro Sasahara
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Asuka Ishihara
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,PhD Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Sumire Matsumoto
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,PhD Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Makoto Satoh
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Ichiyo Matsuzaki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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17
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Franceschi R, Scotton C, Leonardi L, Cauvin V, Maines E, Angriman M, Pertile R, Valent F, Soffiati M, Faraguna U. Impact of intermittently scanned continuous glucose monitoring with alarms on sleep and metabolic outcomes in children and adolescents with type 1 diabetes. Acta Diabetol 2022; 59:911-919. [PMID: 35397650 DOI: 10.1007/s00592-022-01882-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/13/2022] [Indexed: 11/01/2022]
Abstract
AIMS Data about sleep quality and quantity are not available in patients with type 1 diabetes (T1D) using intermittently scanned continuous glucose monitoring (isCGM). We questioned whether the isCGM with alarms could fragment sleep in patients and parents, compared to isCGM without alarms. METHODS A prospective, observational study including 47 child-adolescents with T1D who had experience with isCGM without alarms (Freestyle Libre 1-FSL1). They were asked to wear the isCGM with alarms (Freestyle Libre 2-FSL2) for 14 days. Patients enrolled and their caregiver (s), during a 14 day period with FSL1 and the following 14 days with FSL2, completed psychosocial and sleep-related questionnaires. Furthermore they wore an actigraph that was downloaded to a web platform and processed by the validated and certified algorithm "Dormi®." RESULTS By the switch to the alarmed FSL2 we found about a 5% increase in Time In Range (from 62.5 to 67.8%), a reduction in time spent in hypoglycemia, number of weekly hypoglycemic events, and coefficient of variation. We did not find significant differences in sleep parameters in patients and their parents; therefore, alarms did not worsen the duration and quality of sleep. A significant improvement in the Quality of Life was perceived by parents using FSL2. CONCLUSIONS Introduction of alarms in isCGM systems gives, in the short term, an improvement in metabolic control in terms of time in range and reduction in hypoglycemia, without worsening duration and quality of sleep, measured by actigraphy, in children-adolescent and their parents.
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Affiliation(s)
- Roberto Franceschi
- Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital, Largo Medaglie d'Oro, 9, 38122, Trento, Italy.
| | - Chiara Scotton
- Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital, Largo Medaglie d'Oro, 9, 38122, Trento, Italy
| | - Letizia Leonardi
- Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital, Largo Medaglie d'Oro, 9, 38122, Trento, Italy
| | - Vittoria Cauvin
- Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital, Largo Medaglie d'Oro, 9, 38122, Trento, Italy
| | - Evelina Maines
- Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital, Largo Medaglie d'Oro, 9, 38122, Trento, Italy
| | - Marco Angriman
- Health Management, General Hospital of Bolzano, Bolzano, Italy
| | - Riccardo Pertile
- Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trento, Italy
| | - Francesca Valent
- Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trento, Italy
| | - Massimo Soffiati
- Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital, Largo Medaglie d'Oro, 9, 38122, Trento, Italy
| | - Ugo Faraguna
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCSS Stella Maris Foundation, Pisa, Italy
- SleepActa Srl, A spinoff company of the University of Pisa, Pisa, Italy
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18
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Chin X, Teo SW, Lim ST, Ng YH, Han HC, Yap F. Desmopressin therapy in children and adults: pharmacological considerations and clinical implications. Eur J Clin Pharmacol 2022; 78:907-917. [PMID: 35199198 DOI: 10.1007/s00228-022-03297-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This review aims to provide prescribing clinicians a deeper appreciation of desmopressin's clinical indications and formulation types, to better balance efficacy and safety through proper formulation selection. BACKGROUND Since its discovery 50 years ago, desmopressin's antidiuretic properties have been used for central diabetes insipidus, primary monosymptomatic nocturnal enuresis and adult nocturnal polyuria, while its coagulant effects are useful for mild hemophilia A and von Willebrand Disease. During this time, newer formulations of desmopressin have also been introduced to the market raising questions on interchangeability, dose conversion and safety. The wide array of clinical indications and variable pharmacokinetic properties of different desmopressin preparations raises the possibility of medication error, especially the risk of hyponatraemia. METHODOLOGY A narrative review to explore clinically relevant aspects of desmopressin therapy, synthesising information obtained from searches of published literature. RESULTS We identified that the risk factors for developing hyponatremia include extremes of age, existing comorbidity, drug interaction, intranasal formulations and intercurrent illness. We describe the dose equivalence between all formulations to facilitate conversion. We highlight that in view of inter-subject variability, close monitoring is recommended when switching preparations. We found that paediatric data remains limited, leading to recent proposals for age- and weight-based dosing regimens. CONCLUSION The risk of hyponatremia, albeit small, can be reduced by adhering to the indication-specific doses and taking steps to govern the safe prescription of the drug. Further paediatric clinical trials are awaited to expand the evidence base of childhood desmopressin therapy.
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Affiliation(s)
- Xinyi Chin
- Department of Paediatrics, Endocrinology Service, KK Women's and Children's Hospital, Singapore, Singapore.
| | - Shao Wei Teo
- Pharmacy Department, KK Women's and Children's Hospital, Singapore, Singapore
| | - Soo Ting Lim
- Nursing Specialist Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yong Hong Ng
- Department of Paediatrics, Nephrology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - How Chuan Han
- Department of Urogynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Fabian Yap
- Department of Paediatrics, Endocrinology Service, KK Women's and Children's Hospital, Singapore, Singapore
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19
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Male Lower Urinary Tract Dysfunction: An Underrepresented Endpoint in Toxicology Research. TOXICS 2022; 10:toxics10020089. [PMID: 35202275 PMCID: PMC8880407 DOI: 10.3390/toxics10020089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 02/04/2023]
Abstract
Lower urinary tract dysfunction (LUTD) is nearly ubiquitous in men of advancing age and exerts substantial physical, mental, social, and financial costs to society. While a large body of research is focused on the molecular, genetic, and epigenetic underpinnings of the disease, little research has been dedicated to the influence of environmental chemicals on disease initiation, progression, or severity. Despite a few recent studies indicating a potential developmental origin of male LUTD linked to chemical exposures in the womb, it remains a grossly understudied endpoint in toxicology research. Therefore, we direct this review to toxicologists who are considering male LUTD as a new aspect of chemical toxicity studies. We focus on the LUTD disease process in men, as well as in the male mouse as a leading research model. To introduce the disease process, we describe the physiology of the male lower urinary tract and the cellular composition of lower urinary tract tissues. We discuss known and suspected mechanisms of male LUTD and examples of environmental chemicals acting through these mechanisms to contribute to LUTD. We also describe mouse models of LUTD and endpoints to diagnose, characterize, and quantify LUTD in men and mice.
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20
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Matsushima E, Otsuka Y, Itani O, Matsumoto Y, Kaneita Y. Association between nighttime urinary frequency and sleep problems among Japanese adolescents. Int J Urol 2021; 29:152-157. [PMID: 34786770 DOI: 10.1111/iju.14744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/14/2021] [Accepted: 10/24/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To conduct a cross-sectional study to investigate the relationship between nighttime urinary frequency and sleep problems in Japanese adolescents. METHODS A self-administered questionnaire survey was conducted among 1757 adolescents (mean age 15.6 ± 1.1 years; 49.0% boys). The survey assessed sleep problems (sleep duration, sleep quality, and insomnia symptoms), nighttime urinary frequency, eating habits (breakfast, late-night eating, energy drink consumption), problematic internet use, engagement in club activities, and mental health. We analyzed the association between nighttime urinary frequency and sleep problems using descriptive statistics and logistic regression models. RESULTS The response rate was 99.6% (1699 students). The prevalence of nighttime urinary frequency ≥2 was 5.6% in boys and 4.6% in girls. The prevalence rates of sleep problems were: insomnia, 16.4%; difficulty initiating sleep, 11.8%; difficulty maintaining sleep, 5.9%; early-morning awakening, 5.4%; and poor sleep quality, 19.9%. Analysis of the relationship with sleep problems differentiating between zero, one, and two nighttime urinations showed that an increase in nighttime urinary frequency corresponded to an increase in the prevalence of insomnia, difficulty initiating sleep, and difficulty maintaining sleep. Logistic regression analysis also showed that insomnia, difficulty initiating sleep, and difficulty maintaining sleep had a linear, significant relationship with increased nighttime urinary frequency. CONCLUSION This study suggests that adolescents with high nighttime urinary frequency experience increased sleep problems. Consideration of urinary frequency is required when tackling adolescent sleep problems.
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Affiliation(s)
- Eriko Matsushima
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuuki Matsumoto
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
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21
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Alshehri MM, Alenazi AM, Alothman SA, Rucker JL, Phadnis MA, Miles JM, Siengsukon CF, Kluding PM. Using Cognitive Behavioral Therapy for Insomnia in People with Type 2 Diabetes, Pilot RCT Part I: Sleep and Concomitant Symptom. Behav Sleep Med 2021; 19:652-671. [PMID: 33108932 DOI: 10.1080/15402002.2020.1831501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE/BACKGROUND The primary aim of this study was to examine the effect of Cognitive Behavioral Therapy for Insomnia (CBT-I) on the severity of insomnia in people with Type 2 diabetes (T2D) compared to a health education (HE) control group. The secondary aim was to explore the effect of CBT-I on other sleep outcomes and concomitant symptoms. PARTICIPANTS Twenty-eight participants with T2D were randomly assigned to CBT-I (n = 14) or HE (n = 14). METHODS Validated assessments were used at baseline and post intervention to assess sleep outcomes and concomitant symptoms. In addition, actigraph and sleep diaries were used to measure sleep parameters. Independent sample t tests and Mann-Whitney U tests were utilized to measure between-group differences in the mean change scores. RESULTS Participants in the CBT-I group showed higher improvements in the following mean change scores compared to the HE group: insomnia symptoms (d = 1.78; p < .001), sleep quality (d = 1.53; p =.001), sleep self-efficacy (d = 1.67; p < .001). Both actigraph and sleep diary showed improvements in sleep latency and sleep efficiency in the CBT-I group as compared to the HE group. In addition, participants in the CBT-I group showed greater improvement in the mean change scores of depression symptoms (d = 1.49; p = .002) and anxiety symptoms (d = 0.88; p = .04) compared to the HE group. CONCLUSION This study identified a clinically meaningful effect of CBT-I on sleep outcomes and concomitant symptoms in people with T2D and insomnia symptoms. Further work is needed to investigate the long-term effects of CBT-I in people with T2D and insomnia symptoms.
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Affiliation(s)
- Mohammed M Alshehri
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas.,Physical Therapy Department, Jazan University, Jazan, Saudi Arabia
| | - Aqeel M Alenazi
- Physical Therapy Department, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Shaima A Alothman
- Lifestyle and Health Research Center, Princess Nora Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jason L Rucker
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas
| | - Milind A Phadnis
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas
| | - John M Miles
- Endocrinology Department, University of Kansas Medical Center, Kansas City, Kansas
| | - Catherine F Siengsukon
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas
| | - Patricia M Kluding
- Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas
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22
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Mc Carthy CE. Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person. Med Sci (Basel) 2021; 9:medsci9020031. [PMID: 34063838 PMCID: PMC8162526 DOI: 10.3390/medsci9020031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson's disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.
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Affiliation(s)
- Christine E. Mc Carthy
- Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland;
- HRB-Clinical Research Facility, National University of Ireland, Galway, Co., Galway, Ireland
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23
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Chow PM, Chuang YC, Hsu KCP, Shen YC, Hsieh AWJ, Liu SP. Impacts of nocturia on quality of life, mental health, work limitation, and health care seeking in China, Taiwan and South Korea (LUTS Asia): Results from a cross-sectional, population-based study. J Formos Med Assoc 2021; 121:285-293. [PMID: 33958270 DOI: 10.1016/j.jfma.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/18/2021] [Accepted: 04/07/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While nocturia has been proposed to be related to various systemic diseases and even mortality, there has been little information of the impact of nocturia in other aspects of physical and mental well-being. We evaluated the impact of nocturia on quality of life (QoL), mental health, work limitation, and health-care seeking behavior. METHODS An internet-based self-administered survey was distributed among individuals aged ≥40 years with the ability to use a computer and to read the local language. Survey questions included demographic details, International Continence Society symptom definitions and the international prostate symptom score. Impact on nocturia on health-related QoL physical and mental health domain, Hospital Anxiety and Depression Scale (HADS) score and Work Limitations Questionnaire (WLQ) measures was evaluated. RESULTS There were 8284 participants (women, 51%) of whom 34% were aged ≥60 years. Prevalence of nocturia ≥2 was 35% in men and 37% in women. Across both genders, QoL decreased with increasing frequency of nocturia. Besides nocturia, hypertension, presence of neurological disorder, lower urinary tract symptom measures and female gender were also associated with HADS anxiety and depression scores of ≥8. Nocturia significantly impacted work ability across WLQ measures. Though the utilization of prescription medications increased with the increase in frequency of nocturia, it was also noted that up to 30% of participants who reported nocturia frequency of ≥3 did not seek any treatment for their complaints. CONCLUSION Nocturia significantly affects QoL, work productivity, and mental well-being. However, healthcare utilization remains low and warrants increased awareness and education in the patients, caregivers and physicians.
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Affiliation(s)
- Po-Ming Chow
- Department of Urology, National Taiwan University Hospital and College of Medicine, No. 7, Chung Shan South Road, Taipei, 10002, Taiwan
| | - Yao-Chi Chuang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | | | - Yuan-Chi Shen
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | | | - Shih-Ping Liu
- Department of Urology, National Taiwan University Hospital and College of Medicine, No. 7, Chung Shan South Road, Taipei, 10002, Taiwan.
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Williams V, Qin S, Romano CD, Lewis S, Williams N, Yarr S, Juul KV, Andersson FL. Psychometric evaluation of the Nocturia Sleep Quality Scale based on data from a prospective observational study. J Clin Sleep Med 2021; 17:691-701. [PMID: 33206043 PMCID: PMC8020686 DOI: 10.5664/jcsm.9010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The Nocturia Sleep Quality Scale (NSQS), a novel patient-reported outcomes measure, was developed to assess the impact of sleep disturbance from nocturia. The objective of this study was to assess the psychometric properties of the NSQS, including its structure, reliability, and validity. METHODS Data were collected in the context of a web-based, prospective, longitudinal, observational study. Participants with nocturia were randomized 1:1 to either a group that received sleep hygiene instructions, including instructions to limit liquids at nighttime and empty bladder prior to bedtime, or one that did not receive sleep instructions. All participants were asked to provide responses to the web-based questionnaires from day 1 to day 10. Psychometric analyses, aligned with current regulatory guidance, were conducted to evaluate the daily scores and 3-day average scores of NSQS items and potential composites. Item-level analyses were conducted first, followed by composite-level analyses. RESULTS The NSQS items and supporting measures demonstrated very slight improvement in patient-perceived sleep disturbance from nocturia over the course of the study. NSQS test-retest reliabilities were generally satisfactory. Correlations between NSQS items and related patient-reported measures tended to support the construct validity of the NSQS, and the known-groups analyses supplied evidence of its discriminating ability. NSQS responsiveness statistics were small. CONCLUSIONS The NSQS is a reliable and valid measure of the impact of nocturia on patients' sleep. The present analyses lay the psychometric groundwork for the use of the NSQS in future clinical trials to support product approval and labeling claims.
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Affiliation(s)
| | - Shanshan Qin
- RTI Health Solutions, Research Triangle Park, North Carolina
| | | | - Sandy Lewis
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Nicole Williams
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Stuart Yarr
- RTI Health Solutions, Research Triangle Park, North Carolina
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25
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Tanner L, Thomson K, Drake MJ, Ervin CF, Bower WF, Pearson F. Behavioural interventions for nocturia in adults. Hippokratia 2020. [DOI: 10.1002/14651858.cd013746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Louise Tanner
- Evidence Synthesis Group, Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Katie Thomson
- Evidence Synthesis Group, Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Marcus J Drake
- School of Clinical Sciences; University of Bristol; Bristol UK
| | - Claire F Ervin
- Department of Medicine and Aged Care; The Royal Melbourne Hospital; Parkville Australia
| | - Wendy F Bower
- Department of Medicine and Aged Care; The Royal Melbourne Hospital; Parkville Australia
| | - Fiona Pearson
- Evidence Synthesis Group, Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
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26
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Juul KV, Andersson FL, Yamaguchi O. Achieving clinically meaningful quality of life benefits in nocturia takes time: Results from a long-term, multicenter phase 3 study of desmopressin in Japanese patients. Low Urin Tract Symptoms 2020; 13:129-138. [PMID: 32914581 DOI: 10.1111/luts.12347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/11/2020] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the long-term efficacy, quality of life (QoL), and safety of desmopressin orally disintegrating tablets (ODTs) in Japanese patients with nocturia. METHODS A long-term, multicenter phase 3 study was conducted that enrolled Japanese male and female patients with nocturia (NCT03051009). Male patients received desmopressin 25- or 50-μg ODTs, and female patients received desmopressin 25-μg ODTs for up to 1 year. The primary endpoint was safety. Secondary endpoints included change from baseline in number of nocturnal voids, time to first awakening to void, and QoL assessments (nocturia-specific zQoL [N-QoL], Insomnia Severity Index [ISI], and Hsu bother score). RESULTS Overall, 503 patients were enrolled. Reductions from baseline in mean number of nocturnal voids were observed in all treatment groups from week 1 (-0.62 to -1.00), with improvements continuing through week 52 (-1.39 to -1.71). Changes from baseline above or approximating a clinically meaningful improvement were seen by week 52 in the disease-specific N-QoL total score (improved by 11.5-22.6), ISI (improved by -3.9 to -7.1), and Hsu bother scores (improved by -1.5 to -2.0). Adverse events (AEs) were reported in 54.9% of desmopressin-treated patients. Most AEs were mild or moderate in severity. CONCLUSIONS Desmopressin ODTs (25 and 50 μg) demonstrated long-term efficacy, improved QoL, and were well tolerated in Japanese male and female patients with nocturia treated for up to 1 year. Clinically meaningful improvements in patients' QoL, assessed by N-QoL, sleep quality, and bother, occur later than objective symptom improvements, such as voids.
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Affiliation(s)
- Kristian V Juul
- Ferring International Pharmascience Center, Copenhagen, Denmark
| | | | - Osamu Yamaguchi
- Division of Lower Urinary Tract Symptom Research, Nihon University School of Engineering, Koriyama, Japan
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Weiss JP, van der Meulen EA, Juul KV. Low-dose Desmopressin Orally Disintegrating Tablet: Suggested Clinically Meaningful Benefit in Patients with Nocturia Due to Nocturnal Polyuria. Eur Urol Focus 2020; 6:1006-1012. [DOI: 10.1016/j.euf.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/24/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022]
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28
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Chapple C, Bliwise D, Maislisch L, Roitmann E, Burtea T. Night-time voids, level of bother and sleep characteristics in a non-patient population of wearable devices users. Int J Clin Pract 2020; 74:e13495. [PMID: 32100396 PMCID: PMC7317406 DOI: 10.1111/ijcp.13495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/24/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Nocturia is a highly prevalent and bothersome medical condition characterised mainly by the need to wake up to pass urine during the main sleep period. Using data from wearable devices, it is possible to examine the sleep of large cohorts in natural settings. This study seeks to use data from connected smartwatches combined with a one-time survey to explore the presence of nocturia and associated level of bother and sleep characteristics in a non-patient cohort of wearable device users representing a broad age range. METHODS The data used come from a retrospective dataset containing sleep data from Withings watches of 250 000 users and a prospective dataset containing answers to a 10-item questionnaire completed by a subset of users in the retrospective dataset. RESULTS The prospective dataset contained 6230 users. Overall, 6.0%, 15.3% and 38.9% of users in the age groups 18-44 years, 45-64 years and 65-90 years, respectively, reported 2 or more nocturnal voids as their customary voiding pattern, corresponding to levels of nocturia consistent with previous literature. The level of bother associated with nocturia was higher among younger users with 27.8% of users aged 18-44 years reporting that their daytime activity was highly affected versus just 14.1% among those aged 65-90 years. A higher number of reported voids per night was associated with watch-derived measures of a lower sleep efficiency, a longer awake duration at night and a shorter first uninterrupted sleep period. CONCLUSION This study suggests not only that nocturia is present among the younger population but also that the younger are more bothered by this medical condition. Using data from wearables it was possible to establish that there is an association between the number of nocturnal voids and sleep characteristics.
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Affiliation(s)
| | - Donald Bliwise
- Sleep CenterEmory University School of MedicineAtlantaGAUSA
| | | | | | - Teodor Burtea
- Ferring International Center S.A.Saint‐PrexSwitzerland
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29
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Nocturia in Women With Type 2 Diabetes Mellitus: A Cross-sectional, Correlation Study. J Wound Ostomy Continence Nurs 2020; 47:265-272. [PMID: 32195774 DOI: 10.1097/won.0000000000000635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE The first aim of this study was to compare nighttime voiding frequency (nocturia), serum hemoglobin A1c level, peripheral neuropathy score, and global sleep quality score in younger (>40 to <65 years) versus older (≥65 years) women with type 2 diabetes mellitus (DM). Additional aims were to identify factors associated with clinically relevant nocturia (≥2 episodes/night) and to analyze relationships between nocturia frequency, glycemic control, peripheral neuropathy, and sleep quality in these women. DESIGN Cross-sectional study. SETTING AND SUBJECTS Participants were 118 women older than 40 years and with type 2 DM. Their mean age was 65.25 (SD = 9.66) years; the mean duration since diagnosis of type 2 DM was 10.96 (SD = 7.66) years. The study setting was 2 metabolism and endocrinology outpatient departments located in Taipei City and Taoyuan, Taiwan. METHODS Data were collected using a questionnaire that queried sociodemographic information, lower urinary tract symptoms, and sleep quality. We also assessed peripheral neuropathy and lower extremity edema and obtained pertinent information from participants' medical records. Independent t tests, multivariate logistic regression analyses, Spearman's rank correlation coefficients, and one-way analysis of variance were used to address the 3 study aims. RESULTS Analyses found that older women (aged ≥65 years) had a significantly higher nighttime voiding frequency, a higher peripheral neuropathy score, and a higher sleep quality score than younger (>40 to <65 years) women. Multivariate logistic regression analyses identified 4 factors associated with clinically relevant nocturia advanced age, elevated hemoglobin A1c level, suspected peripheral neuropathy, and lower extremity edema. Significant correlation coefficients were found between nighttime voiding frequency and serum hemoglobin A1c levels, peripheral neuropathy scores, and sleep quality scores. Analyses also found that women with a greater nocturia frequency had higher hemoglobin A1c levels, peripheral neuropathy scores, and sleep quality scores. CONCLUSIONS Healthcare professionals should screen for nocturia in women with type 2 DM and provide appropriate management for those experiencing nocturia.
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Suman S, Robinson D, Bhal N, Fraser S, MacCormick A, Williams A, Tadtayev S. Management of nocturia: overcoming the challenges of nocturnal polyuria. Br J Hosp Med (Lond) 2020; 80:517-524. [PMID: 31498658 DOI: 10.12968/hmed.2019.80.9.517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nocturia may be a multifactorial condition and should be regarded as a syndrome rather than a diagnosis, with many factors contributing to the clinical presentation. The effects of sleep deprivation can have a severely detrimental impact on the quality of life and productivity of the working age population, with considerable economic implications. Patients are unlikely to seek an appointment with their GP complaining of nocturia - they are more likely to complain of the effects of the condition, such as chronic tiredness, or injuries resulting from falls. The main criterion in deciding whether a patient should undergo further investigations into suspected nocturia is the degree to which the patient finds the condition bothersome. In some patients, lifestyle modifications may be an effective way to manage nocturia before medication is considered. As the only licensed product for all adults including those over 65 years of age, low dose desmopressin (Noqdirna® (as lyophilisate) Ferring Pharmaceuticals Ltd) is highly effective in the management of idiopathic nocturnal polyuria, producing improvements in clinical symptoms, sleep parameters and quality of life. Care should be administered as a joint enterprise between the patient's GP and colleagues in secondary care. This article outlines the findings of a roundtable discussion into the optimal management of patients with nocturnal polyuria.
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Affiliation(s)
- Sanjay Suman
- Clinical Co-Director, Therapies and Older Persons Programme, Medway NHS Foundation Trust, Gillingham, Kent
| | - Dudley Robinson
- Consultant Urogynaecologist and Honorary Senior Lecturer, Department of Urogynaecology, King's College Hospital, London
| | - Nadia Bhal
- Consultant Gynaecologist, Royal Glamorgan Hospital, Llantrisant
| | - Susannah Fraser
- Communication and Media Manager, Patient Advisory Group, Bladder Health UK, Birmingham
| | - Angus MacCormick
- Urology Nurse Specialist, Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Taunton
| | | | - Sergey Tadtayev
- Consultant Urological Surgeon, Ashford & St Peter's Hospitals NHS Foundation Trust, Surrey
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Lee DS, Kim SW, Sohn DW. Association between Nocturnal Frequency and Erectile Function in Eugonadal Men with Benign Prostatic Obstruction: A Cross Sectional Study. World J Mens Health 2020; 39:338-345. [PMID: 32202080 PMCID: PMC7994652 DOI: 10.5534/wjmh.190146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/29/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose We aimed to evaluate the association between nocturnal frequency and erectile dysfunction in patients with benign prostatic obstruction. Materials and Methods To evaluate the association, we simultaneous evaluated urodynamic study, prostate ultrasound, nocturnal tumescence test (nocturnal penile tumescence) for sleep-related erection (SRE) and two questionnaires, international prostate symptom score (IPSS) and 5-item version of the international index of erectile function (IIEF-5). Patients with hypogonadism or nocturnal polyuria were excluded. Results Forty-six patients were registered over 4 years. The mean age, prostate size, IPSS score, and IIEF-5 score were 67.65±5.51 years, 65.10±22.12 mL, 24.67±7.89, and 9.50±7.01, respectively. Among the IPSS subscores, nocturia was most significantly related to the total IIEF-5 score (p<0.001). More severe nocturia was associated with less frequent SRE (p=0.003) and shorter total duration of SRE (p=0.002), which in turn elucidated that nocturia was significantly related to the total amount of rigidity signals (rigidity activity unit, RAU) or tumescence signals (tumescence activity unit, TAU). Among objective urodynamic parameters, bladder compliance also correlated to RAU and TAU. Individual subjective erectile function (IIEF-5) was significantly related to both RAU and TAU. Conclusions Sleep fragmentation due to benign prostate obstruction related nocturnal frequency caused by reduced bladder compliance could decrease the frequency and duration of SRE, which decreases the total amount of SRE and reflects the patient's relevant erectile function.
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Affiliation(s)
- Dong Sup Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Wan Sohn
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
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Choi EPH, Wan EYF, Kwok JYY, Chin WY, Lam CLK. The mediating role of sleep quality in the association between nocturia and health-related quality of life. Health Qual Life Outcomes 2019; 17:181. [PMID: 31829192 PMCID: PMC6907224 DOI: 10.1186/s12955-019-1251-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Even though the negative impacts of nocturia on sleep quality and health-related quality of life (HRQOL) have been documented in previous research, their interrelationship has been poorly studied. This study aimed to explore whether nocturia would affect sleep quality, which in turn affects HRQOL. METHODS Participants aged 40 and above were randomly recruited from a Hong Kong public primary care clinic. Participants were asked to report the average number of nocturia (waking up at night to void) pisodes per night over a 1-month period. The Pittsburgh Sleep Quality Index (PSQI) and the 12-Item Short Form Health Survey version 2 (SF-12 v2) were administered. The mediation analysis was tested using multistage regression approach and bootstrap method. RESULTS Of the 500 subjects who completed the survey, 31.2% reported symptomatic nocturia (having ≥2 nocturia episodes per night), and 60.4% experienced poor sleep quality (a PSQI global score > 5). Respondents with symptomatic nocturia had a poorer HRQOL in the domains of physical functioning (PF), role physical (RP) and social functioning (SF), general health (GH), vitality (VT) and physical component summary (PCS) of the SF-12 v2 than those without. Compared with the respondents without poor sleep quality, those with poor sleep quality had poorer HRQOL across all domains and summaries of the SF-12 v2. Mediation analysis found that sleep quality fully mediated the association between nocturia and the PF, RP and SF domains of the SF-12 v2, respectively, and partially mediated the association between nocturia and the GH, VT and PCS domains of the SF-12 v2, respectively. CONCLUSIONS We found that sleep quality mediated the association between nocturia and HRQOL. To enhance the HRQOL of patients with nocturia, clinicians should not only focus on nocturia symptoms, but also on their sleep quality.
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Affiliation(s)
- Edmond Pui Hang Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong
- Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong
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Bliwise DL, Wagg A, Sand PK. Nocturia: A Highly Prevalent Disorder With Multifaceted Consequences. Urology 2019; 133S:3-13. [PMID: 31310770 DOI: 10.1016/j.urology.2019.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/31/2019] [Accepted: 07/05/2019] [Indexed: 12/26/2022]
Abstract
Nocturia is a bothersome, multifactorial condition with many underlying causes and contributing factors. Nocturnal polyuria (NP; overproduction of urine at night) is a frequent component. The prevalence of nocturia increases with age; specific estimates of prevalence are influenced by frequency thresholds used to define it. There is a tendency toward higher prevalence in young women than young men, which is reversed in later life. The association between frequency of nocturnal voiding and sleep disruption is well-documented. Nocturia correlates strongly with shorter sleep during the first part (2-4 hours) of the night, during which the first nocturnal void often occurs. A short time to first void after sleep onset (often referred to as "first uninterrupted sleep period") is associated with increased daytime dysfunction and decreased sleep quality and/or sleep efficiency. Adverse health consequences related to nocturia include poor sleep, depression, reduced quality of life, and increased risk of morbidity, mortality, falls, and fractures; studies have been able to establish a causal role for nocturia in only some of these. The potential impact of nocturia on health increases with age. By age 80, 80% of people will rise at least once per night to void. Despite its associated bother, nocturia is often accepted as a natural consequence of aging and many people do not seek help. Women, in particular, may be reluctant to report nocturia. This article reviews the prevalence of nocturia, possible impact on sleep, mortality and morbidity, and falls, and its importance in the elderly/frail population and women.
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Affiliation(s)
| | - Adrian Wagg
- University of Alberta, Edmonton, Alberta, Canada
| | - Peter K Sand
- NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Chicago, IL
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Development of the Nocturia Sleep Quality Scale: a patient-reported outcome measure of sleep impact related to nocturia. Sleep Med 2019; 59:101-106. [PMID: 31072693 DOI: 10.1016/j.sleep.2019.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/27/2019] [Accepted: 02/08/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND/OBJECTIVE Nocturia's impact on sleep causes significant burden for patients. This study aimed to develop a novel patient-reported outcome (PRO) measure, the Nocturia Sleep Quality Scale (NSQS), for the assessment of the impact of nocturia (defined as ≥2 nocturnal voids/night) on sleep. METHODS Sleep-related concepts were identified through a targeted literature review, after which in-depth concept elicitation interviews with patients with a clinical diagnosis of nocturia were conducted. Draft items were generated to address concepts identified as important, meaningful, and relevant. Items were further refined through three iterative sets of cognitive debriefing interviews to optimize instructions, question wording, and response options. Two sleep research experts also provided input. RESULTS The literature review and data from 18 concept elicitation interviews provided the basis for a comprehensive set of concepts. Constant comparative analysis was used to identify themes and support item development. The draft questionnaire consisted of 14 items with item-specific response scales. Wording and scaling of the items was optimized based on feedback from the 22 cognitive debriefing interviews and expert input. The results confirmed the completeness and relevance of the NSQS, providing support for the content validity and ability of items to reflect patient perception of nocturia-related sleep impacts. CONCLUSIONS The 6-item NSQS assesses the impact of nocturia on sleep by evaluating nighttime awakenings, sleep quantity, and sleep quality. The NSQS is self-administered and is intended to assess change in nocturia's impact on sleep after treatment in a standardized manner. Psychometric evaluation is under way to describe key measurement properties.
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Singer J, O'Connell KA. Relationship of cue-induced urinary urges to nocturia in women ages 18 to 40 years. Neurourol Urodyn 2019; 38:1378-1383. [PMID: 30939224 DOI: 10.1002/nau.23996] [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: 12/11/2018] [Revised: 02/16/2019] [Accepted: 03/19/2019] [Indexed: 11/12/2022]
Abstract
AIMS Although physiological factors have a role in nocturia, research suggests that behavioral processes, especially classical conditioning may also play an important role in nocturia and other lower urinary tract symptoms. The study aimed to assess the relationship of stimulus-associated urges during the day to nocturia in a sample of women aged 18 to 40, after controlling for physiological symptoms (eg, overactive bladder [OAB]; daytime frequency). METHODS An online study was conducted using a panel of 356 female participants between the ages of 18 to 40. One-third of the participants self-reported an OAB diagnosis as determined by their physician. Almost 80% of participants reported having at least one nocturnal voiding per night. Participants completed the Urinary Cues Questionnaire, which assessed the frequency with which respondents experienced the urge to urinate in the presence of a variety of cues and the Overactive Bladder Screening Scale (OABSS), which assesses symptoms of OAB syndrome. RESULTS Controlling for OABSS scores and daytime urinary frequency, the Situational Cues Subscale had a significant relationship with nocturia such that with each unit increase in the subscale, the probability of nocturia increased by 12% to 14% depending on the definition of nocturia. DISCUSSION Behavioral techniques, such as habituation to decrease the association between awakening at night and feeling an urge to urinate, may be an appropriate intervention to mitigate nocturnal urination. Theoretically, this would translate to decreasing this disorder throughout the lifespan, if behavioral techniques could be effectively utilized in early adulthood.
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Affiliation(s)
- Jonathan Singer
- Department of Clinical Psychology, University of Nevada, Reno, Nevada
| | - Kathleen A O'Connell
- Department of Health and Behavior Studies, Teachers College Columbia University, New York City, New York
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Sleep assessment in aging adults with type 2 diabetes: agreement between actigraphy and sleep diaries. Sleep Med 2018; 46:88-94. [DOI: 10.1016/j.sleep.2018.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 02/07/2023]
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Fonseca RS, Escola J, Carvalho A, Loureiro A. Estilo de vida dos Universitários: Estudo comparativo entre Universidade portuguesa e brasileira. REVISTA DE ESTUDIOS E INVESTIGACIÓN EN PSICOLOGÍA Y EDUCACIÓN 2017. [DOI: 10.17979/reipe.2017.0.14.2316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Este estudo apresenta um quadro comparativo entre as semelhanças e diferenças a nível do estilo de vida dos universitários de uma instituição portuguesa e brasileira. Trata-se de um estudo comparativo, do tipo descritivo-correlacional, com recurso a um inquérito por questionário, que inclui uma escala validada, designada por estilo de vida fantástico. Participaram no estudo 1.240 alunos de duas universidades. A maioria dos estudantes (51,7%) se enquadrou na categoria geral de um estilo de vida Muito Bom. Em alguns itens da escala do estilo de vida, verificaram-se diferenças significativas entre as duas instituições de ensino superior.
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Trigg A, Andersson FL, Aldhouse NVJ, Bliwise DL, Kitchen H. Patients' Lived Experiences of Nocturia: A Qualitative Study of the Evening, the Night, and the Next Day. THE PATIENT 2017; 10:711-718. [PMID: 28425062 PMCID: PMC5681617 DOI: 10.1007/s40271-017-0241-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nocturia, waking to urinate two or more times during the night, is a chronic condition associated with significant patient burden due to sleep disruption. This study aimed to explore the lived experiences of patients with nocturia in terms of the disruption to their lives during the night and day. METHODS Adult patients in the US diagnosed with nocturia were recruited for face-to-face qualitative interviews. Thematic analysis of patients' narratives, taking a phenomenological interpretative approach, summarised their experiences throughout the night and day, including any apparent contrasts between patients. RESULTS Twenty patients (10 male, 10 female) aged between 39 and 80 years, averaging three night-time voids, were interviewed. Analysis revealed that nocturia has a substantial impact on sleep quality and quantity, with the frequency of night-time voids a key driver of this. In addition to night-time phenomena, patients faced various difficulties the next day, including day-time tiredness, lack of energy and concerns related to emotional wellbeing, social functioning and cognitive functioning. All of these limited patients' capacity to work, perform daily activities or fulfil role responsibilities. Patients' lifestyles influenced experience, where younger patients in employment more readily emphasised the day-time physical and psychosocial burdens. Patients employed coping behaviours in an attempt to lessen the severity of nocturia and its impact, which were both physician-led and self-taught. CONCLUSIONS While the symptom of nocturia only occurs during the night, the impact is longer lasting, affecting functioning and wellbeing throughout the following day. Patients' circumstances can affect the extent of their burden; recognising this can improve effective delivery of patient-centred care.
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Affiliation(s)
- Andrew Trigg
- Clinical Outcomes Assessment, DRG Abacus, Manchester, UK
| | - Fredrik L. Andersson
- Global Health Economics and Outcomes Research, Ferring Pharmaceuticals A/S, Copenhagen, Denmark
| | | | | | - Helen Kitchen
- Clinical Outcomes Assessment, DRG Abacus, Manchester, UK
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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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Gibson W, MacDiarmid S, Huang M, Siddiqui E, Stölzel M, Choudhury N, Drake MJ. Treating Overactive Bladder in Older Patients with a Combination of Mirabegron and Solifenacin: A Prespecified Analysis from the BESIDE Study. Eur Urol Focus 2017; 3:629-638. [PMID: 28916436 DOI: 10.1016/j.euf.2017.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/02/2017] [Accepted: 08/15/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND The BESIDE study demonstrated that combination therapy (mirabegron and solifenacin 5mg) improved overactive bladder symptoms versus solifenacin 5mg or 10mg, and was well tolerated. OBJECTIVE To ensure efficacy and safety is maintained in older patients (>65 yr), who usually experience greater symptom severity and comorbidities, a prespecified subanalysis stratified by age group was conducted. DESIGN, SETTING, AND PARTICIPANTS Patients remaining incontinent (≥1 episode during 3-d diary) following 4-wk single-blind daily solifenacin 5mg were randomized 1:1:1 to a daily double-blind combination (solifenacin 5mg and mirabegron 25mg, increased to 50mg at wk 4), solifenacin 5mg or 10mg for 12 wk. Four cohorts stratified by age (<65 yr, ≥65 yr and < 75 yr, ≥75 yr) were investigated. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Efficacy assessments: change from baseline to end of treatment in average daily incontinence (primary) and micturition frequency (key secondary), number of incontinence episodes during the 3-d diary (key secondary), and change from baseline in average daily urgency and urgency incontinence episodes. Safety included treatment-emergent adverse events and vital signs. RESULTS AND LIMITATIONS Full analysis set included 2110 patients: 30.9% aged ≥65 yr and 8.9% aged ≥75 yr. At the end of treatment, daily, and 3-d incontinence daily micturitions, urgency, and urgency incontinence, were improved in each treatment group and age group; the largest reductions were observed with combination in each age cohort. There were no notable differences in vital signs or the incidence of treatment-emergent adverse events between treatment and age groups, with the exception of dry mouth, which was highest with solifenacin 10mg. CONCLUSIONS Efficacy and safety in the overall population is maintained in older (≥65 yr) and elderly (≥75 yr) patients treated with a combination of solifenacin and mirabegron, or solifenacin monotherapy; irrespective of age, combination was associated with the greatest improvement in overactive bladder symptoms. PATIENT SUMMARY This study investigated the effectiveness and safety of a combination of two different treatments (mirabegron 50mg and solifenacin 5mg) or solifenacin (5mg or 10mg) alone in patients aged <65 yr or ≥65 yr, and <75 yr or ≥75 yr with overactive bladder. Symptoms of overactive bladder, such as the urgent need to visit the toilet, incontinence, and frequent urination, were improved with all treatments regardless of the patient's age, but combination treatment demonstrated the greatest benefit, and was well tolerated.
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Affiliation(s)
- William Gibson
- Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada.
| | | | | | | | | | | | - Marcus J Drake
- University of Bristol and Bristol Urological Institute, Bristol, UK
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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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Denys MA, Goessaert AS, Dejaeghere B, Decalf V, Hoebeke P, Everaert K. A different way to study frequency volume charts in patients with nocturia. Neurourol Urodyn 2017; 37:768-774. [DOI: 10.1002/nau.23344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/29/2017] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Brecht Dejaeghere
- Faculty of Medicine and Health Sciences; Ghent University; Ghent Belgium
| | - Veerle Decalf
- Department of Urology; Ghent University Hospital; Ghent Belgium
| | - Piet Hoebeke
- Department of Urology; Ghent University Hospital; Ghent Belgium
| | - Karel Everaert
- Department of Urology; Ghent University Hospital; Ghent Belgium
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Developing a successful treatment for co-morbid insomnia and sleep apnoea. Sleep Med Rev 2017; 33:28-38. [DOI: 10.1016/j.smrv.2016.04.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/21/2016] [Accepted: 04/21/2016] [Indexed: 11/23/2022]
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Chang CJ, Pei D, Wu CC, Palmer MH, Su CC, Kuo SF, Liao YM. Correlates of Nocturia and Relationships of Nocturia With Sleep Quality and Glycemic Control in Women With Type 2 Diabetes. J Nurs Scholarsh 2017; 49:400-410. [PMID: 28544465 DOI: 10.1111/jnu.12302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 12/01/2022]
Abstract
PURPOSES To explore correlates of nocturia, compare sleep quality and glycemic control for women with and without nocturia, and examine relationships of nocturia with sleep quality and glycemic control in women with diabetes. DESIGN This study was a cross-sectional, correlational study with data collected from 275 women with type 2 diabetes. METHODS Data were collected using a structured questionnaire. Multivariate logistic regression analyses were used to identify correlates. Chi-squared tests were used to identify candidate variables for the first logistic regression model. A one-way analysis of variance was used to compare sleep quality and glycemic control for women with and those without nocturia. Pearson correlations were used to examine the relationships of nocturia with sleep quality and glycemic control. FINDINGS Of the 275 participants, 124 (45.1%) had experienced nocturia (at least two voids per night). Waist circumference, parity, time since diagnosis of diabetes, sleep quality, and increased daytime urinary frequency were correlated with nocturia after adjusting for age. Compared to women without nocturia, women who had nocturia reported poorer sleep quality. A significant correlation was found between the number of nocturnal episodes and sleep quality. CONCLUSIONS Nocturia and poor sleep are common among women with diabetes. The multifactorial nature of nocturia supports the delivered management and treatments being targeted to underlying etiologies in order to optimize women's symptom management. Interventions aimed at modifiable correlates may include maintaining a normal body weight and regular physical exercise for maintaining a normal waist circumference, and decreasing caffeine consumption, implementing feasible modifications in sleeping environments and maintaining sleep hygiene to improve sleep quality. CLINICAL RELEVANCE Healthcare professionals should screen for nocturia and poor sleep and offer appropriate nonpharmacological lifestyle management, behavioral interventions, or pharmacotherapy for women with diabetes.
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Affiliation(s)
- Chun-Jen Chang
- Attending Physician and Head, Department of Endocrinology, Taipei Municipal Wanfang Hospital, Taipei City, Taiwan
| | - Dee Pei
- Professor and Chairman, College of Medicine, Fu Jen Catholic University, and Attending Physician, Department of Endocrinology, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Chien-Chih Wu
- Attending Physician and Urologist, Department of Urology, Taipei Medical University Hospital and Associate Professor, Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Mary H Palmer
- Helen W. & Thomas L. Umphlet Distinguished Professor in Aging, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ching-Chieh Su
- Attending Physician and Head, Department of Endocrinology, Cardinal Tien Hospital, Assistant Professor, College of Medicine, Fu Jen Catholic University, and PhD Candidate, Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Shu-Fen Kuo
- Assistant Professor, School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Yuan-Mei Liao
- Associate Professor, Institute of Clinical Nursing, School of Nursing, National Yang-Ming University and School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
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Circadian Rhythms in Water and Solute Handling in Adults with a Spinal Cord Injury. J Urol 2017; 197:445-451. [DOI: 10.1016/j.juro.2016.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 11/21/2022]
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Veauthier C, Hasselmann H, Gold SM, Paul F. The Berlin Treatment Algorithm: recommendations for tailored innovative therapeutic strategies for multiple sclerosis-related fatigue. EPMA J 2016; 7:25. [PMID: 27904656 PMCID: PMC5121967 DOI: 10.1186/s13167-016-0073-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 10/21/2016] [Indexed: 12/11/2022]
Abstract
More than 80% of multiple sclerosis (MS) patients suffer from fatigue. Despite this, there are few therapeutic options and evidence-based pharmacological treatments are lacking. The associated societal burden is substantial (MS fatigue is a major reason for part-time employment or early retirement), and at least one out of four MS patients view fatigue as the most burdensome symptom of their disease. The mechanisms underlying MS-related fatigue are poorly understood, and objective criteria for distinguishing and evaluating levels of fatigue and tiredness have not yet been developed. A further complication is that both symptoms may also be unspecific indicators of many other diseases (including depression, sleep disorders, anemia, renal failure, liver diseases, chronic obstructive pulmonary disease, drug side effects, recent MS relapses, infections, nocturia, cancer, thyroid hypofunction, lack of physical exercise). This paper reviews current treatment options of MS-related fatigue in order to establish an individualized therapeutic strategy that factors in existing comorbid disorders. To ensure that such a strategy can also be easily and widely implemented, a comprehensive approach is needed, which ideally takes into account all other possible causes and which is moreover cost efficient. Using a diagnostic interview, depressive disorders, sleep disorders and side effects of the medication should be identified and addressed. All MS patients suffering from fatigue should fill out the Modified Fatigue Impact Scale, Epworth Sleepiness Scale, the Beck Depression Inventory (or a similar depression scale), and the Pittsburgh Sleep Quality Index (or the Insomnia Severity Index). In some patients, polygraphic or polysomnographic investigations should be performed. The treatment of underlying sleep disorders, drug therapy with alfacalcidol or fampridine, exercise therapy, and cognitive behavioral therapy-based interventions may be effective against MS-related fatigue. The objectives of this article are to identify the reasons for fatigue in patients suffering from multiple sclerosis and to introduce individually tailored treatment approaches. Moreover, this paper focuses on current knowledge about MS-related fatigue in relation to brain atrophy and lesions, cognition, disease course, and other findings in an attempt to identify future research directions.
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Affiliation(s)
- Christian Veauthier
- Interdisciplinary Center for Sleep Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany ; NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Helge Hasselmann
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany ; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Stefan M Gold
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany ; Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology (ZMNH), University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany ; Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany ; Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
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Turner AD, Lim AS, Leurgans SE, Bennett DA, Buchman AS, Barnes LL. Self-Reported Sleep in Older African Americans and White Americans. Ethn Dis 2016; 26:521-528. [PMID: 27773979 PMCID: PMC5072481 DOI: 10.18865/ed.26.4.521] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Assess the relationship of self-reported sleep quality and possible sleep disorders with disability in a racially diverse sample of community-dwelling older adults. METHODS Participants included 943 non-demented older African Americans (n=452) and Whites (n=491) from two cohort studies, the Minority Aging Research Study (MARS) and the Rush Memory and Aging Project (MAP). Participants completed a 32-item questionnaire assessing sleep quality and the possible presence of three sleep disorders (sleep apnea, restless leg syndrome [RLS] and REM behavior disorder [RBD]). Disability was assessed with scales that quantified the ability to perform instrumental activities of daily living (IADL), basic activities of daily living (ADL), and physical mobility activities. RESULTS More than half of the participants reported impaired sleep quality (51%), or the possible presence of at least one sleep disorder (57%; sleep apnea 44%, RLS 25% and RBD 7%). Sleep quality was rated poorer in African Americans, those with advancing age and fewer years of education (all P<.05). Only sleep apnea risk was associated with age (P<.02). In logistic regression models adjusted for age, sex, years of education, and race, both sleep quality and disorders were associated with disability (sleep quality with mobility disability (P<.001), sleep apnea risk with mobility disability and IADL disability (all P<.001) and RLS symptoms with mobility disability (P<.01). CONCLUSIONS Results indicate that self-assessed impaired sleep is common in old age and is associated with disability.
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Affiliation(s)
- Arlener D Turner
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Andrew S Lim
- Sunnybrook Health Sciences Centre, University of Toronto
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; Behavioral Sciences, Rush University Medical Center, Chicago, IL
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Kiełbasa G, Stolarz-Skrzypek K, Pawlik A, Łątka M, Drożdż T, Olszewska M, Franczyk A, Czarnecka D. Assessment of sleep disorders among patients with hypertension and coexisting metabolic syndrome. Adv Med Sci 2016; 61:261-268. [PMID: 27124215 DOI: 10.1016/j.advms.2016.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/06/2016] [Accepted: 03/18/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE The coexistence of hypertension, abdominal obesity, and carbohydrate and lipid metabolism disturbances favors the acceleration of other disease entities - also apart from cardiovascular system disorders. This study was planned to estimate the relationship between the presence of metabolic syndrome and sleep disorders among a group of hypertensive patients. PATIENTS/METHODS The study was conducted on unselected group of 261 patients from the Outpatient Hypertension Clinic. The standardized questionnaire was used to collect the data on medical history, prescribed drugs and lifestyle. Sleep disorders were diagnosed based on the Athens Insomnia Scale and STOP-Bang Questionnaire. According to the study protocol, anthropometric parameters (weight, height, waist and neck circumferences), blood pressure, serum lipids and fasting glucose laboratory measurements were performed. Metabolic syndrome was defined according to IDF criteria. RESULTS Sleep disorders were recognized in 183 participants of the study - significantly more frequently (P=0.03) among patients with diagnosed metabolic syndrome (120; 75%) in comparison with participants without this disturbance (63; 62.38%). Male gender, poor financial situation, tingling sensations before falling asleep and combination therapy of hypertension significantly increased the risk of sleep disorder occurrence in the group of patients with metabolic syndrome. Night food intake, aging, hypertension combination therapy and poor socioeconomic status were the factors increasing the risk of sleep problems among participants without metabolic syndrome. CONCLUSIONS Sleep disorders often coexist with metabolic syndrome in hypertensive patients. A number of factors increase the probability of occurrence of sleep disorders, but most of them are modifiable.
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Ikeda A, Kawai K, Tsutsumi M, Yoshimura K, Ohno G, Hasegawa T, Ooe H, Watanabe K, Miyazaki J, Nishiyama H. Impact of Living at the Japanese Antarctic Research Expedition Base on Urinary Status. Low Urin Tract Symptoms 2016; 10:27-31. [PMID: 27438338 DOI: 10.1111/luts.12137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/04/2016] [Accepted: 03/22/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Urinary disorders are generally well understood, but there are few reports on the urinary status of people living in unusual climates such as the polar regions. We studied the impact of living conditions on the urinary status of members of the Japanese Antarctic Research Expedition. METHODS This prospective study enrolled 12 consenting members of the wintering party stationed at the Syowa Station in Antarctica between November 2012 and March 2014. The subjects completed questionnaires (the International Prostate Symptom Score [IPSS], Overactive Bladder Syndrome Score [OABSS] and Pittsburgh Sleep Quality Index [PSQI]) and kept daily voiding dairies for 3 days consecutively every 2 months. RESULTS Compared with baseline values, the mean scores on all the questionnaires decreased during the stay in Antarctica, from 3.42 to 2.31 for the IPSS, 1.25 to 0.986 for the OABSS, and 4.58 to 3.78 on the PSQI. A significant difference was noted in the scores of seven subjects with a 3 point or more decrease in IPSS score and five members with a decrease less than 3 points (-2.22 vs 0.448, P = 0.0416). CONCLUSION This is the first survey of the urinary status of people living in a polar environment. The findings obtained by questionnaires and voiding dairies indicated that urination and sleep status did not worsen during the stay in Antarctica.
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Affiliation(s)
- Atsushi Ikeda
- Department of Urology, Hitachi General Hospital, Ibaraki, Japan.,Department of Urology, University of Tsukuba, Ibaraki, Japan
| | - Koji Kawai
- Department of Urology, University of Tsukuba, Ibaraki, Japan
| | | | - Koji Yoshimura
- Department of Urology, Shizuoka General Hospital, Shizuoka, Japan
| | - Giichiro Ohno
- Department of Surgery, Tokatsu Hospital, Chiba, Japan
| | | | - Hirofumi Ooe
- The 54th Japanese Antarctic Research Expedition, Tokyo, Japan
| | | | - Jun Miyazaki
- Department of Urology, University of Tsukuba, Ibaraki, Japan
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Shao IH, Wu CC, Hsu HS, Chang SC, Wang HH, Chuang HC, Tam YY. The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study. Clin Interv Aging 2016; 11:879-85. [PMID: 27418814 PMCID: PMC4933563 DOI: 10.2147/cia.s104634] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nocturia has been proven to have a negative impact on the quality of life and sleep quality in general elderly population. However, there are limited studies on the quantitative effect of nocturia on sleep quality and daytime dysfunction, specifically in patients with lower urinary tract symptoms. Patients and methods During March 1, 2015 to December 31, 2015, a total of 728 patients who visited our urology department due to voiding dysfunction and experienced nocturia at least once per night were enrolled. Three questionnaires were administered to them after obtaining their written consents. Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS) questionnaire, and International Prostate Symptom Score (IPSS) questionnaire were applied to evaluate their sleep quality, daytime dysfunction, and voiding problems, respectively. Statistical analysis of the impact of nocturia on sleep quality and daytime dysfunction was performed. Results The mean age of patients was 61 years, with a male-to-female ratio of 2.7. The mean nocturia number was 3.03. The IPSS, PSQI, and ESS scores were 17.56, 8.35, and 8.22, respectively. The nocturia number increased with age and was significantly correlated to ESS score (daytime dysfunction) and PSQI total score (sleep quality) in overall group. Among subgroups divided by age and sex, there was a significant correlation between nocturia number and daytime dysfunction in male patients or patients younger than 65 years. Conclusion In patients with lower urinary tract symptoms, nocturia number increased with age and was significantly correlated with poor sleep quality. Nocturia plays an important role in patients younger than 65 years in daytime dysfunction.
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Affiliation(s)
- I-Hung Shao
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Chia-Chen Wu
- Department of Otorhinolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| | - Hueih-Shing Hsu
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Shyh-Chyi Chang
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Hsu-Hsiang Wang
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Heng-Chang Chuang
- Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County
| | - Yuan-Yun Tam
- Department of Otorhinolaryngology - Head and Neck Surgery, Lotung Poh-Ai Hospital, Yilan County, Taiwan, Republic of China
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