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Chen J, Liu Z, Yang L, Zhou J, Ma K, Peng Z, Dong Q. Sleep-related disorders and lower urinary tract symptoms in middle-aged and elderly males: a cross-sectional study based on NHANES 2005-2008. Sleep Breath 2024; 28:359-370. [PMID: 37775620 DOI: 10.1007/s11325-023-02927-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Lower urinary tract symptoms (LUTS) and sleep disorders both commonly affect people's quality of life. This study aimed to explore the associations between sleep-related disorders and LUTS through epidemiological investigations. METHODS Data were generated from the cross-sectional study called the National Health and Nutrition Examination Survey (NHANES) 2005-2008. Multivariable logistic regression models were conducted to investigate the relationships between sleep-related disorders and LUTS. RESULTS A total of 2516 men were included in the study. Participants sleeping ≤ 6 h/night had higher odds ratios of LUTS (OR: 1.38; 95% CI 1.08, 1.77), daytime LUTS (OR: 1.26; 95% CI 1.03, 1.54), and nocturia (OR: 1.23; 95% CI 1.02, 1.49) than those sleeping 7-8 h/night. Participants who required > 30 min to fall asleep had an approximately 39% higher odds ratios of nocturia than those who fell asleep within 6 to 30 min (OR: 1.39; 95% CI 1.12, 1.73). Sleep problems were positively related to LUTS (OR: 1.42; 95% CI 1.11, 1.82), daytime LUTS (OR: 1.32; 95% CI 1.08, 1.61), urinary hesitancy (OR: 1.75; 95% CI 1.31, 2.34), and nocturia (OR: 1.52; 95% CI 1.26, 1.84). Obstructive sleep apnea (OSA) symptoms were positively associated with urinary incontinence (OR: 1.52; 95% CI 1.12, 2.08). In addition, participants with daytime sleepiness were at higher prevalence of LUTS (OR: 1.66; 95% CI 1.29, 2.15), daytime LUTS (OR: 1.44; 95% CI 1.16, 1.78), urinary hesitancy (OR: 1.95; 95% CI 1.45, 2.63), and nocturia (OR: 1.66; 95% CI 1.35, 2.05). CONCLUSION The findings suggested that sleep-related disorders were associated with LUTS, daytime LUTS, urinary hesitancy, incomplete emptying, urinary incontinence, and nocturia in middle-aged and elderly males.
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Affiliation(s)
- Junhao Chen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- West China School of Medicine, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhenghuan Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- West China School of Medicine, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Luchen Yang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- West China School of Medicine, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jing Zhou
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- West China School of Medicine, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kai Ma
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- West China School of Medicine, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhufeng Peng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Qiang Dong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.
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Mittal A, Singh G, Ghorai RP, Panwar VK, Sharma GS, Gupta R. Sleep quality and obstructive sleep apnea among male patients with lower urinary tract symptoms: A prospective observational study. Indian J Urol 2024; 40:56-61. [PMID: 38314078 PMCID: PMC10836455 DOI: 10.4103/iju.iju_325_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Apart from nocturia, few reports have been published on the relationship between lower urinary tract symptoms (LUTS) and sleep disturbances in patients visiting urology outpatient clinics. This study assessed the association between our population's LUTS and sleep disturbances. Methods This was a prospective observational study. A total of 123 male patients with a history of LUTS aged more than 40 years were recruited from urology outpatient clinic. International Prostate Symptom Score was utilized to assess LUTS. To determine the quality of sleep, the Pittsburgh Sleep Quality Index (PSQI) was used. Berlin questionnaire (BQ) was used for screening obstructive sleep apnea. Results A total of 123 participants were enrolled in this study. The mean age of the participants was 61 ± 11.1 years. Nocturia >3 episodes were significantly more in patients with PSQI >5 (P < 0.05). There was a greater prevalence of severe LUTS in patients with PSQI >5 (P < 0.05). The association between LUTS and BQ score showed an increased prevalence of severe symptoms in patients with high BQ. Patients with PSQI >5 had more severe LUTS (53% of patients) compared to patients with PSQI ≤5 (5% of patients) (P = 0.000). Patients with PSQI >5 had overall poorer quality of life (QOL) scores, with QOL being 5 and 6 in 18% and 4.8% of the patients, respectively. Conclusions There is a significant association between the prevalence of nocturia, moderate-to-severe LUTS, and the existence of sleep disorders. Therefore, screening for sleep disturbances may be performed on male patients who present with LUTS.
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Affiliation(s)
- Ankur Mittal
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | | | - Rudra Prasad Ghorai
- Department of Urology, All India Institute of Medical Sciences, Delhi, India
| | - Vikas Kumar Panwar
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Gaurav Saurabh Sharma
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Gupta
- Department of Psychiatry and Sleep Clinic, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Shigehara K, Konaka H, Sugimoto K, Nohara T, Izumi K, Kadono Y, Namiki M, Mizokami A. Sleep disturbance as a clinical sign for severe hypogonadism: efficacy of testosterone replacement therapy on sleep disturbance among hypogonadal men without obstructive sleep apnea. Aging Male 2018; 21:99-105. [PMID: 28920756 DOI: 10.1080/13685538.2017.1378320] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The present subanalysis of the EARTH study investigates the effects of one year testosterone replacement therapy (TRT) on sleep disturbance among hypogonadal men without obstructive sleep apnea. METHODS Sleep disturbance was defined as three or more points in question 4 of the aging males symptoms (AMS) questionnaire. All participants completed the AMS scale, International Prostatic Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) and Short Form 36 (SF-36) health survey at baseline and after 12 months. Sexual symptoms were also evaluated based on three AMS subscores (Q15, 16 and 17). RESULTS We identified 100 patients with sleep disturbance, of whom 48 (24 each in the TRT and control groups) were ultimately included for analysis. All SF-36 categories , AMS scale, IPSS and SHIM score subdomains were significantly worse in patients with sleep disturbance than in those without disturbance. Statistically significant differences in sleep disturbance, erectile symptoms, sexual desire and some domains of the SF-36 were observed between the TRT and control groups after 12 months. CONCLUSION Sleep disturbance may be one of the clinical signs for severe hypogonadism. Moreover, TRT improved sleep conditions, sexual function and quality of life among hypogonadal men with sleep disturbance.
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Affiliation(s)
- Kazuyoshi Shigehara
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Hiroyuki Konaka
- b Department of Urology , Kanazawa Red Cross Hospital , Kanazawa , Japan
| | | | - Takahiro Nohara
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Koji Izumi
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Yoshifumi Kadono
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Mikio Namiki
- d Department of Urology , Hasegawa Hospital , Toyama , Japan
| | - Atsushi Mizokami
- a Department of Integrative Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
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Shimizu N, Nozawa M, Sugimoto K, Yamamoto Y, Minami T, Hayashi T, Yoshimura K, Ishii T, Uemura H. Therapeutic efficacy and anti-inflammatory effect of ramelteon in patients with insomnia associated with lower urinary tract symptoms. Res Rep Urol 2013; 5:113-9. [PMID: 24400242 PMCID: PMC3826936 DOI: 10.2147/rru.s44502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES This study was conducted to examine the therapeutic efficacy and anti-inflammatory effect of ramelteon in elderly patients with insomnia associated with lower urinary tract symptoms (LUTS), who visited our urology department. METHODS The study included 115 patients (102 men, 13 women) who scored ≥4 on the Athens Insomnia Scale and who wished to receive treatment. The assessment scales for therapeutic efficacy included the International Prostate Symptom Score (IPSS) for LUTS and the Insomnia Severity Index (ISI) for sleep disorders. The high-sensitivity C-reactive protein (hs-CRP) test was used to an objective assessment. The patients were treated with ramelteon (8 mg/day) for an average of 10 weeks and were then reexamined using the questionnaires and hs-CRP test to evaluate therapeutic efficacy. RESULTS IPSS total scores declined significantly from 11.39 ± 8.78 to 9.4 ± 7.72. ISI total scores improved significantly from 11.6 ± 5.2 to 9.2 ± 5.3 (P < 0.0001). The levels of hs-CRP decreased significantly from 0.082 (standard deviation [SD] upper limit, 0.222; SD lower limit, -0.059) to 0.06 (SD upper limit, 0.152; SD lower limit, -0.032). The ISI scores ≥ 10 (n = 51) showed a weak correlation with the hs-CRP levels. CONCLUSION Ramelteon had a systemic anti-inflammatory effect and improved sleep disorders and LUTS, suggesting that it may be a useful treatment for patients with LUTS-associated insomnia.
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Affiliation(s)
- Nobutaka Shimizu
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Masahiro Nozawa
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Koichi Sugimoto
- Department of Urology, Sakai Hospital, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Yutaka Yamamoto
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Takafumi Minami
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Taiji Hayashi
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Kazuhiro Yoshimura
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Tokumi Ishii
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - Hirotsugu Uemura
- Department of Urology, Faculty of Medicine, Kinki University, Osaka, Japan
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