AUA 2017: Does treating nocturia lead to better sleep? Results from REDUCE

Boston, MA (UroToday.com) Older men have been commonly presenting with nocturia, the frequency of having to urinate during the night, which has led to complaints of lack of sleep and not feeling well rested when waking up in the mornings. Nocturia is usually treated with anti-BPH medication in hopes of sleep improvement. This randomized controlled trial aimed to treat different lower urinary tract symptoms (LUTS) with dutasteride to see whether nocturia and/or sleep complaints were changed.

The REDUCE data was used for this study that compared 0.5mg/day of dustaride vs. placebo for chemoprevention of prostate cancer. Dustaride shrinks the prostate and helps urinary flow. This trial included 6,915 male patients at baseline, 2 years and 4 years, who completed the International Prostate Symptom Score (IPSS) survey and the MOS-Sleep questionnaire. Linear regression was used to test both IPSS, specifically focusing on nocturia results, and MOS-Sleep results using linear mixed models that were adjusted for DRE, BMI, PSA, age, smoking, race, prostate volume, geographical region, and diabetes. A sub analyses was conducted in symptomatic men who presented with IPSS ≥ 8 and those with ≥ 2 nocturne episodes at baseline.

In conclusion, dutasteride improved LUTS in men at 2-year and 4-years as well as improving nocturia. According to Freedland, improvement of nocturia is highly statistically significant, but not clinically significant. Overall, dutasteride did not have any improvement on sleep. Poor sleep was unlikely to be correlated with LUTS but instead can represent an underlying sleep problem such as sleep apnea or insomnia in those who presented with nocturia and complained of poor sleep. These results held true when only the symptomatic men were analyzed. According to the authors, these men who present with sleep problems should be referred to sleep experts to be evaluated.

Authors: Freedland SJ, Howard LE, Moreira DM, Pomona GM, Andriole G, Castro- Santamaria R, Hopp M, Roehrborn C

Affiliation: Cedars-Sinai Medical Center, Durham VA Health Care System, Duke University Medical Center, University of Illinois at Chicago, Washington University School of Medicine in St. Louis, GlaxoSmithKline, UT Southwestern

Presented by: Freedland SJ

Written By: Kheira Bettir for UroToday.com

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA
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