Publication #: MP04-15
Nocturia is Associated with an Increased Risk of Death: Results from REDUCE: Nocturia is a common complaint among aging men and is when a patient wakes up two or more times each night to urinate. While nocturia is known to be associated with an increased risk of falls, it is less clear if nocturia correlates with long-term overall health or a higher risk of death. Researchers from around the country conducted a study using data from the REDUCE, a four-year study to reduce the incidence of prostate cancer in men who are at increased risk. Cox proportional hazards models were used to test the association between nocturia (modeled per 1-unit increase in episodes on a continuous scale 0-5) and risk of death in nearly 7,700 men. Multivariable models were adjusted for age, treatment arm, body mass index, coronary artery disease, diabetes, geographic region, and race. Secondary analysis adjusted for IPSS score and a validated sleep survey.
- More nocturia episodes were associated with increased hazard of death on univariable (HR 1.23, p=0.003) and multivariable analyses (HR 1.16, p=0.048).
- After adjusting for composite IPSS score without nocturia among men with complete IPSS surveys or sleep survey questions, the relationship between nocturia and death was slightly lower, but overall, little changed and nocturia remained associated with an increased risk of death.
Publication Number: PD09-10
Impaired Sleep is Associated with Low Testosterone in U.S. Adult Males: Results from the National Health and Nutrition Survey: Testosterone deficiency has been linked to several adverse health outcomes including cardiovascular disease, erectile dysfunction, and metabolic syndrome; however, recent data have suggested abnormal sleep quality may also result in lower testosterone levels. Using data from the 2011-2012 National Health and Nutrition Surveys (NHANES), researchers set out to assess the effect of sleep patterns on testosterone levels in males 16 years and older.
Using a 2011-2012 NHANES dataset, researchers extracted serum total testosterone level, sleep duration, physical activity, demographics and comorbidities for nearly 2,700 men aged 16 years and older. Univariate and multivariate linear regression was used to estimate the association between the number of hours slept, prior comorbidities, physical activity level and demographics with serum testosterone.
- Among men aged 16-80 in the U.S., low testosterone was associated with impaired sleep and an elevated BMI.
- Researchers concluded that future evaluations of reduced testosterone levels should focus on diet and exercise, as well as sleep quality and habits.
Publication #: PD27-08
Poor Sleep Quality is Associated with Clinically Significant Erectile Dysfunction: Questionnaires were utilized to assess the relationship between sleep quality and erectile function in 377 men, with a mean age of 46. Patients were asked about comorbidities, smoking and shift work status, BMI, as well as daily caffeine and medication use. Researchers assessed the relationship between sleep and erectile function while controlling for age, BMI, burden of comorbidity, testosterone and PDE5 inhibitor use. Caffeine, melatonin, and other sleep medication use, CPAP use, shift work, smoking, depression status and antidepressant use were also assessed.
- As measured using the PSQI (Pittsburgh Sleep Quality Index), men had worse erectile function as sleep quality decreased.
- Sleep apnea was not associated with worse erectile function while melatonin use was associated with significantly worse erectile function.
- Age, depression and increased comorbidities were associated with worse erectile function.
“These studies point to some very alarming consequences for men with impaired sleep habits,” said Dr. Köhler. “Men should be aware that a commitment to improving one’s sleep habits could lead to improved erectile function along with a host of many other established health benefits that accompany a good night’s sleep.”
View AUA 2018 Complete Coverage