Sleep disturbance worsens lower urinary tract symptoms (LUTS): The Nagahama study.

Multiple factors are associated with lower urinary tract symptoms (LUTS), and sleep disturbance is well known to be associated with nocturia. The association between sleep disturbance and LUTS has not been sufficiently elucidated. Here we evaluated the impact of sleep disturbance on LUTS, especially voiding symptoms, in the Nagahama Study.

The Nagahama Study is a prospective cohort study of healthy individuals. Among them, participants ≥50 years old who completed both the International Prostate Symptom Score [IPSS] questionnaire and a sleep problem questionnaire were included in this analysis and followed-up for 5 years. Sleep disturbance was stratified into poor sleep quality, sleep restriction and sleep medication use. We analyzed the association between sleep disturbance and the worsening of LUTS adjusted by various clinical factors in a multivariate logistic regression analysis.

Among the 5,297 participants, the prevalence of LUTS at baseline was 23% and prevalence rates of poor sleep quality, sleep restriction and sleep medication were 20%, 6% and 7%, respectively. Participants with poor sleep quality, sleep restriction or sleep medication use had significantly greater incidence of LUTS and voiding symptoms than those without (p<0.01) Poor sleep quality and sleep medication use were significantly associated with LUTS worsening (increase of IPSS ≥4) with the odds ratios (ORs) of 1.23 (p=0.03) and 1.67 (p<0.01), and with worsening of voiding symptoms (increase of ≥3) with ORs of 1.35 (p<0.005) and 1.85 (p<0.001), respectively.

Sleep disturbance was significantly associated with presence of LUTS cross-sectionally and worsening of LUTS longitudinally.

The Journal of urology. 2019 Mar 13 [Epub ahead of print]

Arinobu Fukunaga, Takahisa Kawaguchi, Satoshi Funada, Takayuki Yoshino, Yasuharu Tabara, Fumihiko Matsuda, Koji Yoshimura, Osamu Ogawa, Hiromitsu Negoro, Nagahama Study Group

Department of Urology, Kyoto University Hospital , Kyoto , Japan., Center for Genomic Medicine, Kyoto University Graduate School of Medicine , Kyoto , Japan., Department of Urology, Shizuoka General Hospital , Shizuoka , Japan.