Differences in the Association of Nocturia and Functional Outcomes of Sleep by Age and Gender: A Cross-sectional, Population-based Study

Nocturia is associated with poor sleep quality; however, little is known about the relationship between nocturia and sleep quality across different workforce-relevant age groups of adults. This has implications for developing new treatment strategies that are well tolerated across populations.

We conducted a cross-sectional study involving merged data from the 2005-2006 and 2007-2008 waves of the National Health and Nutrition Examination Survey. Participants responded to validated questions on nocturia frequency and sleep from the Functional Outcomes of Sleep Questionnaire General Productivity subscale (FOSQ-gp, range 1-4). Analyses included multivariable linear regression with stratification by gender to examine associations between nocturia frequency (higher worse) and the FOSQ-gp scores (lower scores indicating worse daytime function related to sleep disturbance).

Of 10,512 adults aged ≥20 years who completed the survey, 9148 (87%) had complete nocturia and FOSQ-gp data. The population age-adjusted prevalence of nocturia at least twice nightly was 21.1% among men and 26.6% among women (P < 0.001), and nocturia increased with age (P < 0.001). Compared with those with no or 1 episode of nocturia, those with nocturia at least twice nightly reported lower mean FOSQ-gp scores (3.65; 95% CI, 3.61-3.69 vs 3.19; 95% CI, 3.09-3.31 for men and 3.52; 95% CI, 3.48-3.56 vs 3.09; 95% CI, 3.02-3.16 for women). Older adults (aged >65 years) with greater nocturia frequency reported worse FOSQ-gp scores compared with younger adults with similar nocturia frequency (P < 0.001 among men and women).

In a population-based sample of community-dwelling men and women, the association between nocturia and worsened functional outcomes of sleep was greater among adults older than 65 years-a group more vulnerable to drug side effects, and in whom nocturia is typically multifactorial. Additionally, these analyses found that the association between nocturia and functional outcomes of sleep is stronger with increasing age among men. Effective treatment strategies that are well tolerated by older adults, such as multicomponent treatments that simultaneously address the combined effects of lower urinary tract and sleep dysfunction, are needed.

Clinical therapeutics. 2016 Oct 14 [Epub ahead of print]

Camille P Vaughan, Constance H Fung, Alison J Huang, Theodore M Johnson, Alayne D Markland

Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama; Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, Georgia; Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia. Electronic address: ., Department of Medicine, University of California Los Angeles, North Hills, California; Department of Veterans Affairs Greater Los Angeles Geriatric Research, Education, and Clinical Center, North Hills, California., Department of Medicine, University of California San Francisco, San Francisco, California., Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama; Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, Georgia; Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia., Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama; Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, Georgia; Department of Medicine, Division of Geriatrics, Gerontology and Palliative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

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