Sleep problems tied to LUTS development, progression
Sleep problems appear to be associated with progression of lower urinary tract symptoms (LUTS) in men with the urologic condition and with LUTS development among asymptomatic men, according to data from the REDUCE* study.
Researchers examined the association between sleep, measured by the 6-item Medical Outcomes Study Sleep Scale (MOS-Sleep) survey, and LUTS development and progression in a cohort of 1,452 asymptomatic males and 1,136 male LUTS patients. All participants were followed for 4 years, during which the International Prostate Symptom Score (IPSS) was obtained at baseline and every 6 months.
During follow-up, 14 percent of men in the asymptomatic group developed LUTS and 50 percent in the LUTS group demonstrated progression. Multivariable Cox analysis found that higher sleep scores were associated with increased risk of LUTS development among asymptomatic men (quartile 4 vs 1: hazard ratio [HR] 1.50; 95 percent CI, 1.00 to 2.23; p=0.048) and heightened risk of LUTS progression among symptomatic men (HR per 10-points increase in sleep score, 1.06; 1.02 to 1.12; p=0.029).
The present data, if confirmed, suggest that sleep problems may precede LUTS, researchers said. In light of this, more studies are needed to examine whether treating sleep problems may improve LUTS.
Long-term insomnia and nocturia are frequently associated in the elderly. Evidence shows that poor sleep quality may increase arousal during sleep, leading to secondary nocturia. Furthermore, prostatic hyperplasia has been shown to cause nocturia, which in turn induces a sleep disorder. [Nat Sci Sleep 2013;5:7–13]
The mechanism underlying the development of sleep disorders is said to involve imbalances in steroid hormone action, sympathetic nervous system activity and immune dysfunction, all of which are considered to potentially contribute to the development of symptomatic benign prostatic hyperplasia and bladder outlet obstruction. [Curr Urol Rep 2012;13:407-12]
*Reduction by Dutasteride of Prostate Cancer Events