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Nocturia and Quality of Life: Results from the Boston Area Community Health Survey

Varant Kupelian, John T. Wei, Michael P. O’Leary, Jens Peter Norgaard, Raymond C. Rosen, John B. McKinlay.

Accepted 29 August 2011, pages 78 - 84

European Urology, Volume 61, Issue 1, Pages 78-84, January 2011


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Abstract

Background

Nocturia, a common complaint in aging men and women, is frequently cited as the cause of nocturnal awakenings leading to sleep loss, daytime fatigue, and reduced quality of life (QOL).

Objective

Investigate the association of nocturia with QOL and depressive symptoms among men and women.

Design, setting, and participants

A population-based epidemiologic survey of urologic symptoms among persons aged 30–79 yr. A multistage stratified cluster sample design was used to randomly sample 5503 residents of Boston, MA, USA.

Measurements

Nocturia was defined as a self-report of two or more voiding episodes nightly or having to get up to urinate more than once nightly “fairly often,” “usually,” or “almost always.” QOL was assessed using the physical and mental health component scores of the 12-Item Short-Form Survey (SF-12). Depression was assessed using the Center for Epidemiological Studies Depression Scale. Multiple linear and logistic regression methods were used to model the nocturia and QOL association and to control for confounders.

Results and limitations

Nocturia was associated with decreased SF-12 scores for both the physical and mental health components after multivariate adjustment. Nocturia was also associated with increased odds of depressive symptoms (men: adjusted odds ratio [OR]: 2.79; 95% confidence interval [CI], 1.81–4.31; women: adjusted OR: 1.80; 95% CI, 1.29–2.51). Among women who reported sleep interference due to urologic symptoms, nocturia was associated with a threefold increase in odds of depression. In this cross-sectional analysis, the temporal sequence of causality of the nocturia and depression association could not be assessed.

Conclusions

Nocturia is associated with decreased QOL and with an increased prevalence of depressive symptoms in both men and women.

Take Home Message

Nocturia is associated with increased symptom bother and depressive symptoms. Two or more nighttime voiding episodes constitute a threshold level for nocturia beyond which adverse effects on quality of life are detected.

Keywords: Nocturia, Quality of life, Depression, Epidemiology.


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