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Quantitative association between nocturnal voiding frequency and objective sleep quality in the general elderly population: the HEIJO-KYO cohort

Sleep Medicine 16 (2015) 577–582

Highlights

 

  • Increased nocturnal void frequency and lower actigraphic sleep efficiency.
  • Increased nocturnal void frequency and longer actigraphic wake after sleep onset.
  • Increased nocturnal void frequency and shorter actigraphic sleep onset latency.

Abstract

Objective

A significant association between nocturia and subjective sleep quality has previously been reported; however, the association between nocturia and objective sleep quality remains unclear. The purpose of this study was to evaluate the quantitative association between nocturnal voiding (NV) frequency and objective sleep quality in a large, general, elderly population.

Methods

Nocturnal voiding frequency, objective sleep quality, and subjective sleep quality were measured among 1086 community-based elderly individuals using actigraphy and the Pittsburgh Sleep Quality Index (PSQI) questionnaire.

Results

In multivariate analyses adjusted for potential confounding factors (such as age, gender, body mass index, medication use, renal function, bedtime, rising time, daytime physical activity, endogenous melatonin levels, and bedroom light levels), increased NV frequency, ranging from zero, one, two, three or more voids, was significantly associated with poorer objective sleep quality, including lower sleep efficiency (SE) and longer wake after sleep onset (WASO) (mean SE, 86.3, 84.8, 83.6, and 81.2%, respectively; p for trend <0.001; mean WASO: 42.6, 49.0, 53.6, and 66.1 min, respectively; p for trend <0.001), but shorter sleep onset latency (SOL) (mean SOL, 3.0, 3.0, 2.8, and 2.8 log min, respectively; p for trend = 0.018). In addition, an increased NV frequency was significantly associated with poorer subjective sleep quality in a multivariate model (mean PSQI global score, 4.60, 4.86, 5.22, and 5.48, respectively; p for trend 0.012).

Conclusion

The present study revealed a quantitative association between NV frequency and objective sleep quality in the general elderly population.

Keywords: Nocturia, Nocturnal voiding frequency, Sleep quality, Actigraphy, Melatonin.

Footnotes

Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan

* Corresponding author. Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashiharashi, Nara, 634-8521, Japan. Tel.: +81 744 22 3051; fax: +81 744 25 7657.