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Self-rated sleep characteristics and bother from nocturia

By C.P. Vaughan, R. Eisenstein, D.L. Bliwise, Y.K. Endeshaw, Z.J. Nagamia, R.A. Wolf and T.M. 2nd Johnson

International Journal of Clinical Practice Volume 66, Issue 4, April 2012, Pages 369-373

Editor’s comments:
Background: sleep loss has been hypothesised to be the major mechanism by which nocturia disrupts quality. In this study the authors investigated the relationship between episodes of nocturia, bother and sleep characteristics in 55 participants reporting frequency and bother of nocturia  (AUA Symptom Inventory and 7-day sleep diaries)

The authors found that participants who were categorised with HIGH bother were significantly more likely than those with LOW bother to report difficulty initiating sleep and difficulty returning to sleep after an awakening.These results highlighted the importance of sleep outcomes in studies of nocturia. The clinical relevance of nocturia-related studies depends on reducing bother related to  as much as the absolute reduction in nocturia frequency.

Summary
Purpose:
The aim of this study was to evaluate if men with varying degrees of bother from a similar number of nocturia episodes differ with respect to self-rated sleep characteristics and fatigue.

Materials and methods:
As part of the baseline assessments during a nocturia treatment trial, 55 participants reported frequency and bother of nocturia using the AUA Symptom Inventory and completed 7-day sleep diaries prior to treatment. Participants who reported moderate nocturia (either two or three episodes nightly) were further grouped into categories of LOW (nocturia is no problem or a very small problem) or HIGH bother (nocturia is a big problem). Information from the participant completed sleep diaries was abstracted, including information on daytime napping, total sleep time, mean time needed to return to sleep, nighttime ratings of fatigue, and daytime ratings of fatigue.

Results:
Of the 55 individuals who completed the pilot study, 24 study participants reported two or three episodes of nocturia and had either HIGH (n = 11) or LOW (n = 13) bother. Participants categorised with HIGH bother were significantly more likely than those with LOW bother to report difficulty initiating sleep (47.7 ± 34.4 vs. 23.5 ± 13.6 min, p = 0.05), difficulty returning to sleep after an awakening (28.9 ± 16.1 vs. 15.4 ± 9.6 min, p = 0.03) and greater morning fatigue (3.3 ± 0.7 vs. 2.5 ± 1.0, p = 0.04 on a 7-point scale).

Conclusions:
Since bother related to nocturia is linked to sleep quality, interventions targeting fatigue and sleep maintenance may provide useful targets in the management of nocturia in men.