Poor Sleep May Raise Risk of Urologic Symptoms

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WASHINGTON, D.C.—Poor sleep quality may be a novel and modifiable risk factor that precedes the development of urologic symptoms in men and women, researchers concluded.

Investigators at New England Research Institutes studied a population-based cohort of 1,610 men and 2,535 women who completed the baseline (2002-2005) and follow-up (2006-2010) phases of the Boston Area Community Health Survey, which is funded by the National Institute of Diabetes and Digestive and Kidney Disorders.

The researchers defined short sleep duration (data available in men only) as sleeping fewer than five hours per night and restless sleep as reporting restless sleep in the past week. The researchers tested whether sleep duration/restless sleep measured at baseline predicted the development of urologic symptoms 5 years later.   

Moderate-to-severe lower urinary tract symptoms (LUTS) were related to short sleep duration among men and restless sleep among men and women, Andre B. Araujo, PhD, and colleagues reported at the American Urological Association 2011 annual meeting.

Among the women, those who reported having restless sleep in the past week had a 17.2% cumulative incidence of LUTS, compared with 10.4% among subjects reporting restful sleep. The cumulative incidence of urinary incontinence (UI) was 13% and 7.1% for those reporting restless and restful sleep, respectively. The cumulative incidence of nocturia was 25.1% and 13.5%, respectively.

Compared with women who had restful sleep, those reporting restless sleep had an approximately 1.5 times increased risk of LUTS and nearly twofold increased risk of UI and nocturia.

Among the men, the cumulative incidence of LUTS was 12.5% for those with short sleep duration and 7.1% for subjects with long sleep duration. Men who reported restless sleep had an 11.5% cumulative incidence of LUTS compared with 6.4% among those reporting restful sleep. The survey revealed no significant association between sleep quantity or quality and urinary incontinence and nocturia.

In men, the risk of LUTS was increased approximately twofold among men reporting short sleep duration or restless sleep compared with men reporting long sleep duration or restful sleep.

The increased risks for urologic symptoms diminished after adjusting for levels of C-reactive protein—a marker of systemic inflammation—suggesting that the development of such symptoms proceed via inflammatory and other pathways, according to the investigators. Dr. Araujo noted that “the results of the current study call into question the assumption that the link between urologic symptoms and sleep is in one direction, that is, that urologic symptoms lead to sleep disturbance, but not vice versa.”

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