BPH Development, Progression Linked to Sleep Problems
Findings emerged from an analysis of data from 2588 men who participated in the REDUCE trial.
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BOSTON—Sleep problems are associated with an elevated the risk of benign prostatic hyperplasia (BPH) development and progression, researchers reported at the American Urological Association 2017 annual meeting.
The findings, by Brandee Branche, MD, of Duke University in Durham, North Carolina, and colleagues, are from an analysis of data from 2588 men who participated in the placebo arm of the 4-year REDUCE (Reduction by Dutasteride of Prostate Cancer Events) trial. At baseline, the patients were not taking alpha blockers or 5-alpha reductase inhibitors and all of them completed the Medical Outcomes Study Sleep Scale (MOSSS-6) questionnaire, a 6-item scale that assesses sleep and is score 1-100. Men were followed up for 4 years. Investigators obtained the International Prostate Symptom Score (IPSS) at baseline and every 6 months.
For men without symptomatic BPH at baseline (IPSS less than 8), the investigators defined BPH development as 2 values of IPSS greater than 14. In men with symptomatic BPH at baseline, (IPSS 8 or higher), BPH symptom progression was defined as a 4 or greater increase IPSS increase from baseline, any surgical procedure for BPH, or the start of a drug to treat BPH.
During follow-up, BPH developed in 209 (14%) of 1452 men without BPH at baseline and 527 (46%) of 1136 men with BPH at baseline experienced BPH progression. On multivariate analysis, higher MOSSS-6 scores among men without BPH at baseline were associated with a significant 28% increased risk of BPH development. Among men with BPH at baseline, higher MOSSS-6 scores were associated with a significant 23% increased risk of BPH progression, Dr Branche and colleagues reported.
“As it is often inferred that BPH leads to sleep problems, the fact that sleep problems in asymptomatic men predict BPH development suggest BPH symptoms may be a manifestation of sleep problems rather than the reverse,” Dr Branche and colleagues reported. “Whether treating sleep problems improves BPH symptoms needs to be tested.”
Branche B, Howard L, Moreira D, et al. Sleeping problems area associated with increased risk of BPH progression: Results from REDUCE [abstract]. J Urol 2017;197:e102. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. MP09-08.