Associations between improvements in lower urinary tract symptoms and sleep disturbance over time in the CAMUS trial.
OBJECTIVE
We recently reported an association between the bother and severity of lower urinary tract symptoms secondary to benign prostatic hyperplasia and the severity of sleep disturbance. However, few studies have examined whether alterations in the severity of urinary symptoms influence the degree of sleep problems over time.


METHODS
The severity of lower urinary tract symptoms in men enrolled in CAMUS (Complementary and Alternative Medicine for Urological Symptoms), a clinical trial of saw palmetto (Serenoa repens), was evaluated using AUASI (American Urological Association symptom index) and quality of life scores. Sleep disturbance was evaluated by the Jenkins sleep scale at 0, 24, 48 and 72 weeks. Statistical analyses were used to assess the relationship(s) between changes in lower urinary tract symptoms and sleep disturbance.


RESULTS
The baseline characteristics of the 339 men (172 placebo arm and 167 saw palmetto arm) enrolled in the CAMUS trial with assessment of sleep disturbance and urinary symptoms were similar. There were no differences between improvements in the severity of sleep disturbance or urinary symptoms between the 2 experimental arms. Combined analyses of the entire cohort revealed significant associations (p <0.001) between the AUASI score and sleep disturbance severity with time. Multivariate analyses demonstrated that improvements in lower urinary tract symptoms other than nocturia were the most significant predictors of improvements in sleep disturbance. Specific analyses adjusting for other baseline characteristics demonstrated that a 3-point improvement in AUASI score was associated with a 0.73-point improvement in the Jenkins sleep scale with time.


CONCLUSIONS
Improvements in lower urinary tract symptoms correlate with changes in sleeping abilities with time in men with benign prostatic hyperplasia. While nocturia is significantly associated with sleep disturbance, other changes in overall lower urinary tract symptoms are better predictors of changes in sleep dysfunction.
Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Brian T
BT
Helfand
Jeanette Y
JY
Lee
Victoria
V
Sharp
Harris
H
Foster
Michael
M
Naslund
O Dale
OD
Williams
Kevin T
KT
McVary
D004311:Double-Blind Method; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D028024:Serenoa; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology*; D013997:Time Factors
D010936:Plant Extracts