title: Nocturia, Other Lower Urinary Tract Symptoms and Sleep Dysfunction in a Community-Dwelling Cohort of Men.
abstract: To examine the influence of obstructive sleep apnea (OSA) on nocturia, controlling for their shared co-morbidities, in a population of community-based middle aged to elderly men.
  
  
  
  Participants were drawn from a randomly selected, community-dwelling cohort of men in Adelaide, Australia. Seven hundred and eight men (mean: 60.7 [41.6-88.2] years) who had polysomnography recordings, complete lower urinary tract symptoms (LUTS) measures (International Prostate Symptom Score), without prostate or bladder cancer and/or surgery, and no prior OSA diagnosis were selected. Nocturia was defined as ≥2 voids per main sleep. Unadjusted and multi-adjusted regression models of nocturia were combined with OSA, wake after sleep onset, total sleep period, excessive daytime sleepiness (EDS), and sleep quality (SQ) data, together with socio-demographic, and health-related factors.
  
  
  
  Men with nocturia were found to have higher levels of OSA (32.2% [n = 65]), wake after sleep onset time (97.2 ± 52.9 minutes), sleep period (467.3 ± 58.4 minutes), EDS (18.2% [n = 37]), and poorer SQ (54.3% [n = 108]). Multiple-adjusted models showed nocturia was positively associated with OSA (odds ratio:1.64, 95% confidence interval [1.03,2.55]), EDS (1.72 [1.01,2.93]), and poorer SQ (1.65 [1.10,2.48]). Including other storage and voiding LUTS attenuated the effect of OSA and strengthened the association with EDS (2.44 [1.45,4.10] and 2.24 [1.19,4.22]), whereas voiding LUTS also strengthened the association with poorer SQ (2.61 [1.63,4.17]). Men with increasing nocturic frequency spent less time in N2 and rapid eye movement stage sleep.
  
  
  
  Nocturia is strongly associated with OSA in community-based men. Nocturia also reduces sleep efficiency/SQ, N2, and rapid eye movement sleep time, while increasing EDS. Other LUTS increase EDS through non-OSA means.
authors.affiliation: Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, SA, Australia. Electronic address: sean.martin@adelaide.edu.au.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Martin
authors.affiliation: The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA, Australia.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Appleton
authors.affiliation: The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, SA, Australia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Adams
authors.affiliation: Population Research and Outcome Studies, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Taylor
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Catcheside
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia; The NHMRC Centres of Research Excellence, CIRUS and NEUROSLEEP, Woolcock Institute of Medical Research, Central Clinical School, University of Sydney, NSW, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Vakulin
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
authors.forename: R Douglas
authors.initials: RD
authors.lastname: McEvoy
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Antic
authors.affiliation: Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Wittert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D006801:Humans; D057187:Independent Living; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000453:epidemiology* / Q000503:physiopathology; D017286:Polysomnography; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D012894:Sleep Stages; D011795:Surveys and Questionnaires; D013997:Time Factors