Prostatic hyperplasia is highly associated with nocturia and excessive sleepiness: a cross-sectional study

OBJECTIVES The objective of this study is to assess the impact of nocturia on sleep in patients with lower urinary tract symptoms (LUTS)/benign prostatic enlargement (BPE) (nocturia≥2). DESIGN Cross-sectional survey. SETTING 798 urologists and general practitioners randomly selected from the overall population of urologists and general practitioners of every French region. PARTICIPANTS A total of 2179 LUTS/BPE men (aged 67.5±7.5 years old) were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES Validated patients' self-administered questionnaires were used to assess the severity of LUTS/BPE (the International Prostate Symptom Score), sleep characteristics (sleep log) and sleep disorders (the International Classification of Sleep Disorders (ICSD-2) and the DSM-IV). Sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The volume of 24 h diuresis (1500 ml) was measured. RESULTS Participants had on average 2.9±0.9 nocturia episodes (three or more episodes in 67%) and the International Prostate Symptom Score of 15.8±5.7; 60.9% complained of insomnia according to the ICSD-2, 7.9% of restless leg syndrome and 6.4% of obstructive sleep apnoea. 32.3% had excessive sleepiness (ESS >10) and 3.1% severe excessive sleepiness (ESS >16). Insomnia was mainly nocturnal awakenings with an average wake after sleep onset of 89±47 min. The number of episodes of nocturia per night correlated significantly with wake after sleep onset and ESS but not with total sleep time and sleep latency. CONCLUSION Nocturia is significantly associated with sleep maintenance insomnia and sleepiness in men with BPE.