Nocturia: Impact on quality of life in an Egyptian adult population

Salma M S El Said,Marian Wagieh Mansour,Tomader Abd El Rahman,Ahmed K Mortagy

doi:10.4236/aar.2013.24023

Abstract

OBJECTIVE: To estimate the effects of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Background: Nocturnal urination (nocturia) is such a commonplace occurrence in the lives of many older adults that it is frequently overlooked as a potential cause of sleep disturbance. Methods: The current study was carried out to assess the prevalence of nocturia in elderly males and its impact on sleep quality and QoL. The study enrolled 200 elderly males aged 60 years old and above. All participants were recruited from geriatric clubs in Cairo. All participants in the study were subjected to: comprehensive geriatric assessment, American Urological Association (AUA) score used to measure the severity of nocturia ,assessment of sleep quality using Pittsburgh Sleep Quality Index (PSQI) and assessment of QoL using “SF-12 Short Form Health Survey”. Results: The study showed that the prevalence of nocturia in elderly males aged ≥60 years old was 68% with significant association between nocturia and diabetes mellitus, heart failure, stroke, prostatism, recurrent UTI and diuretic use. As regard sleep quality, the current study showed that the prevalence of poor sleep in the studied subjects is 70.5% with significant association between nocturia and poor sleep quality. Nocturia significantly affects sleep latency, sleep efficiency and daytime dysfunction, high significantly affecting sleep disturbance. Also diabetes mellitus, ischemic heart disease, heart failure, prostatism, recurrent UTI, osteoarthritis and diuretic use are significantly associated with poor sleep quality. As regard quality of life, the current study showed significant association between nocturia and physical and mental health components of HRQL in the univariate analysis. But after multivariate analysis, nocturia is not an independent risk factor for poor quality of life. Nocturia affects QoL through its effect on sleep quality which is an independent risk factor for poor physical and mental health components of QoL. Conclusion: Nocturia may lead to sleep insufficiency and consequently to a decrease in mental and physical health. Patients who consult a doctor for nocturia should thus be treated adequately. In addition, it is worthwhile for doctors to routinely check if patients’ who contact them for sleep problems also have nocturia.

Highlights

Nocturia is defined as the complaint that the individual has woken at night one or more time to void [1]
As regard quality of life, the current study showed significant association between nocturia and physical and mental health components of HRQL in the univariate analysis
Using American Urological Association (AUA) symptom score to assess the severity of prostatic symptoms revealed that patient with nocturia scores higher in AUA score and the increase in severity of Lower urinary tract symptoms (LUTS) is associated with increase in severity in nocturia (P value 0.000)

Summary

Introduction

Nocturia is defined as the complaint that the individual has woken at night one or more time to void [1]. The standard definition for nocturia, by the international continence society, is waking at night to void, applying to any number of voids at any time during night’s sleep; each void is preceded and followed by sleep and the person is awake before voiding. Iatrogenic factors such as the use of diu- OPEN ACCESS. Overlapping causes of frequent urination at night in the aged population have been described, including loss of bladder capacity, decreased glomerular filtration rate, and nocturnal polyuria from decreased arginine vasopressin, incipient diabetes, sleep-disordered breathing, congestive heart failure and/or diuretic use [5]. Lower urinary tract symptoms (LUTS) and, lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are a common condition in older men [6]

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Discussion

Conclusion