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 (<or >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.