AB021. Management of sleep disorder in elderly patients with urological disease

Sleep is the body’s rest cycle of 7–8 hours in healthy adult characterizing as a very complex physiological and behavioral process under a state marked by bouts of lessened consciousness, lessened movement of the skeletal muscles and slowed-down metabolism. Sleep disorder has very important effects on fatigue resolve, growth, endocrine, immune, cardiopulmonary, metabolic function, general health and eventually life-span. Prevalence of insomnia in elderly revealed as persistent insomnia in 10–15% and sleep disorder in 40–70%, which is basically accompanied with decreasing melatonin secretion as a person ages. Urological diseases related with sleep disorder are nocturia, overactive bladder, benign prostate hyperplasia, bladder & prostate cancer, cystitis, prostatitis, neurogenic bladder, urethral stricture, nocturnal polyuria, late onset hypogonadism, et cetera. Of these disorders, nocturia is one of the most bothersome self-reported insomnia in the elderly which is associated with poor quality of life. Voiding and sleep patterns should be strictly evaluated in elderly patients to define which of urological disease or sleep disorder is primitive factor. Various medical options to control voiding and/or storage symptoms with sleep disorder have chosen as monotherapy or combination therapy including alpha-blockers, anticholinergics and antidiuretic hormone for urinary symptoms as well as good sleep hygiene practice of sleep disorder and hypnotics for insomnia. Therefore, to clarify underlying disease to cause patient’s chief complaint is essential resulting to maximize therapeutic results. This lecture will provide pathogenesis, diagnostic approach, ideal pharmacologic treatment with underlying action mechanism and cognitive behavior therapy in elderly with simultaneous sleep disorder and urological disease.