[Impact of nocturia on sleep efficiency in patients with benign prostatic hypertrophy].

OBJECTIVE

To assess sleep efficiency in patients presenting with nocturia and symptomatic benign prostatic hypertrophy (BPH).

MATERIAL AND METHODS

This prospective observational survey was carried out in France by 113 urologists. A total of 1376 patients (mean+/-SD age: 68.8+/-9.0 years) consulting for BPH with greater than two nocturia episodes per 24 hours were assessed with a mean I-PSS score of 15.5+/-6.4 (symptoms greater than 19 [severe] in 26.9% of cases). Patients used a sleep diary to record the previous night's total; sleep efficiency is expressed as percentage ratio, representing the total amount of actual sleep between initial sleep onset and final awakening. Sleep disorders were assessed using HD-43 questionnaire based on International classification of sleep disorders.

RESULTS

29.2% of the patients suffered from chronic insomnia, considered as primary insomnia (in 29.5% of cases) or related to either BPH (63.0%); snoring/sleep apnoea in 12.5% of cases. The mean sleep efficiency index was 87.2+/-13.7% and appeared to be significantly lower in BPH-related insomnia. Significantly lower sleep efficiency index values were observed as the severity (I-PSS score) of the BPH symptoms increased (89.5+/-12.1% for mildly symptomatic BPH vs. 84.0+/-15.6% for severely symptomatic BPH, P<0.001). Sleep efficiency index lowered with nocturia frequency (89.8+/-11.3% for two nocturia episodes vs. 80.4+/-17.3% for five nocturia episodes or more, P<0.001) and chronic insomnia frequency increased with nocturia frequency (21.4% for two nocturia episodes vs. 45.2% for five nocturia episodes or more, P<0.001).

CONCLUSIONS

Insomnia is frequent in patients presenting with BPH-related lower urinary tract symptoms (LUTS) and is mainly secondary to these LUTS. There is a significant correlation between the frequency of nocturia and the severity of insomnia.