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Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE.

Publication ,  Journal Article
Branche, BL; Howard, LE; Moreira, DM; Roehrborn, C; Castro-Santamaria, R; Andriole, GL; Hopp, ML; Freedland, SJ
Published in: The Journal of urology
February 2018

Although lower urinary tract symptoms and sleep problems often develop together, to our knowledge it is unknown whether sleep disturbances are linked to lower urinary tract symptoms development and progression. As measured by the 6-item MOS-Sleep (Medical Outcomes Study Sleep Scale) survey we examined the relationship between sleep problems, and the development and progression of lower urinary tract symptoms in the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study.REDUCE was a randomized trial testing prostate cancer chemoprevention with dutasteride in men with prostate specific antigen 2.5 to 10 ng/ml and a negative biopsy. At baseline men completed MOS-Sleep and a scaled average was used to calculate the sleep score. Men were followed for 4 years and I-PSS (International Prostate Symptom Score) was completed at baseline and every 6 months. Asymptomatic men had I-PSS less than 8 while symptomatic men had I-PSS 8 or greater. In the placebo arm of 2,588 men not receiving α-blockers or 5α-reductase inhibitors at baseline we tested the association between sleep problems and lower urinary tract symptom development and progression using Cox models.During followup lower urinary tract symptoms developed in 209 of 1,452 asymptomatic men (14%) and 580 of 1,136 (51%) with lower urinary tract symptoms demonstrated progression. On multivariable analysis higher sleep scores were suggestively associated with increased lower urinary tract symptoms in asymptomatic men (quartile 4 vs 1 HR 1.41, 95% CI 0.92-2.17, p = 0.12) and with lower urinary tract symptom progression in symptomatic men (per 10 points of sleep score HR 1.06, 95% CI 1.01-1.12, p = 0.029).Among men with lower urinary tract symptoms worse sleep scores were associated with the progression of lower urinary tract symptoms and among asymptomatic men worse sleep scores were suggestively associated with the development of lower urinary tract symptoms. If confirmed, these data suggest that sleep problems may precede such symptoms. Whether treating sleep problems would improve lower urinary tract symptoms requires further testing.

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Published In

The Journal of urology

DOI

EISSN

1527-3792

ISSN

0022-5347

Publication Date

February 2018

Volume

199

Issue

2

Start / End Page

536 / 542

Related Subject Headings

  • Urology & Nephrology
  • Sleep Wake Disorders
  • Risk Factors
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Lower Urinary Tract Symptoms
  • Humans
  • Follow-Up Studies
  • Disease Progression
 

Citation

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Branche, B. L., Howard, L. E., Moreira, D. M., Roehrborn, C., Castro-Santamaria, R., Andriole, G. L., … Freedland, S. J. (2018). Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE. The Journal of Urology, 199(2), 536–542. https://doi.org/10.1016/j.juro.2017.08.108
Branche, Brandee L., Lauren E. Howard, Daniel M. Moreira, Claus Roehrborn, Ramiro Castro-Santamaria, Gerald L. Andriole, Martin L. Hopp, and Stephen J. Freedland. “Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE.The Journal of Urology 199, no. 2 (February 2018): 536–42. https://doi.org/10.1016/j.juro.2017.08.108.
Branche BL, Howard LE, Moreira DM, Roehrborn C, Castro-Santamaria R, Andriole GL, et al. Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE. The Journal of urology. 2018 Feb;199(2):536–42.
Branche, Brandee L., et al. “Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE.The Journal of Urology, vol. 199, no. 2, Feb. 2018, pp. 536–42. Epmc, doi:10.1016/j.juro.2017.08.108.
Branche BL, Howard LE, Moreira DM, Roehrborn C, Castro-Santamaria R, Andriole GL, Hopp ML, Freedland SJ. Sleep Problems are Associated with Development and Progression of Lower Urinary Tract Symptoms: Results from REDUCE. The Journal of urology. 2018 Feb;199(2):536–542.
Journal cover image

Published In

The Journal of urology

DOI

EISSN

1527-3792

ISSN

0022-5347

Publication Date

February 2018

Volume

199

Issue

2

Start / End Page

536 / 542

Related Subject Headings

  • Urology & Nephrology
  • Sleep Wake Disorders
  • Risk Factors
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Lower Urinary Tract Symptoms
  • Humans
  • Follow-Up Studies
  • Disease Progression