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No AccessJournal of UrologyAdult Urology1 Feb 2011

Association of Nocturia and Mortality: Results From the Third National Health and Nutrition Examination Survey

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    Purpose:

    Nocturia, a common problem in men and women, has been associated with chronic illnesses such as heart disease and hypertension. Using data from the Third National Health and Nutrition Examination Survey we investigated the association of nocturia with subsequent mortality risk.

    Materials and Methods:

    NHANES III is a national probability survey of the United States between 1988 and 1994. Mortality data were obtained by linkage of NHANES III to the National Death Index. Cox proportional hazards regression models were used to assess the association between nocturia and all cause mortality, controlling for potential confounders in a sample of 15,988 men and women 20 years old or older.

    Results:

    The prevalence of nocturia, defined as 2 or more voiding episodes nightly, was 15.5% in men and 20.9% in women. Multivariate analyses showed a statistically significant trend of increased mortality risk with increased number of voiding episodes in men and women. The magnitude of the nocturia and mortality association was greater in those younger than 65 years with attenuated associations in the 65 years old or older age group.

    Conclusions:

    Nocturia is a strong predictor of mortality, more so in younger men and women than in the elderly, with a dose-response pattern in increased mortality risk with increasing number of voiding episodes nightly. Potential underlying mechanisms of the observed association of nocturia and increased mortality risk include sleep disruption and subsequent development of related comorbid conditions.

    References

    • 1 : Prevalence of and racial/ethnic variation in lower urinary tract symptoms and noncancer prostate surgery in U.S. men. Urology2002; 59: 877. Google Scholar
    • 2 : The prevalence of nocturia and its effect on health-related quality of life and sleep in a community sample in the USA. BJU Int2003; 92: 948. Google Scholar
    • 3 : The association of nocturia with cardiac disease, diabetes, body mass index, age and diuretic use: results from the BACH survey. J Urol2007; 177: 1385. LinkGoogle Scholar
    • 4 : Is nocturia equally common among men and women?: A population based study in Finland . J Urol2006; 175: 596. LinkGoogle Scholar
    • 5 : Nocturnal awakenings and comorbid disorders in the American general population. J Psychiatr Res2008; 43: 48. Google Scholar
    • 6 : Nocturia in relation to sleep, somatic diseases and medical treatment in the elderly. BJU Int2002; 90: 533. Google Scholar
    • 7 : Impact of sleep debt on metabolic and endocrine function. Lancet1999; 354: 1435. Google Scholar
    • 8 : Mortality in the elderly in relation to nocturnal micturition. BJU Int1999; 84: 297. Google Scholar
    • 9 : Hip fractures, nocturia, and nocturnal polyuria in the elderly. Arch Gerontol Geriatr2006; 43: 319. Google Scholar
    • 10 : Usefulness of nocturia as a mortality risk factor for coronary heart disease among persons born in 1920 or 1921. Am J Cardiol2006; 98: 1311. Google Scholar
    • 11 : Evaluating potentially modifiable risk factors for prevalent and incident nocturia in older adults. J Am Geriatr Soc2005; 53: 1011. Google Scholar
    • 12 : Association of urological symptoms and chronic illness in men and women: contributions of symptom severity and duration–results from the BACH Survey. J Urol2009; 181: 694. LinkGoogle Scholar
    • 13 Plan and operation of the Third National Health and Nutrition Examination Survey. 1988–94: Series 1: programs and collection procedures . Vital Health Stat1994; 32: 1. Google Scholar
    • 14 : Office of Analysis and Epidemiology, The Third National Health and Nutrition Examination Survey (NHANES III) Linked Mortality File, Matching Methodology. Hyattsville, Maryland: National Center for Health Statistics2010. Google Scholar
    • 15 : Regression models and life tables. J R Stat Soc Ser B Stat Methodol1972; 34: 187. Google Scholar
    • 16 : Are racial/ethnic disparities in the prevalence of nocturia due to socioeconomic status?: Results of the BACH Survey . J Urol2009; 181: 1756. LinkGoogle Scholar
    • 17 : Beyond the lower urinary tract: the association of urologic and sexual symptoms with common illnesses. Eur Urol2007; 52: 407. Google Scholar
    • 18 : A systematic evaluation of factors associated with nocturia–the population-based FINNO study. Am J Epidemiol2009; 170: 361. Google Scholar
    • 19 : Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med2006; 166: 1768. Google Scholar
    • 20 : Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care2006; 29: 657. Google Scholar