Nocturic episodes in patients with benign prostatic enlargement may suggest the presence of obstructive sleep apnea

Abstract

Background: Nocturia is a common symptom of benign prostatic enlargement (BPE) that is generally attributed to a urologic pathology. This study assessed whether nocturia severity in BPE patients may be related to an underlying sleep disorder. Methods: Cross-sectional study based in urban community primary care clinics. Study population included men aged 55 to 75 years old. The research group included patients with documented BPE and nocturia of at least once per night versus a comparison group without BPE and with either no or one nocturia episode per night. The presence of symptoms of obstructive sleep apnea (SOSA) was assessed using the Berlin questionnaire. Results: Patients with BPE were significantly more likely to report weight gain (21% vs 10%), loudness of snoring (22.6% vs 4%), daytime sleepiness (35.3% vs 12.0%), and hypertension (61.8% vs 41.0%). Fifty-nine patients (57.8%) in the research group were considered high risk for OSA compared with 31 patients (31.0%) from the comparison group (P < .001). The odds ratio (OR) for SOSA gradually increased from 1.00 in patients reporting no nocturia to 2.44, 5.75, and 12.3 in patients reporting 1, 2 to 3, and >3 episodes of nocturia per night, respectively. Conclusion: The odds for SOSA increased log-linearly in correlation with the number of nocturia episodes. We imply that nocturic episodes in patients with BPE may suggest the presence of OSA. Physicians following patients with BPE who report frequent awakenings from sleep to urinate should suspect OSA as a possible comorbidity.