Nocturia, insomnia symptoms and mortality among older men: The health, aging and body composition study

Abstract

Study Objectives: To examine the association between nocturia (walking up from sleep for urination) and mortality risk among community dwelling older men. Methods: This is a secondary data analysis using data obtained from the Health Aging Body Composition (Health ABC) study. Frequency of nocturia was determined at baseline using a questionnaire. Results: A total of 1,478 older men, mean (SD) age 73.8 (2.9) years, were included in the analysis. During a follow up period of 9.9 years, a total of 760 deaths were reported. Mortality rate was significantly higher for participants with 3 or more nocturia episodes per night, in comparison to those with 0-1 episodes (HR [CI] : 1.21 [1.00-1.47], p = 0.055), even after controlling for baseline characteristics which included demographic variables, body mass index, lower urinary tract symptoms, use of loop diuretics, insomnia symptoms, feeling excessively sleepy during the day/daytime naps, sleep duration, and use of sleep medications. However, the association between ≥ 3 nocturia episodes per night and mortality risk was no longer statistically significant once prevalent diabetes mellitus and cardiovascular disease were included in the model (HR [CI]: 1.18 [0.97-1.44], p = 0.100). Conclusions: Nocturia is associated with mortality independent of insomnia symptoms and sleep duration. The relationship is explained in part by prevalent cardiovascular disease and diabetes mellitus. The results underscore the impact of these medical conditions on the association between 3 or more nocturia episodes and increased mortality risk among older men.