A Longitudinal Study of Bidirectional Relationships between Sleep Disorder and Frequency of Nocturia: Results from the Iwaki Health Promotion Project

Abstract

<b><i>Introduction:</i></b> The causal relationship between sleep disorder and frequency of nocturia remains unclear. <b><i>Methods:</i></b> We longitudinally evaluated sleep disorder and frequency of nocturia in 547 community-dwelling adults between baseline and 5-year follow-up. We included participants ≥50 years old who have no sleep disorder (the Pittsburgh Sleep Quality Index [PSQI] ≥ 5) nor nocturia (≥1). For 5 years, we evaluated the temporal changes in sleep disorder and nocturia and the bidirectional relationships between sleep disorder and nocturia. <b><i>Results:</i></b> Of the 547 participants, we included 268 adults with a median age of 61 years in this study. Median PSQI and nocturia were significantly increased for 5 years from 2 to 3 and from 1 to 2, respectively. New onset of sleep disorder (PSQI > 5) and nocturia >1 was observed in 42 (16%) and 137 (51%) participants, respectively. The cross-lagged panel analysis showed that the path coefficient from PSQI to nocturia (β = 0.22, <i>p</i> = 0.031) was significantly higher than that from nocturia to PSQI (β = 0.02, <i>p</i> = 0.941). <b><i>Conclusions:</i></b> Our longitudinal study showed the effect of sleep disorder on nocturia was significant, although nocturia may not significantly worsen sleep disorder in community-dwelling adults.

Effect of advanced glycation end products on nocturia or sleep disorders: A longitudinal study

“…‘Nocturia is a result of sleep disorder because of high oxidative stress’ can be speculated because several previous studies suggested that sleep problems may be a key factor for preceding nocturia. 13 , 14 , 15 , 28 Although this connection could not be directly proven, the results may support the concept that nocturia is one of the consequences of the ageing syndrome (e.g., comorbidities and higher AGEs). However, there is not enough evidence to address this point.…”

“…'Nocturia is a result of sleep disorder because of high oxidative stress' can be speculated because several previous studies suggested that sleep problems may be a key factor for preceding nocturia. [13][14][15]28 Although this connection could not be directly proven, the results may support the concept that nocturia is one of the consequences of F I G U R E 1 Selection of participants and stratification for AGEs-low and -high groups. This study longitudinally evaluated the AGEs level, sleep disorders and nocturia frequency in 447 community-dwelling adults for 5 years.…”

“…The Iwaki Health Promotion Project was a comprehensive study clarifying the aetiology of lifestyle‐related disease to promote health and extend the lifespan of residents of the city of Hirosaki (Iwaki district) in the northern part of Japan. 14 , 23 , 24 Of those, sleep disorders, nocturia frequency and oxidative stress in 521 adults in the Iwaki Health Promotion Project were longitudinally evaluated with baseline and 5‐year follow‐up between 2011 and 2016. Information on the baseline characteristics (age, gender, body mass index and smoking history), history of hypertension (HTN), cardiovascular disease (CVD), and type 2 diabetes mellitus (DM) was obtained via a questionnaire.…”

“… 10 , 11 , 12 Recent longitudinal studies suggested a negative influence of sleep problems on nocturia. 13 , 14 However, the exact association of nocturia with sleep disorders is difficult to define due to complexity. 15 …”

“…[10][11][12] Recent longitudinal studies suggested a negative influence of sleep problems on nocturia. 13,14 However, the exact association of nocturia with sleep disorders is difficult to define due to complexity. 15 Oxidative stress is an imbalance between free radicals and antioxidants and has been defined as harmful because oxygen free radicals attack biological molecules such as lipids, proteins and DNA.…”