Letter to editor
J.F. Brugne, in 1995, published a manuscript entitled ‘A better quality of sleep for a better quality of life’Citation1. Eleven years have passed but this statement is still valid. Nocturia is a cause of sleep disturbance and consequently a decrease in quality of life (QoL)Citation2. It was with great interest that we read the manuscript concerning the impact of nocturia on QoL by Hernández et al., recently published in Current Medical Research and OpinionCitation3. They stated that nocturia negatively impacts on the QoL of LUTS/BPH patients, which is reflected in worse sleep, reduced energy levels and increased bother and concernCitation3. Moreover, they highlight the fact that an adequate treatment of this symptom is necessaryCitation3. We have recently evaluated the impact of nocturia on QoL and sleep quality by using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the International Consultation on Incontinence Nocturia Quality-of-Life module (ICIQ-Nqol)Citation4. Our results highlight the serious impact of nocturia on sleep quality and the possible role of surgical treatment in improving QoL. The serious impact of nocturia was demonstrated by the reported correlation between the number of times when waking up to urinate and the Sleep/Energy ICIQ-Nqol subscale (r = 0.87, p < 0.001), ESS (r = 0.79, p < 0.001) and C7 PSQI subscale (r = 0.61, p < 0.001). Sleep fragmentation due to nocturia is reported as a common cause of daytime sleepiness and tiredness that is consequently related to a decrease in QoL. Marschall-Kehrel reported that as the number of nocturnal voiding episodes increased, women were more prone to develop poor appetite and unhappinessCitation5. Lentz et al. reported that sleep interruption in the first third of the night increases discomfort, daytime fatigue, even without a reduction in the total sleep quantityCitation6. Our findings demonstrated that sleep interruption ≥8 times has a significant impact on sleep quality in whatever part of the night. The second finding that could be taken into account is the evidence that surgical treatment increases QoL. The statistically relevant response in all questionnaires, with decrease in scores, is probably due to improvement in general QoL, obtained by surgical resolution of bladder outlet obstruction. These findings underline the role of general well-being in sleep quality, even if sleep interruption times due to waking up to urinate, are the same.
References
- Brugne JF, Fernandez J, Rouger Y. A better quality of sleep for a better quality of life. [French]. Rev Infirm 1995;17:64-8
- Coyne KS, Zhou Z, Bhattacharyya SK, et al. The prevalence of nocturia and its effect on health-related quality of live and sleep in a community sample in the USA. BJU Int 2003;92:948-54
- Hernández C, Estivill E, Prieto M, et al. Nocturia in Spanish patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Curr Med Res Opin 2008;24:1033-8
- Cai T, Gardener N, Boddi V, et al. Impact of surgical treatment on nocturia in men affected by benign prostatic obstruction. BJU Int 2006;98:799-805
- Marschall-Kehrel D. Update on nocturia: the best of rest is sleep. Urology 2004;64:21-4
- Lentz ML, Landis CA, Rothermel J, et al. Effects of slow wave disruption on musculoskeletal pain and fatigue in middle age women. J Rheumatol 1999;26:1586-92