Association between Lower Urinary Tract Symptoms and Sleep Quality of Patients with Depression

Abstract

Background and Objectives: In the general population, sleep disorders are associated with lower urinary tract symptoms (LUTS) including urinary incontinence (UI). This connection has not been explored fully in specific patient groups. Thus, we investigated the association between sleep quality and LUTS for patients with depression. Materials and Methods: This study was prospective and cross-sectional. We analyzed questionnaire data on depression, sleep quality, LUTS, and UI from depressed patients treated in our department of adult psychiatry. We used the Hamilton Rating Scale for Depression, the Holland Sleep Disorders Questionnaire, the International Prostate Symptom Score, and the International Consultation on Incontinence Questionnaire-Short Form. Results: In total, 102 patients treated for depression were enrolled. We found a statistically significant correlation between depression severity and sleep quality. A significant correlation was also investigated for sleep quality and LUTS severity. The group of depressed patients with moderate or severe LUTS had greater sleep problems compared with patients who had mild urinary tract symptoms or no symptoms. With regression analysis, we further demonstrated that the relationships between LUTS and sleep quality as well as UI and sleep quality in depressed patients are independent from age and sex. Conclusions: In the cohort of patients treated for depression, sleep quality correlated with LUTS including UI. We suggest that the negative effect of LUTS and UI on sleep quality that we observed should lead to the re-evaluation of current recommendations for diagnosis and treatment of sleep problems among patients with depression.

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Link between circadian rhythm and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS)

“…However, frequent night urination is significantly associated with reduced time and quality of sleep, thus, leading to chronic day‐time tiredness and circadian rhythm disruption 76 . Reduced sleep quality and time can also cause hormonal abnormalities, including low testosterone, increased stress hormone levels such as cortisol, and lower thyroid levels which in turn could be associated with increased circadian rhythm disruption 77,78 . Furthermore, Arauju et al found that poor sleep quality increased the risk of obstructive and irritative LUTS, and sleep restriction increased the risk of irritative LUTS by twofold.…”

“…76 Reduced sleep quality and time can also cause hormonal abnormalities, including low testosterone, increased stress hormone levels such as cortisol, and lower thyroid levels which in turn could be associated with increased circadian rhythm disruption. 77,78 Furthermore, Arauju et al found that poor sleep quality increased the risk of obstructive and irritative LUTS, and sleep restriction increased the risk of irritative LUTS by twofold. This study however did not evaluate specifically a diagnosis of BPH, but rather only general LUTS.…”