Nocturia Compounds Nocturnal Wakefulness in Older Individuals with Insomnia
1Department of Psychiatry, Stanford University, Palo Alto CA; 2Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto CA; 3Department of Neurology, Emory University, Atlanta GA
To determine the impact of nocturia on objective measures of sleep in older individuals with insomnia.
The sleep and toileting patterns of a group of community-dwelling older men (n = 55, aged 64.3 ± 7.52 years) and women (n = 92, aged 62.5 ± 6.73 years) with insomnia were studied for two weeks using sleep logs and one week using actigraphy. The relationships between nocturia and various sleep parameters were analyzed with ANOVA and linear regression.
More than half (54.2% ± 39.9%) of all log-reported nocturnal awakenings were associated with nocturia. A greater number of trips to the toilet was associated with worse log-reported restedness (p < 0.01) and sleep efficiency (p < 0.001), as well as increases in actigraph-derived measures of the number and length of nocturnal wake bouts (p < 0.001) and wake after sleep onset (p < 0.001). Actigraph-determined wake bouts were 11.5% ± 23.5% longer on nights on which there was a trip to the toilet and wake after sleep onset was 20.8% ± 33.0% longer during these nights.
Nocturia is a common occurrence in older individuals with insomnia and is significantly associated with increased nocturnal wakefulness and decreased subjective restedness after sleep.
A commentary on this article appears in this issue on page 263.
Zeitzer JM; Bliwise DL; Hernandez B; Friedman L; Yesavage JA. Nocturia compounds nocturnal wakefulness in older individuals with insomnia. J Clin Sleep Med 2013;9(3):259-262.
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