Nocturia, sleep-disordered breathing, and cardiovascular morbidity in a community-based cohort

• Published in: PloS one 2012-02, Vol.7 (2), p.e30969-e30969
• Main Authors: Parthasarathy, Sairam, Fitzgerald, MaryPat, Goodwin, James L, Unruh, Mark, Guerra, Stefano, Quan, Stuart F
• Format: Article
• Language: English
• Subjects: Adjustment; Age; Aged; Analysis; Apnea; Body mass; Body mass index; Breathing; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Communities; Cross-Sectional Studies; Diabetes mellitus; Diuretics; Female; Geriatrics; Health aspects; Health risk assessment; Health risks; Heart; Humans; Hypertension; Insomnia; Male; Medical research; Medicine; Middle Aged; Morbidity; Mortality; Nocturia - epidemiology; Nocturia - physiopathology; Older people; Polysomnography; Respiration; Sleep; Sleep and wakefulness; Sleep apnea; Sleep Apnea Syndromes - epidemiology; Sleep Apnea Syndromes - physiopathology; Sleep deprivation; Sleep disorders; Sleepiness; Stroke
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0030969

Nocturia has been independently associated with cardiovascular morbidity and all-cause mortality, but such studies did not adjust for sleep-disordered breathing (SDB), which may have mediated such a relationship. Our aims were to determine whether an association between nocturia and cardiovascular morbidity exists that is independent of SDB. We also determined whether nocturia is independently associated with SDB. In order to accomplish these aims we performed a cross-sectional analysis of the Sleep Heart Health Study that contained information regarding SDB, nocturia, and cardiovascular morbidity in a middle-age to elderly community-based population. In 6342 participants (age 63±11 [SD] years, 53% women), after adjusting for known confounders such as age, body mass index, diuretic use, diabetes mellitus, alpha-blocker use, nocturia was independently associated with SDB (measured as Apnea Hypopnea index >15 per hour; OR 1.3; 95%CI, 1.2-1.5). After adjusting for SDB and other known confounders, nocturia was independently associated with prevalent hypertension (OR 1.23; 95%CI 1.08-1.40; P = 0.002), cardiovascular disease (OR 1.26; 95%CI 1.05-1.52; P = 0.02) and stroke (OR 1.62; 95%CI 1.14-2.30; P = 0.007). Moreover, nocturia was also associated with adverse objective alterations of sleep as measured by polysomnography and self-reported excessive daytime sleepiness (P