Nocturia and overnight polysomnography in Parkinson disease

• Published in: Neurourology and urodynamics 2013-11, Vol.32 (8), p.1080-1085
• Main Authors: Vaughan, Camille P., Juncos, Jorge L., Trotti, Lynn Marie, Johnson II, Theodore M., Bliwise, Donald L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Apnea; bother; Female; Humans; Male; Middle Aged; nocturia; Nocturia - complications; Nocturia - physiopathology; Parkinson disease; Parkinson Disease - complications; Parkinson Disease - physiopathology; Polysomnography; Quality of Life; Sleep - physiology; sleep efficiency
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.22365

Aim Characterize clinical factors related to nocturia and sleep disruption in Parkinson disease (PD) using polysomnography (PSG). Methods Sixty‐three PD patients were recruited regardless of sleep or voiding complaints from a university‐based movement disorders clinic for a 48 hr inpatient PSG protocol. Nocturia frequency and bother related to urinary symptoms were assessed using the International Prostate Symptom Score (IPSS) and were corroborated by measurements of PSG‐defined sleep made immediately preceding and subsequent to each in‐lab voiding episode. PSG measures included whole‐night total sleep time (TST), sleep efficiency (SE), apnea/hypopnea index (AHI), and time to PSG‐defined sleep following nocturia episodes. Differences between groups were assessed using Mantel–Haenszel chi‐square, t‐tests, or Wilcoxon signed rank tests. Linear regression was used to assess factors associated with reported nocturia frequency. Results Sixty patients completed the IPSS. Thirty‐seven (61%) reported at least two nocturia episodes nightly; those individuals demonstrated lower PSG‐defined SE (P = 0.01) and TST (P = 0.02) than patients with 0–1 episodes. Participants reporting 2–3 episodes of nocturia with high bother on the IPSS (n = 12) demonstrated lower whole‐night TST (280.5 ± 116.1 min vs. 372.5 ± 58.7 min, P = 0.03) and worse SE (59.2 ± 22.7% vs. 75.9 ± 11.2%, P = 0.04) when compared to participants with 2–3 episodes of nocturia with low bother (n = 13). Conclusions These results verify objectively that PD patients with nocturia have poor sleep. Furthermore, among individuals with comparable levels of reported nocturia, higher bother is associated with poorer sleep as defined on PSG. Neurourol. Urodynam. Published 2013. This article is a U.S. Government work and is in the public domain in the USA. Neurourol. Urodynam. 32:1080–1085, 2013.