Nocturia and overnight polysomnography in Parkinson disease

Authors

  • Camille P. Vaughan,

    Corresponding author
    1. Department of Veterans Affairs Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, Georgia
    2. Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
    • Correspondence to: Camille P. Vaughan, MD, MS, Atlanta VA Medical Center, 1670 Clairmont Rd, Mailstop 11B, Decatur, GA 30033.

      E-mail: camille.vaughan@emory.edu

    Search for more papers by this author
  • Jorge L. Juncos,

    1. Department of Neurology, Emory University, Atlanta, Georgia
    Search for more papers by this author
  • Lynn Marie Trotti,

    1. Department of Neurology, Emory University, Atlanta, Georgia
    Search for more papers by this author
  • Theodore M. Johnson II,

    1. Department of Veterans Affairs Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, Georgia
    2. Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
    Search for more papers by this author
  • Donald L. Bliwise

    1. Department of Neurology, Emory University, Atlanta, Georgia
    2. Departments of Psychiatry/Behavioral Sciences and Nursing, Program in Sleep, Aging and Chronobiology, Emory University, Atlanta, Georgia
    Search for more papers by this author

  • Conflict of interest: Dr. Vaughan receives research support from Astellas. Dr. Trotti serves as a consultant and receives research support from UCB Pharma. Dr. Johnson serves as a consultant for Ferring, Vantia, Pfizer, and Johnson and Johnson and participated in trials for Pfizer and Vantia. Dr. Bliwise is a consultant for Vantia, New England Research Institute and Ferring.
  • Christopher Chapple led the peer-review process as the Associate Editor responsible for the article.

Abstract

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.

Ancillary