Impact of nocturia on steep efficiency in patients with benign prostatic hypertrophy

Objective. - To assess steep efficiency in patients presenting with nocturia and symptomatic benign prostatic hypertrophy (BPH). Material and methods. - This prospective observational survey was carried out in France by 113 urologists. A total of 1376 patients (mean +/- SD age: 68.8 +/- 9.0 years) consulting for BPH with greater than two nocturia episodes per 24 hours were assessed with a mean I-PSS score of 15.5 +/- 6.4 (symptoms greater than 19 [severe] in 26.9% of cases). Patients used a steep diary to record the previous night's total; steep efficiency is expressed as percentage ratio, representing the total amount of actual steep between initial steep onset and final awakening. Steep disorders were assessed using HD-43 questionnaire based on International classification of steep disorders. Results. - 29.2% of the patients suffered from chronic insomnia, considered as primary insomnia (in 29.5% of cases) or related to either BPH (63.0%); snoring/sleep apnoea in 12.5% of cases. The mean sleep efficiency index was 87.2 +/- 13.7% and appeared to be significantly lower in BPH-related insomnia. Significantly tower steep efficiency index values were observed as the severity (I-PSS score) of the BPH symptoms increased (89.5 +/- 12.1% for mildly symptomatic BPH vs. 84.0 +/- 15.6% for severely symptomatic BPH, P < 0.001). Steep efficiency index lowered with nocturia frequency (89.8 +/- 11.3% for two nocturia episodes vs. 80.4 +/- 17.3% for five nocturia episodes or more, P < 0.001) and chronic insomnia frequency increased with nocturia frequency (21.4% for two nocturia episodes vs. 45.2% for five nocturia episodes or more, P < 0.001). Conclusions. - Insomnia is frequent in patients presenting with BPH-related tower urinary tract symptoms (LUTS) and is mainly secondary to these LUTS. There is a significant correlation between the frequency of nocturia and the severity of insomnia. (C) 2008 Elsevier Masson SAS. All rights reserved.