Nocturia and associated mortality: observational data from the REDUCE trial

Importance: Nocturia (voids arising from sleep) is a ubiquitous phenomenon reflecting many diverse conditions, but whether it has significance in its own right remains uncertain. Objective: To determine whether nocturia is an independent risk factor for mortality Design: Observational study Setting: Global study with most sites in North America and Europe Participants: 7,343 men, ages 50-75 at Baseline from the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) trial Exposures: Nocturia Main Outcome and Measures: Cox proportional hazards models were used to test the association between nocturia (voiding 3 more times per night) and all-cause mortality. Potential confounding variables included: age, race, region of origin, treatment group, self-reported coronary artery disease, diabetes mellitus, hypertension, and peripheral vascular disease, smoking, alcohol use, prostate volume, and diuretics. Self-reported sleep quality, as measured with the Medical Outcomes Study sleep scale, was entered as a final step in the model. Results: Nocturia was associated with increased risk for mortality (Hazard Ratio [HR] = 1.72; 95% CI 1.15-2.55) independent from all demographics and medical comorbidities. Inclusion of disturbed sleep in the model reduced the magnitude of the association (HR = 1.43; 95% CI 0.93-2.19). Conclusions and Relevance: The interruption of sleep by nocturia may have long-term impact on health and may warrant targeted intervention.