Association of sleep-related factors with nocturia

Purpose: Sleep-related factors, such as snoring or sleep duration may be causes for or consequence of nocturia. The purpose of this study was to evaluate the associations between sleep-related factors and nocturia in the absence of sleep disorders.


Materials and Methods: Using the National Health and Nutrition Examination Survey (NHANES) database from 2005/06 to 2017/18, we analyzed respondents who completed the kidney conditions and sleep disorders questionnaires. Respondents who reported a physician-diagnosed sleep disorder, did not provide an answer to this sleep disorder question, or had other conditions impacting nocturia were excluded. After sample weighing, the prevalence of nocturia for responses to sleep-related factors (hours of sleep, work schedule, snoring, snorting or stopping breathing, and sleepiness) was analyzed using chi-square analysis and the association of sleep-related factors to nocturia, accounting for age, gender, race, and BMI, was determined using univariate and multivariate regression.

Results: From the 2005/06–2017/18 NHANES database, 23,895 respondents (11,672 males and 12,223 females; mean age, SD = 45.2, 20.1 years) were included. For sleep-related factors, greatest nocturia prevalence was seen in those sleeping <6 h (38.4%) or >8 h (38.0%), snoring ≥5 nights per week (33.4%), snorting or stopping breathing ≥5 nights per week (38.7%), and feeling sleepy 16–30 times per month (44.7%). Work schedule differences (morning, evening/night, rotating) showed no differences in nocturia prevalence (21.1–22.5%) or significant odds of nocturia. On univariate analysis, nocturia was associated with age (OR = 1.035, p < 0.001), BMI (OR = 1.038, p < 0.001), sleeping <6 h (OR = 1.603, p < 0.001) or >8 h (OR = 1.673, p < 0.001), snoring ≥5 nights per week (OR = 1.192, p = 0.004), snorting or stopping breathing 3–4 nights (OR = 1.425, p < 0.001) to ≥5 nights per week (OR = 1.528, p < 0.001), and feeling sleepy 5–15 times (OR = 1.579, p < 0.001) to 16–30 times per month (OR = 1.970, p < 0.001). On multivariate analysis, only age (OR = 1.035, p < 0.001), BMI (OR = 1.032, p < 0.001), and sleepiness (OR = 1.169, p < 0.001) showed an association with nocturia.

Conclusion: While most sleep-related factors showed increasing prevalence of nocturia at their extremes, only sleepiness showed an association to nocturia on multivariate analysis. Further examination of sleep issues related to nocturia elucidating causality are warranted.

Lakshay Khosla,1 Aaron J. Huang,2 Susan Gong,1 Donald L. Bliwise,3 Jason M. Lazar,4 Jeffrey P. Weiss,1 Abdo E. Kabarriti1

  1. Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
  2. Department of Urology, Stony Brook University, Stony Brook, NY, USA
  3. Division of Sleep Medicine, Department of Neurology, Emory, Atlanta, GA, USA
  4. Division of Cardiovascular Medicine, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
Source: Khosla L, Huang AJ, Gong S, et al. Association of sleep-related factors with nocturia. Continence. 2024. https://doi.org/10.1016/j.cont.2023.101062.