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Author Notes:

Corresponding Author: Andre B. Araujo, PhD, Vice President of Epidemiology, New England Research Institutes, Inc., Watertown, MA 02472, Tel: 617.972.3152, Fax: 617.673.9509, aaraujo@neriscience.com.

The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMHD, NIDDK, NIH, VA, SIU Urology Endowment Fund, or Havana Day Dreamers Foundation.

Conflicts of Interest: None


Research Funding:

This study was supported by the following awards: R21MD006769 from the National Institute on Minority Health and Health Disparities; U01DK056842 from the National Institute of Diabetes and Digestive and Kidney Disorders; CDTA 150S829 from the VA Clinical Science Research and Development Career Development Program; SIU Urology Endowment Fund, Havana Day Dreamers Foundation.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Urology & Nephrology
  • cohort studies
  • epidemiology
  • sleep
  • urologic diseases
  • MEN

Sleep Related Problems and Urological Symptoms: Testing the Hypothesis of Bidirectionality in a Longitudinal, Population Based Study


Journal Title:

Journal of Urology, The


Volume 191, Number 1


, Pages 100-106

Type of Work:

Article | Post-print: After Peer Review


Purpose: We evaluate the bidirectional association between urological symptoms (urinary incontinence, lower urinary tract symptoms and nocturia) and sleep related variables. Materials and Methods: Data were obtained from a prospective cohort study of 1,610 men and 2,535 women who completed baseline (2002 to 2005) and followup (2006 to 2010) phases of the BACH (Boston Area Community Health) Survey, a population based random sample survey. Sleep restriction (5 hours or less per night), restless sleep, sleep medication use and urological symptoms were assessed by self-report. Urinary incontinence was defined as weekly leakage or moderate/severe leakage, lower urinary tract symptoms (overall, obstructive, irritative) were defined by the AUA-SI (American Urological Association symptom index) and nocturia was defined as urinary frequency 2 or more times per night. Results: At the 5-year followup 10.0%, 8.5% and 16.0% of subjects newly reported lower urinary tract symptoms, urinary incontinence and nocturia, respectively, and 24.2%, 13.3% and 11.6% newly reported poor sleep quality, sleep restriction and use of sleep medication, respectively. Controlling for confounders, the odds of urological symptoms developing were consistently increased for subjects who reported poor sleep quality and sleep restriction at baseline, but only baseline nocturia was positively associated with incident sleep related problems at followup. Body mass index, a potential mediator, reduced selected associations between sleep and incident urinary incontinence and irritative symptoms, but C-reactive protein did not. Conclusions: These data suggest that self-reported sleep related problems and urological symptoms are linked bidirectionally, and that body mass index may be a factor in the relationship between sleep and the development of urological symptoms.

Copyright information:

© 2014 by American Urological Association Education Research, Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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