Nocturia is a complex and multifactorial condition, associated with several genitourinary abnormalities as well as a host of conditions beyond the urinary tract, and thus often poses a significant diagnostic challenge in real-world practice. Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications, the so-called "Sleep C.A.L.M." factors, are five common causes of nocturia requiring judicious evaluation according to current consensus guidelines. This study aims to assess the prevalence of the Sleep C.A.L.M. factors in a nocturia clinical population.
Retrospective analysis of frequency-volume charts from men with ≥2 nocturnal voids as well as concurrent demographic, clinical, and medical history data to identify patients with each of the Sleep C.A.L.M.
Comorbidities and medications were classified as a single group.
A total of 213 subjects met the criteria for inclusion (median age 68.0 [63.5-75.5] years). The prevalence of 1) sleep disorders, 2) comorbidities and/or medication use, 3) actions (i.e., modifiable behaviors/lifestyle factors), and 4) lower urinary tract dysfunction was 31%, 31%, 19%, and 41%, respectively. Among included participants, 73% were found to have at least 1 Sleep C.A.L.M. factor, and 33% had multiple Sleep C.A.L.M.
Results were similar upon stratification by age and nocturnal polyuria status.
The Sleep C.A.L.M. factors are highly common among nocturia patients in the clinical urology setting. Although many of these factors are strongly associated with advanced age in community-based nocturia study samples, they appear common even among younger men in a nocturia patient population; the differential effect of age and individual Sleep C.A.L.M. factors on nocturia pathophysiology requires further investigation.
Neurourology and urodynamics. 2024 Mar 21 [Epub ahead of print]
Thomas F Monaghan, Alexander Fang, Lennox R Ksido, Carla Hachicho, Manahil Muneeb, Syed N Rahman, George Bou Kheir, Jason M Lazar, Karel Everaert, Alan J Wein, Jeffrey P Weiss
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA., Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Department of Urology, Yale University School of Medicine, New Haven, Connecticut, USA., Department of Urology, Ghent University Hospital, Ghent, Belgium., Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Desai Sethi Urology Institute, Department of Urology, University of Miami Health System, Miami, Florida, USA.