Difficulty with sleep may impact LUTS in men

Lower urinary tract symptoms (LUTS) are not just a problem with staying asleep. Difficulty with sleep may actually impact LUTS. That was the message of researchers at Baylor College of Medicine in Houston, who presented new study findings at a press conference during the 2015 AUA annual meeting in New Orleans.

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Researchers looked at the incidence of LUTS among men working non-standard hours (defined as “starting before 7 a.m. or after 2 p.m., rotating, or regularly including hours outside of the standard 7 a.m. to 6 p.m. work day”), to determine whether quality of sleep may contribute to these symptoms. Examining responses from 239 male workers with non-standard shift work, they found those who reported problems falling asleep or staying asleep had more severe LUTS compared to men who did not experience these difficulties.

In addition, men who reported a decreased sense of well-being or decreased physical and/or mental function, as a result of their work, also had worse LUTS.

“Men who had more difficulty falling asleep had an IPSS of 7.1 compared to a 4.9 in men who had no difficulty falling asleep. I think that’s the big take home,” said co-author Jason Scovell, a medical student at Baylor College of Medicine.

Interesting: 90% of men with LUTS do not undergo treatment

“We always ask questions of what kind of work do you do and so on, but the questions usually stop at that point,” said moderator Howard L. Adler, MD, who encouraged physicians to ask patients about shift and when they go to sleep. “There are a number of different sleep disorders and this may become impetus to really start to identifying those patients who have disorders and getting them to people, where necessary, who actually deal with sleep disorders,” said Dr. Adler, associate professor of urology and medical director of the Prostate Care Program at Stony Brook Medicine, Stony Brook, NY.

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Best practices

“These men need to be counseled regarding how to optimize their sleep, and I think a bigger emphasis needs to be put on their sleep patterns,” said first author Alexander W. Pastuszak, MD, PhD, who recommended “a more holistic approach to the patient.”

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“The impact on sleep and how that ties into urinary symptoms hasn’t really been studied,” said Dr. Adler. “This paper takes a nice starting look at that and opens the door to conversation for physicians to have with their patients. As it’s been said by Jason Scovell and certainly in the literature that I looked at, we know that non-standard shift work and impaired sleep patterns affect many aspects of a patient’s health. As Dr. Pastuszak said, we need to look at the overall patient.”

“I hope over the next couple of years we start to recognize that shift work is a big problem,” said Scovell. “Shift workers do comprise 15% to 25% of the U.S. work force, and I don’t think that there’s really anything that we’re going to do to change that. I think it’s just important as urologists and physicians to understand that this is a health problem and talk to patients about how they can mitigate these health issues.”