Could Treating Sleep Disorders in Parkinson's Help Bladder Frequency and Urgency

Many patients with Parkinson's disease have episodes during the night where they awaken and have to use the restroom.  This can occur many times and can be disruptive to sleep, and consequently may cause the Parkinson's patient to be fatigued the following day.  Recent information suggests that these episodes disrupt the quality of sleep, and though it is unknown whether treating the sleep disorder can help the urinary symptoms, many Parkinson's experts have begun doing just that.  Here is a recent abstract on sleep studies and urinary symptoms. 

Neurourol Urodyn. 2013 Jan 28. doi: 10.1002/nau.22365. [Epub ahead of print]

Nocturia and overnight polysomnography in Parkinson disease.

Vaughan CP, Juncos JL, Trotti LM, Johnson TM 2nd, Bliwise DL.

Source

Department of Veterans Affairs Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, Georgia; Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia. camille.vaughan@emory.edu.

Abstract

AIM:

Characterize clinical factors related to nocturia and sleep disruption in Parkinson disease (PD) using polysomnography (PSG).

METHODS:

Sixty-three PD patients were recruited regardless of sleep or voiding complaints from a university-based movement disorders clinic for a 48 hr inpatient PSG protocol. Nocturia frequency and bother related to urinary symptoms were assessed using the International Prostate Symptom Score (IPSS) and were corroborated by measurements of PSG-defined sleep made immediately preceding and subsequent to each in-lab voiding episode. PSG measures included whole-night total sleep time (TST), sleep efficiency (SE), apnea/hypopnea index (AHI), and time to PSG-defined sleep following nocturia episodes. Differences between groups were assessed using Mantel-Haenszel chi-square, t-tests, or Wilcoxon signed rank tests. Linear regression was used to assess factors associated with reported nocturia frequency.

RESULTS:

Sixty patients completed the IPSS. Thirty-seven (61%) reported at least two nocturia episodes nightly; those individuals demonstrated lower PSG-defined SE (P = 0.01) and TST (P = 0.02) than patients with 0-1 episodes. Participants reporting 2-3 episodes of nocturia with high bother on the IPSS (n = 12) demonstrated lower whole-night TST (280.5 ± 116.1 min vs. 372.5 ± 58.7 min, P = 0.03) and worse SE (59.2 ± 22.7% vs. 75.9 ± 11.2%, P = 0.04) when compared to participants with 2-3 episodes of nocturia with low bother (n = 13).

CONCLUSIONS:

These results verify objectively that PD patients with nocturia have poor sleep. Furthermore, among individuals with comparable levels of reported nocturia, higher bother is associated with poorer sleep as defined on PSG. Neurourol. Urodynam. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

To read more books and articles by Michael S. Okun MD check Twitter @MichaelOkun and these websites with blogs and information on his books and http://parkinsonsecrets.com/ #EndingPD and https://www.tourettetreatment.com/