MP09-08 SLEEPING PROBLEMS ARE ASSOCIATED WITH INCREASED RISK OF BPH PROGRESSION: RESULTS FROM REDUCE

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical & Non-surgical Therapy1 Apr 2017MP09-08 SLEEPING PROBLEMS ARE ASSOCIATED WITH INCREASED RISK OF BPH PROGRESSION: RESULTS FROM REDUCE Brandee Branche, Lauren Howard, Daniel Moreira, Ramiro Castro-Santamaria, Gerald Andriole, Martin Hopp, and Stephen Freedland Brandee BrancheBrandee Branche More articles by this author , Lauren HowardLauren Howard More articles by this author , Daniel MoreiraDaniel Moreira More articles by this author , Ramiro Castro-SantamariaRamiro Castro-Santamaria More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , Martin HoppMartin Hopp More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.316AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While there is a known correlation between nocturia due to BPH and sleep disturbance, it is unknown if sleep disturbances affect BPH development and symptom progression. We examined the relationship between sleep problems as measured by the Medical Outcomes Study Sleep Scale (MOSSS-6) questionnaire and BPH development and progression in the placebo arm of the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study. METHODS REDUCE was a 4-year trial testing prostate cancer chemoprevention with dutasteride in men with a PSA 2.5-10 ng/ml and a negative biopsy. At baseline, men completed the MOSSS-6 questionnaire, a 6-item scale that assesses sleep and is scored 1-100. Men were followed for 4 years and the International Prostate Symptom Scores (IPSS) was obtained at baseline and every 6 months. In men without symptomatic BPH at baseline (IPSS<8), we defined BPH development as two values of IPSS >14, any surgical procedure for BPH, or the start of a drug for BPH. In men with symptomatic BPH at baseline (IPSS≥8), BPH symptom progression was defined as ≥4 IPSS increase from baseline, any surgical procedure for BPH, or the start of a drug for BPH. In men in the placebo arm and not taking alpha blockers or 5-alpha reductase inhibitors at baseline (n=2,588), we tested the association between sleep problems as measured by the MOSSS-6 and BPH development and BPH progression using Cox models, adjusting for age, race, body mass index (BMI), smoking, digital rectal exam, prostate volume, PSA, and baseline IPSS. RESULTS During follow-up, 209/1452 men (14%) without BPH at baseline developed BPH and 527/1136 men (46%) with BPH progressed. Median age was 62 (IQR: 58-67) and 90% were white. Median BMI was 26.8 kg/m2 (IQR: 24.7-29.1) and 15% were current smokers. Median MOSSS-6 score was 17 (IQR: 7-27). On multivariable analysis, higher MOSSS-6 scores were associated with increased risk of BPH development in men without BPH at baseline (HR 1.28, p=0.014). Among men with BPH at baseline, higher MOSSS-6 scores were associated with increased risk of BPH symptom progression (HR 1.23, p<0.001). CONCLUSIONS Among men with BPH symptoms, worse sleep scores predicted the risk of BPH symptom progression. Among asymptomatic men, worse sleep scores predicted the development of BPH. As it is often inferred that BPH leads to sleep problems, the fact that sleep problems in asymptomatic men predict BPH development suggests BPH symptoms may be a manifestation of sleep problems rather than the reverse. Whether treating sleep problems improves BPH symptoms needs to be tested. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e102 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Brandee Branche More articles by this author Lauren Howard More articles by this author Daniel Moreira More articles by this author Ramiro Castro-Santamaria More articles by this author Gerald Andriole More articles by this author Martin Hopp More articles by this author Stephen Freedland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...