The relationship between lower urinary tract symptom severity and sleep disturbance in the CAMUS trial

J Urol. 2011 Jun;185(6):2223-8. doi: 10.1016/j.juro.2011.02.012. Epub 2011 Apr 17.


Purpose: Bothersome lower urinary tract symptoms, including nocturia, significantly impact general health related quality of life in men, as does sleep disturbance. However, few groups have examined the relationship between urinary symptom severity and sleep disturbance.

Materials and methods: Men enrolled in a clinical trial of saw palmetto (Serenoa repens) were studied at baseline. Lower urinary tract symptom severity, as determined by the American Urological Association symptom index and quality of life scores, and the degree of sleep disturbance were determined by the Jenkins sleep scale. Analysis was done, adjusting for baseline characteristics, to identify predictors of severe sleep disturbance.

Results: A total of 366 men with a mean ± SD age of 60.9 ± 8.3 years who had moderate-severe lower urinary tract symptoms (mean American Urological Association symptom index score 14.58 ± 4.6 points) and a mean Jenkins sleep score of 7.3 ± 4.7 points were included in analysis. Overall there were significant associations between the American Urological Association symptom index score and sleep disturbance severity. Multivariate analysis revealed that obstructive and irritative symptoms were significantly associated with severe sleep disturbance. Further analysis showed that lower serum prostate specific antigen and post-void residual urine volume were also significantly associated with the degree of sleep disturbance.

Conclusions: Lower urinary tract symptom severity is a risk factor for severe sleep disturbance in men. While nocturia was significantly associated with sleep disturbance, other lower urinary tract symptoms were also independent predictors of sleep dysfunction.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Male
  • Middle Aged
  • Plant Extracts / therapeutic use
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / drug therapy
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Sleep Wake Disorders / etiology*
  • Urologic Diseases / complications*
  • Urologic Diseases / etiology


  • Plant Extracts
  • saw palmetto extract