Introduction:
Nocturia causes sleep disturbances and is more common as people age. Therefore, it often overlaps with cardiometabolic risk factors. However, relationships between nocturia frequency and cardiometabolic risk as not been explored, over and above covariates such as age, sex, sleep duration, etc.
Methods:
Data from the 2015-2016 National Health and Nutrition Examination Survey was used. Nocturia was coded as 0 times/night, 1 time/night, 2-3 times/night, and 4-5+ times/night. Cardiometabolic disease risk factors examined included history of hypertension, taking antihypertensive medication, history of hypercholesterolemia, taking cholesterol-lowering drugs, diabetes, obesity, smoking, and poor diet. Covariates included age sex, education, race/ethnicity, income-poverty ratio, and habitual sleep duration category (very short, short, normal, and long). Logistic regression analyses were analyzed using NHANES sampling weights.
Results:
In adjusted analyses, the highest category of nocturia (4-5+ times per night) was associated with increased likelihood of hypertension (OR=2.12, 95%CI [1.34,3.38], p=0.001), antihypertensive medication (OR=2.52, 95%CI [1.56,4.09], p<0.0005), diabetes (OR=3.44, 95%CI [2.09,5.68], p<0.0005), hypercholesterolemia (OR=1.81, 95%CI [1.18,2.75], p=0.006), cholesterol-lowering medication (OR=2.25, 95%CI [1.38,3.68], p=0.001), poor diet (OR=2.17, 95%CI [1.41,3.34], p<0.0005), and obesity (OR=2.16, 95%CI [1.40,3.32], p<0.0005), but not smoking. Nocturia 2-3 times per night was also associated with increased likelihood of antihypertensive use (OR=1.40, 95%CI [1.04,1.88], p=0.025), diabetes (OR=1.85, 95%CI [1.27,2.71], p=0.001), hypercholesterolemia (OR=1.43, 95%CI [1.09,1.88], p=0.010), cholesterol-lowering medications (OR=1.81, 95%CI [1.31,2.51], p<0.0005), and obesity (OR=1.52,95%CI [1.18,1.96], p=0.001). When obesity was added as a covariate, significant relationships were still seen for hypertension, antihypertensive medication, diabetes, hypercholesterolemia, cholesterol-lowering medications, and poor diet.
Conclusions:
Frequent nocturia is associated with a wide range of cardiometabolic risk factors, after adjusting for age, sleep duration, and a wide range of other potential factors, as well as obesity. Complaints of nocturia might be considered an independent risk factor. Mechanisms, such as sleep fragmentation, should be explored.