A recent study presented at the 2017 American Urological Association meeting in Boston, states that men who deal with sleep issues have an associated increased risk and progression of developing benign prostatic hyperplasia (BPH). 

These findings are from research conducted at Duke University of an analysis of data from 2,588 men participating in the placebo arm of the 4-year REDUCE (Reduction by Dutasteride of Prostate Cancer Events) trial.  It is well-known that there is a strong correlation between men with BPH and nocturia or the need to urinate two or more times during the night.  This issue can be very distressing for men with BPH who end up not obtaining a full night’s sleep without interruption resulting in waking up unrested and tired the next day.

This study wanted to explore the relationship between sleep disturbances and how that affected BPH development and symptom progression.  To do this the researchers 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 4-year REDUCE study.

At baseline, none of the participants were taking alpha blockers or 5-alpha reductase inhibitors.  Each participant took the MOSSS-6 questionnaire assessing their sleep.  Over the course of the 4-year REDUCE study, all of the men were followed with investigators obtaining International Prostate Symptoms Score (IPSS) at baseline and then every 6 months.

To assess men the difference between men without BPH symptoms compared to men with BPH symptoms, men who did not have symptoms at baseline (IPSS less than 8) were considered to have BPH development as 2 values of IPSS greater than 14.  For men who were symptomatic at baseline (IPSS 8 or higher), BPH progression was defined as a 4 or greater increase IPSS increase from baseline, or had any surgical procedure for BPH or had started a medication for BPH. 

What was found was that in 1,452 men without any symptoms of BPH at baseline, 209 of these men or 14% developed BPH.  Of the 1,136 men who did have symptoms of BPH at baseline, 527 of them or 46% experienced BPH progression.  Men without BPH at baseline who had higher MOSSS-6 scores had an associated significant 28% increased risk of BPH development.  The men who already had BPH at baseline, those with a higher MOSSS-6 score had an associated significant 23% increased risk of BPH progression.

This finding contradicts the understood belief that what leads to sleep disturbances of increased nocturia in men was due to BPH.  Now, this study is suggesting that men who are asymptomatic but yet still have nocturia or sleep problems and who go on to develop BPH, may be a manifestation that sleep problems is what leads to BPH and not vice versa. 

Because of this finding, it does warrant further studies to determine if treating a man’s sleep problems could help reduce BPH symptoms and the progression of it.