A multicenter cross-sectional study on the correlation between lower urinary tract symptoms and sleep status in...

This multicenter cross-sectional study aimed to identify factors associated with lower urinary tract symptoms (LUTS) and to examine the relationship between LUTS, voiding behaviors, and sleep quality among female nurses aged ≥40 years in Shandong Province, China.

Using a two-stage stratified cluster sampling design based on regional economic status, we selected 20 public tertiary hospitals and enrolled 2,455 eligible female nurses. LUTS were assessed using the validated Chinese version of the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), voiding behaviors with the Voiding Behavior Questionnaire, and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Multivariable binary logistic regression was used to identify factors associated with LUTS.

Age, BMI, cesarean section, vaginal delivery, constipation, diarrhea, daily fluid intake (≤500 mL) and coffee consumption were independently associated with LUTS (p < 0.05). Total LUTS score, total voiding behavior score and subdomain scores were positively correlated with PSQI score (p < 0.05). Hierarchical regression analysis showed that LUTS (yes/no), total voiding behavior score and the "urine holding" subdomain score entered the regression equation, collectively explaining 12% of the variance in sleep quality (p < 0.05).

LUTS and maladaptive voiding behaviors, particularly habitual urine holding, are significantly correlated with poor sleep quality in female nurses aged ≥40 years. Occupational health interventions targeting modifiable voiding behaviors may offer a novel approach to improving sleep in this high-risk population. Future longitudinal studies are needed to establish causality.