Effect on Serotonin Uptake Inhibitors (SSRI) on Nocturnal Urinary Frequency: A Retrospective Study

Boris Medarov, MD; Haroon Chaudry, MBBS; Johnathan Sun, DO

PURPOSE: Anectdotal data suggest that SSRI's may increase urinary frequency, especially in patients suffering of overactive bladder. Increased urinary frequency at night has a significant negative impact on the quality of sleep. This study was designed to evaluate the impact of SSRI's on the urinary frequency at night in patients undergoing nocturnal polysomnography. Hypothesis: SSRI's increase nocturnal urinary frequency.

METHODS: Study design: Retrospective chart review. Study population: all patients 18 years and older undergoing polysomnography in the period 9/2012-8/2013. Exclusion criteria: diuretic use after 12 pm; documented history of chronic kidney disease or creatinine > 2, incontinence requiring diapers. Primary outcome: nocturnal urinary frequency in patients on SSRIs vs patients not taking an SSRI. Data collected: demographics, use of SSRI, number of bathroom visits, use of antocholinergic agents, sleep architecture, awake time after sleep onset, history of congestive heart failure, overactive bladder. Statistical anlysis: The study population was divided into 2 groups- subjects on SSRIs and subjects not taking SSRIs. The average number of batthroom visits per night was calculated for both groups and the means were compared using a non-paired student t-test.

RESULTS: Total of 317 subjects were reviewed. There was no significant demographic differencfes between the subjects treated with an SSRI (n=89) and the ones not on an SSRI (n=228). The average number of bathroom visits per night was found to be 0.40 in the SSRI group and 0.33 in the non-SSRI group (p=0.40).

CONCLUSIONS: This study failed to confirm the hypothesis that SSRIs increase nocturnal urinary frequency. The reason for that may be 1. SSRIs are not associated with nocturnal frequency; 2. SSRIs are associated with worsening nocturia only in a specific population (e.g. patients with hyperactive bladder); 3. The power of our study was not sufficient to detect a real associationn betgween frequency and SSRI's (type 2 error).

Chest. 2015;148(4_MeetingAbstracts):1063A. doi:10.1378/chest.2267494