The association of nocturia with sleep disorders and metabolic and chronic pulmonary conditions: data derived from the polysomnographic evaluations of 730 patients

To evaluate the prevalence of nocturia among different degrees of obstructive sleep apnea (OSA) and its association with various clinical conditions. Materials and methods: In 730 OSA patients, the prevalence and frequency of nocturia was determined, and the association of nocturia with clinical and laboratory variables such as the apnea-hypopnea index (AHI), apnea duration, and minimum oxygen saturation and clinical conditions such as diabetes mellitus, coronary heart disease, and chronic obstructive pulmonary disease (COPD) was determined. Results: The overall prevalence of nocturia (>=2 wakes/night) was 50.9%. Prevalences of nocturia in simple snoring and mild, moderate, and severe OSA patients were 40.6%, 44.4%, 58.6%, and 57.1%, respectively (P < 0.005). The frequency of nocturia significantly increases with the severity of OSA (1.4 ± 1.0 wakes/night in mild OSA vs. 2.0 ± 1.4 wakes/night in severe OSA, P = 0.001). Age, AHI, average oxygen saturation, and presence of diabetes mellitus, hypertension, and COPD were found to be significant risk factors associated with nocturia (P < 0.001). Conclusion: The frequency of nocturia increases as the severity of OSA increase. The increased prevalence of nocturia in patients with OSA, diabetes mellitus, hypertension, and COPD indicates the complex physiological background of this bothersome urologic symptom.
Anahtar Kelimeler:

Key words: Sleep, apnea, nocturia

The association of nocturia with sleep disorders and metabolic and chronic pulmonary conditions: data derived from the polysomnographic evaluations of 730 patients

To evaluate the prevalence of nocturia among different degrees of obstructive sleep apnea (OSA) and its association with various clinical conditions. Materials and methods: In 730 OSA patients, the prevalence and frequency of nocturia was determined, and the association of nocturia with clinical and laboratory variables such as the apnea-hypopnea index (AHI), apnea duration, and minimum oxygen saturation and clinical conditions such as diabetes mellitus, coronary heart disease, and chronic obstructive pulmonary disease (COPD) was determined. Results: The overall prevalence of nocturia (>=2 wakes/night) was 50.9%. Prevalences of nocturia in simple snoring and mild, moderate, and severe OSA patients were 40.6%, 44.4%, 58.6%, and 57.1%, respectively (P < 0.005). The frequency of nocturia significantly increases with the severity of OSA (1.4 ± 1.0 wakes/night in mild OSA vs. 2.0 ± 1.4 wakes/night in severe OSA, P = 0.001). Age, AHI, average oxygen saturation, and presence of diabetes mellitus, hypertension, and COPD were found to be significant risk factors associated with nocturia (P < 0.001). Conclusion: The frequency of nocturia increases as the severity of OSA increase. The increased prevalence of nocturia in patients with OSA, diabetes mellitus, hypertension, and COPD indicates the complex physiological background of this bothersome urologic symptom.

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  • Collop NA, Cassel DK. Snoring and sleep disordered breathing. In: Chiong TLL, Sateie MJ, Carskadon MA, editors. Sleep Medicine. Philadelphia, PA, USA: Hanley and Belfus; 2002. pp. 349–55. van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose GR, Mattiasson A et al. The standardization of terminology in nocturia: report from the Standardization Sub-committee of the International Continence Society. BJU 2002; 90 (Suppl. 3): 11–5.
  • Abrams P. Nocturia: the effect on sleep and health consequences. Eur Urol Supplements 2005; 3: 1–7.
  • Schatzl G, Temml C, Schmidbauer J, Dolezal B, Haidinger G, Madersbacher S. Cross-sectional study of nocturia in both sexes: analysis of a voluntary health screening project. Urology 2000; 56: 71–5.
  • Abrams P. Nocturia: the major problem in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO). Eur Urol Supplements 2005; 3: 8–16.
  • Hajduk IA, Strollo PJ, Jasani RR, Atwood CW, Houck PR, Sanders MH. Prevalence and predictors of nocturia in obstructive sleep apnea-hypopnea syndrome – a retrospective study. Sleep 2003; 26: 61–4.
  • Kaynak H, Kaynak D, Oztura I. Does frequency of nocturnal urination reflect the severity of sleep-disordered breathing? J Sleep Res 2004; 13: 173–6.
  • Oztura I, Kaynak D, H C Kaynak. Nocturia in sleep-disordered breathing. Sleep Med 2006; 7: 362 –7.
  • Krieger J, Petiau C, Sforza E, Delanoe C, Hecht MT, Chamouard V. Nocturnal pollakiuria is a symptom of obstructive sleep apnea. Urol Int 1993; 50: 93–7.
  • Umlauf MG, Chasens ER. Sleep disordered breathing and nocturnal polyuria: nocturia and enuresis. Sleep Med Rev 2003; 7: 403–11.
  • Margel D, Shochat T, Getzler O, Livne PM, Pillar G. Continuous positive airway pressure reduces nocturia in patients with obstructive sleep apnea. Urology 2006; 67: 974–7.
  • Krieger J, Follenius M, Sforza E, Brandenberger G, Peter JD. Effects of treatment with nasal continuous positive airway pressure on atrial natriuretic peptide and arginine vasopressin release during sleep in patients with obstructive sleep apnoea. Clin Sci 1991; 80: 443–9.
  • Rechtschaffen A, Kales A. A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects. Los Angeles, CA, USA: UCLA Brain Research Institute; 1968.
  • Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. 1st ed. Westchester, IL, USA: American Academy of Sleep Medicine; 2007.
  • American Academy of Sleep Medicine. International Classification of Sleep Disorders (ICSD): Diagnostic and Coding Manual. 2nd ed. Westchester, IL: American Academy of Sleep Medicine; 2005.
  • Yoshimura K, Terada N, Matsui Y, Terai A, Kinukawa N, Arai Y. Prevalence of and risk factors for nocturia: analysis of a health screening program. Int J Urol 2004; 11: 282 –7.
  • Klein BE, Klein R, Lee KE, Bruskewitz RC. Correlates of urinary symptom scores in men. Am J Public Health 1999; 89: 1745–8.
  • Parthasarathy S, Fitzgerald MP, Goodwin JL, Unruh M, Guerra S, Quan SF. Nocturia, sleep-disordered breathing, and cardiovascular morbidity in a community-based cohort. PLoS ONE 2012; 7: e30969.
  • Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet 1991; 24: 469 –
  • Hale WE, Perkins LL, May FE, Marks RG, Stewart RB. Symptom prevalence in the elderly. An evaluation of age, sex, disease, and medication use. J Am Geriatr Soc 1986; 34: 333–40.
  • Lin CC, Tsan KW, Lin CY. Plasma levels of atrial natriuretic factor in moderate to severe obstructive sleep apnea syndrome. Sleep 1993; 16: 37–9.
  • Follenius M, Krieger J, Krauth MO, Sforza F, Brandenberger G. Obstructive sleep apnea treatment: peripheral and central effects on plasma renin activity and aldosterone. Sleep 1991; 14: 211–7.
  • Arai H, Furuta H, Kosaka K. Polysomnographic and urodynamic changes in a case of obstructive sleep apnea syndrome with enuresis. Psychiatry Clin Neurosci 1999; 53: 319–20.
  • Gökçe A, Aslan S, Yalçınkaya FR, Davarcı M, Kaya YS, Savaş N, Görür S, Dağlı Ş, Kiper AN, Balbay MD. Improvement of monosymptomatic enuresis after adenotonsillectomy in children with obstructive sleep apnea syndrome. Turk J Med Sci 2012; 42: 757–61.
  • Odabaş Ö, Ceylan C, Yığman M. Does the treatment of obstructive sleep apnea syndrome improve lower urinary tract symptoms? Turk J Med Sci 2012; 42: 619–22.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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