Objectives
To investigate the impact of age on the relationship between obstructive sleep apnea
syndrome (OSAS), nocturia, and other lower urinary tract symptoms (LUTSs).
Methods
This was a secondary analysis study based on data derived from a previously conducted
prospective observational cohort study on OSAS and nocturia. We analyzed 90 subjects
who were suspected of having OSAS. Prior to polysomnography, we assessed International
Prostate Symptom Score-Quality of Life scores, Overactive Bladder Symptom Scores,
and International Consultation on Incontinence Modular Questionnaire-Nocturia Quality
of Life scores to evaluate LUTSs. Nocturnal urine volume, night-time frequency, and
night-time urine electrolyte content were measured during polysomnography. Patients
were divided into groups according to age and OSAS severity determined using apnea-hypopnea
index (AHI) scores. Young patients were those aged <65 years and elderly patients,
≥65 years. A multiple linear regression with multiple imputations was performed to
examine the association of night-time frequency with demographic, polysomnographic,
and clinical characteristics.
Results
In young patients, night-time frequency was significantly associated with nocturnal
urine volume, AHI score, and total IPSS. However, night-time frequency in elderly
subjects was not associated with demographic and polysomnographic characteristics.
In order to compare the severity of OSAS, night-time frequency and urinary sodium
content significantly increased only in young patients (P = .007 and .004, respectively).
Conclusion
OSAS is a strong candidate of causative factor for nocturia in younger individuals.
When a younger patient complains nocturia without any urological disorders, OSAS should
be kept in mind as a potential cause of nocturia.
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References
- Effects of age on the clinical features of men with obstructive sleep apnea syndrome.Respiration. 2009; 78: 23-29
- Sleep-disordered breathing and mortality: a prospective cohort study.PLoS Med. 2009; 1000132https://doi.org/10.1371/journal.pmed.1000132
- Association between treated and untreated obstructive sleep apnea and risk of hypertension.JAMA. 2012; 307: 2169-2176
- Endothelial injury markers before and after nasal continuous positive airway pressure treatment for obstructive sleep apnoea hypopnea syndrome.Sleep Breath. 2014; 18: 599-607
- Prevalence and predictors of nocturia in obstructive sleep apnea-hypopnea syndrome-a retrospective study.Sleep. 2003; 26: 61-64
- Changes of circulating atrial natriuretic peptide and antidiuretic hormone in obstructive sleep apnea syndrome.Respiration. 1992; 59: 164-168
- Sleep-disordered breathing as a mechanism for nocturia: preliminary findings.Ostomy Wound Manage. 1999; 45: 52-60
- Obstructive sleep apnea, nocturia and polyuria in older adults.Sleep. 2004; 27: 139-144
- Does frequency of nocturnal urination reflect the severity of sleep-disordered breathing?.J Sleep Res. 2004; 13: 173-176
- Nocturia in sleep-disordered breathing.Sleep Med. 2006; 7: 362-367
- Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment.Am J Obstet Gynecol. 2006; 194: 1399-1403
- Effect of the continuous positive airway pressure on the nocturnal urine volume or night-time frequency in patients with obstructive sleep apnea syndrome.Urology. 2015; 85: 333-336
- The occurrence of sleep-disordered breathing among middle-aged adults.N Engl J Med. 1993; 328: 1230-1235
- Linguistic validation of Japanese version of International Prostate Symptom Score and BPH impact index.Nihon Hinyokika Gakkai Zasshi. 2002; 93: 669-680
- Symptom assessment tool for overactive bladder syndrome-overactive bladder symptom score.Urology. 2006; 68: 318-323
- Development of Japanese version of the Nocturia Quality of Life questionnaire (N-QOL).Jpn J Urol Surg. 2010; 23: 833-838
- The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society.Neurourol Urodyn. 2002; 21: 167-178
- Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research.Sleep. 1999; 22: 667-689
- Epidemiologic survey of lower urinary tract symptoms in Japan.Urology. 2006; 68: 560-564
- The prevalence and causes of nocturia.J Urol. 2013; 189: 86-92
- Nocturia in men less than 50 years of age may be associated with obstructive sleep apnea syndrome.Urology. 2008; 71: 1096-1098
- The impact of sleep apnoea syndrome on nocturia according to age in men.BJU Int. 2012; 110: 851-856
- The impact of obstructive sleep apnea syndrome on nocturnal urine production in older men with nocturia.Urology. 2014; 84: 892-896
- Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms.Can Urol Assoc J. 2016; 10
Article info
Publication history
Published online: May 28, 2020
Accepted:
April 30,
2020
Received:
December 27,
2019
Footnotes
Competing interests: The authors have no competing interests.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.