Nocturia in Men Less Than 50 Years of Age May Be Associated with Obstructive Sleep Apnea Syndrome

Moriyama, Yoji; Miwa, Kosei; Tanaka, Haruhito; Fujihiro, Shigeru; Nishino, Yoshinori; Deguchi, Takashi

doi:10.1016/j.urology.2008.02.038

Cited by 59 publications

(31 citation statements)

References 14 publications

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“…Previous reports have indicated that the prevalence of nocturia among patients with OSAS (≥2 urinations per night) ranges from 40-50%. [17][18][19] The results of the present study are consistent with those findings and indicate that nocturia is a general symptom of moderate-to-severe OSAS. However, most patients (and even physicians) do not recognize the association between nocturia and OSAS.…”

Section: Discussionsupporting

confidence: 91%

Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms

Maeda

Fukunaga

Nagata

et al. 2016

CUAJ

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Introduction: This study aimed to evaluate urination frequency among patients with obstructive sleep apnea syndrome (OSAS) and the effect of continuous positive airway pressure (CPAP) treatment.Methods: We evaluated 138 men with moderate-to-severe OSAS by using polysomnography. Urination status was assessed at baseline and three months using the International Prostate Symptom Score and Overactive Bladder Symptom Score. Nocturia was defined as ≥2 nighttime urinations and patients were classified into Group A (<50 years old with nocturia), Group B (≥50 years old with nocturia), and Group C (patients without nocturia). OSAS severity and other urinary symptoms were also evaluated.Results: Patients with nocturia exhibited more severe OSAS, compared to patients without nocturia (apnea-hypopnea index [AHI]: 52.0 vs. 44.7; p=0.021). Group A had the worst AHI, but did not have additional voiding symptoms, compared to Group B (p<0.001). The number of urinations was significantly correlated with OSAS severity in <50-year-old patients (p=0.013). CPAP reduced the number of urinations in Group A (75% of patients) and Group B (90% of patients). Patients with and without improved nocturia exhibited significant differences in their baseline OSAS severity (AHI: 53.7 vs. 37.3; p=0.042).Conclusions: OSAS severity was associated with the number of urinations in <50-year-old patients. CPAP decreased the nocturia frequency in 85% of patients with nocturia and was most effective in patients with severe AHI. However, additional studies should evaluate voiding volume in order to elucidate the mechanism of nocturia in patients with OSAS.

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Section: Discussionsupporting

confidence: 91%

Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms

Maeda

Fukunaga

Nagata

et al. 2016

CUAJ

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“…However, no associations have been found between the frequency of nocturia and the symptoms of SDB in older populations, as in our patients (23). It was believed that an association between SDB and nocturia in the older population has not been confirmed due to the increased rate of urological symptoms leading to LUTS in elderly patients.…”

Section: Discussioncontrasting

confidence: 78%

Prevalence of Sleep Disordered Breathing among Patients with Nocturia at a Urology Clinic

et al. 2016

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Objective We assessed the prevalence of sleep disordered breathing (SDB) and characteristics among patients who visited a urology clinic complaining of nocturia (URO group) and those who visited a sleep apnea (SA) clinic complaining of excessive daytime sleepiness (EDS) (SA group). Additionally, we evaluated the effects of continuous positive airway pressure (CPAP) therapy in the URO group patients with nocturia and SDB resistant to conventional therapy for nocturia. Methods Questionnaires were used to assess EDS, nocturia and lower urinary tract symptoms in 34 URO group patients and 49 age-matched SA group patients. We also compared these factors in the male patients in both groups and the male and female patients in the SA group. Significant SDB was diagnosed as a 3% oxygen desaturation index (3%ODI) on pulse oximeter of >5/h. The treatment response was analyzed in six URO group patients treated with CPAP after not responding to the conventional medical treatment. Results SDB was found in 91.8% of the SA group patients and 70.6% of the URO group patients. The level of EDS and lower urinary tract symptoms were similar in both groups. The SA group showed higher 3%ODI values, while the frequency of urination during bedtime was higher in the URO group. The frequency of nocturnal urination was reduced after CPAP in the subjects resistant to conventional therapy. Conclusion SDB is as prevalent in patients who visit a urology clinic complaining of nocturia as in those who visit a sleep apnea clinic. Patients who complains of nocturia must be assessed for SDB before starting therapy for nocturia.

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“…11 Patients with OSA occasionally experience nocturia, which is a particularly important issue in patients of advanced age, as it may impair their quality of life. 12 The major complaint in patients with nocturia is waking up at night one or more times to void. 13 Furthermore, nocturia in elderly people is associated with high mortality rates.…”

mentioning

confidence: 99%

Nocturia in Patients With Sleep-Disordered Breathing and Cardiovascular Disease

Miyazaki

Kojima

Yamamuro

et al. 2015

Circ J

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Background: Sleep apnea is a common condition and a cardiovascular risk factor. Continuous positive airway pressure (CPAP) reduces cardiovascular events and sleep apnea-related symptoms, especially in patients with obstructive sleep apnea (OSA), who occasionally experience nocturia, a common problem in individuals of advanced age. Methods and Results:The present study was a prospective, observational study including 1,429 consecutive patients with cardiovascular disease (CVD). A questionnaire on nocturia was administered and nocturnal pulse oximetry was performed. Patients with moderate-to-severe sleep-disordered breathing (SDB) underwent polysomnography, and patients with OSA received CPAP therapy. Nocturia was observed in 561 of 666 patients included in the analysis. A multiple logistic regression analysis revealed that nocturia was associated with oxygen desaturation defined as a 3% decrease (P=0.0335) independent of age (P<0.0001), male sex (P=0.0078), hypertension (P=0.0139), and B-type natriuretic peptide (BNP) level (P=0.0185). Nocturia was reduced in patients who continued CPAP treatment and they also showed a decrease in the apnea-hypopnea index (45.3±13.6 vs. 2.5±3.7 events/h, P<0.0001), systolic blood pressure (121.6±11.9 vs. 113.4±8.8 mmHg, P=0.0002), and BNP level (57.7 [15.0-144.4] vs. 27.4 [8.5-111.7] pg/ml, P=0.0006).Conclusions: CPAP has the potential to reduce nocturia and risk factors for SDB such as increased blood pressure and BNP level, which may be beneficial in older men with CVD and OSA. (Circ J 2015; 79: 2632 -2640

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Nocturia in Men Less Than 50 Years of Age May Be Associated with Obstructive Sleep Apnea Syndrome

Cited by 59 publications

References 14 publications

Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms

Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms

Prevalence of Sleep Disordered Breathing among Patients with Nocturia at a Urology Clinic

Nocturia in Patients With Sleep-Disordered Breathing and Cardiovascular Disease

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