The Efficacy of Continuous Positive Airway Pressure Therapy on Nocturia in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Wang, Tao; Huang, Wei; Zong, Huantao; Zhang, Yong

doi:10.5213/inj.2015.19.3.178

Cited by 48 publications

(43 citation statements)

References 29 publications

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“…Nocturia often improves in patients with OSA using continuous positive airway pressure . Patients who undergo uvulopalatopharyngoplasty for their OSA have also seen an improvement in nocturia symptoms …”

Section: Resultsmentioning

confidence: 99%

“…40 Nocturnalpolyuriamaybebehavioural(excessfluidintake),druginducedorapartofglobalpolyuria.Systemicdiseasessuchascongestive heart failure,venous stasis in the lower extremities, obstructive sleep apnoea (OSA), renal tubular dysfunction, hepatic failure and hypoalbuminaemiacancausefluidandelectrolytesequestrationand, therefore, may also be reasons for nocturnal polyuria. 31,33,41…”

Section: Nocturnal Polyuriamentioning

confidence: 99%

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A practical approach to the management of nocturia

et al. 2017

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SummaryAimTo raise awareness on nocturia disease burden and to provide simplified aetiologic evaluation and related treatment pathways.MethodsA multidisciplinary group of nocturia experts developed practical advice and recommendations based on the best available evidence supplemented by their own experiences.ResultsNocturia is defined as the need to void ≥1 time during the sleeping period of the night. Clinically relevant nocturia (≥2 voids per night) affects 2%‐18% of those aged 20‐40 years, rising to 28%‐62% for those aged 70‐80 years. Consequences include the following: lowered quality of life; falls and fractures; reduced work productivity; depression; and increased mortality. Nocturia‐related hip fractures alone cost approximately €1 billion in the EU and $1.5 billion in the USA in 2014. The pathophysiology of nocturia is multifactorial and typically related to polyuria (either global or nocturnal), reduced bladder capacity or increased fluid intake. Accurate assessment is predicated on frequency‐volume charts combined with a detailed patient history, medicine review and physical examination. Optimal treatment should focus on the underlying cause(s), with lifestyle modifications (eg, reducing evening fluid intake) being the first intervention. For patients with sustained bother, medical therapies should be introduced; low‐dose, gender‐specific desmopressin has proven effective in nocturia due to idiopathic nocturnal polyuria. The timing of diuretics is an important consideration, and they should be taken mid‐late afternoon, dependent on the specific serum half‐life. Patients not responding to these basic treatments should be referred for specialist management.ConclusionsThe cause(s) of nocturia should be first evaluated in all patients. Afterwards, the underlying pathophysiology should be treated specifically, alone with lifestyle interventions or in combination with drugs or (prostate) surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Nocturnal Polyuriamentioning

confidence: 99%

A practical approach to the management of nocturia

et al. 2017

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“…CPAP also seems to be effective in reducing the frequency of nocturia and the associated nighttime polyuria 21 . In a meta‐analysis by Wang et al, 22 it was concluded that CPAP possibly is an effective treatment for reducing nocturia associated with OSAS and improves the QoL in these patients. At this time CPAP is not the only treatment option in OSAS and the effect of other treatment options like lifestyle changes, oral devices, and surgical procedures must also be evaluated.…”

Section: Discussionmentioning

confidence: 99%

The effect of continuous positive airway pressure on nocturia in patients with obstructive sleep apnea syndrome

Vrooman

Balken

Koeveringe

et al. 2020

Neurourology and Urodynamics

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Objective: The prevalence of nocturia in patients with obstructive sleep apnea syndrome (OSAS) who received continuous positive airways pressure (CPAP) treatment was studied as well as the effect of CPAP treatment on nocturia.Methods: All patients that were referred to the pulmonology department of a large teaching hospital in the Netherlands and received a CPAP mask for OSAS were interviewed and invited to take part in the study (N = 274). After informed consent, all patients were asked about the number of nocturia episodes before and after CPAP.Results: In this prospective analysis, 274 patients (190 male and 84 female) were included. The mean age was 60.3 years (SE = 0.7). Sixty-four patients (23.4%) reported no nocturia episodes before CPAP and 210 patients (76.4%) reported ≥1 nocturia episode(s). Treatment of OSAS with CPAP reduced nocturia with one or more episodes per night in 42.3% of the patients. Clinically relevant nocturia (≥2 voids per night) was reduced from 73.0% to 51.5%.There were no statistically significant gender differences. Conclusion: The prevalence of nocturia in patients diagnosed with OSAS is 75.8% in both sexes. After treatment with CPAP, almost half of patients experienced a decrease in the nocturia frequency of one or more voids. Clinically relevant nocturia was reduced with one-third after CPAP. CPAP not only reduced the number of voids during the night but also improved the associated quality of life. K E Y W O R D S CPAP, nocturia, OSAS

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“…To date, there are few reports of the change in nocturia frequency after intervention for clinically relevant sleep disturbance, aside from sleep‐disordered breathing (SDB). Following continuous positive airway pressure (CPAP) treatment for SDB a reduction of up to 2.28 nocturia episodes per night has been reported . Of interest, given the high risk for frequent nocturia with urinary urgency, is a recent report of women with moderate or severe SDB who experienced a reduction in overactive bladder symptoms after 3 months of CPAP therapy .…”

Section: Discussionmentioning

confidence: 99%

“…Following continuous positive airway pressure (CPAP) treatment for SDB a reduction of up to 2.28 nocturia episodes per night has been reported. [18][19][20] Of interest, given the high risk for frequent nocturia with urinary urgency, is a recent report of women with moderate or severe SDB who experienced a reduction in overactive bladder symptoms after 3 months of CPAP therapy. 21 Similarly, in a CPAP trial controlled for type 2 diabetes mellitus, 90% of participants across both groups evidenced improved nocturia.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal voiding frequency does not describe nocturia‐related bother

Rose

Denys

Kumps

et al. 2019

Neurourology and Urodynamics

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Aim Nocturia frequency has been used as a measure of treatment efficacy for nocturia even though fluctuation of the symptom over time has been well described in the literature. Additionally, given the multifactorial causal pathway and clinically relevant comorbidities, frequency alone may be an insufficient marker of treatment direction. The aim of this study was to investigate factors associated with nocturia‐related bother to identify additional variables that may capture the impact of nocturia, direct clinical care and have potential to quantify treatment outcome. Methods Prospective data from tertiary hospital Urology and Continence cohorts were matched for identical variables to generate a sample of 204 datasets. Descriptive statistics were obtained to describe the two cohorts. Characteristics of patients were evaluated across levels of nocturia frequency and nocturia‐related bother using nonparametric methods; statistically significant differences between groups in each cohort were established. Results Nocturia frequency alone does not comprehensively reflect attributable bother. Five sleep variables (poor quality sleep, short time to first awakening to void, less than 7 hours of total sleep, primary sleep latency, and daytime sleepiness) and daily urinary urgency were significantly associated with high nocturia‐related bother. Attributable bother, despite high‐frequency nocturia, was minimized by male gender, lack of daily urinary urgency and good sleep quality. Poor health status, urinary urgency and sleep latency were associated with nocturia frequency. Conclusions Items of importance to individuals with nocturia have been identified from patient data. These variables have the potential to sit alongside change in nocturia frequency as potential markers of treatment response.

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The Efficacy of Continuous Positive Airway Pressure Therapy on Nocturia in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Cited by 48 publications

References 29 publications

A practical approach to the management of nocturia

A practical approach to the management of nocturia

The effect of continuous positive airway pressure on nocturia in patients with obstructive sleep apnea syndrome

Nocturnal voiding frequency does not describe nocturia‐related bother

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