Arai H, Furuta H, Kosaka K, Kaneda R, Koshino Y, Sano J, Yokoyama O
Department of Neuropsychiatry, Kanazawa University School of Medicine, Ishikawa, Japan.
Psychiatry Clin Neurosci. 1999 Apr;53(2):319-20. doi: 10.1046/j.1440-1819.1999.00550.x.
A 53-year-old female patient with obstructive sleep apnea syndrome was reported. She had complained of enuresis as well as a 15-year history of snoring, but she had no complaint of sleep and awake disturbance. Polysomnographic study showed repeated obstructive apnea and hypopnea with an apnea/hypopnea index of 52.6, and severe oxygen desaturation during sleep. On cystometography during sleep, the changing amplitude of the spike wave corresponds to the changes of respiratory efforts against a closed upper airway. The patient was treated successfully with imipramine and acetazolamide for the obstructive sleep apnea and enuresis. Apnea/hypopnea index, nocturnal oxygen desaturation, and sleep architecture were improved, and enuresis completely disappeared. Cystometrography during sleep showed that the average amplitude of the spike wave tended to be low. Percentage urinary volume during sleep compared with 24 h volume was significantly reduced. We considered that the enuresis was mainly related to increased intra-abdominal pressure produced by respiratory efforts and enhanced nocturnal urine production.
报告了一名53岁患有阻塞性睡眠呼吸暂停综合征的女性患者。她主诉有遗尿症以及15年的打鼾病史，但没有睡眠和觉醒障碍的主诉。多导睡眠图研究显示反复出现阻塞性呼吸暂停和呼吸不足，呼吸暂停/低通气指数为52.6，睡眠期间有严重的氧饱和度下降。睡眠期间进行膀胱压力描记时，尖峰波的变化幅度与对上气道关闭的呼吸努力变化相对应。该患者使用丙咪嗪和乙酰唑胺成功治疗了阻塞性睡眠呼吸暂停和遗尿症。呼吸暂停/低通气指数、夜间氧饱和度下降和睡眠结构得到改善，遗尿症完全消失。睡眠期间的膀胱压力描记显示尖峰波的平均幅度趋于降低。睡眠期间尿量占24小时尿量的百分比显著降低。我们认为遗尿症主要与呼吸努力产生的腹内压增加和夜间尿量增加有关。
