Chung Shiu-Dong, Lin Ching-Chun, Liu Shih-Ping, Lin Herng-Ching
Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
Neurourol Urodyn. 2014 Mar;33(3):278-82. doi: 10.1002/nau.22401. Epub 2013 Mar 28.
Previous studies indicated a possible association between bladder pain syndrome/interstitial cystitis (BPS/IC) and sleep disorders including sleep abnormalities with delayed onset of sleep, waking up before needed, and snoring. Nevertheless, no previous study has reported the association between obstructive sleep apnea (OSA) and BPS/IC. In this retrospective cohort study, we examined the risk of BPS/IC among subjects with OSA during a 3-year follow-up in Taiwan using a population-based dataset.
This study comprised 2,940 study subjects with OSA, and 29,400 randomly selected comparison subjects. We individually followed-up each sampled subject (n = 32,340) for a 3-year period to identify those subjects who subsequently received a diagnosis of BPS/IC. A Cox proportional hazards regression model was constructed to estimate the risk of subsequent BPS/IC following a diagnosis of OSA.
Incidences of BPS/IC during the 3-year follow-up period were 13.61 (95% confidence interval [CI] = 7.37-23.13) and 3.60 (95% CI = 2.06-4.39) for subjects with and those without OSA, respectively. After adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, asthma, tobacco use disorder, and alcohol abuse, the stratified Cox proportional hazards regressions revealed that the hazard ratio for BPS/IC among subjects with OSA was 3.71 (95% CI = 1.81-7.62, P < 0.001) that of comparison subjects.
This study provides epidemiological evidence of a link between OSA and a subsequent BPS/IC diagnosis. We suggest that clinical practitioners treating subjects with OSA be alert to urinary complaints in this population.
先前的研究表明膀胱疼痛综合征/间质性膀胱炎（BPS/IC）与睡眠障碍之间可能存在关联，这些睡眠障碍包括入睡延迟、过早醒来和打鼾等睡眠异常情况。然而，此前尚无研究报道阻塞性睡眠呼吸暂停（OSA）与BPS/IC之间的关联。在这项回顾性队列研究中，我们使用基于人群的数据集，对台湾地区3年随访期间患有OSA的受试者发生BPS/IC的风险进行了研究。
本研究包括2940名患有OSA的研究对象和29400名随机选择的对照对象。我们对每个抽样对象（n = 32340）进行了为期3年的随访，以确定那些随后被诊断为BPS/IC的对象。构建了Cox比例风险回归模型，以估计OSA诊断后发生后续BPS/IC的风险。
在3年随访期间，患有OSA的受试者和未患有OSA的受试者的BPS/IC发病率分别为13.61（95%置信区间[CI]=7.37 - 23.13）和3.60（95%CI = 2.06 - 4.39）。在对糖尿病、高血压、冠心病、肥胖、高脂血症、慢性盆腔疼痛、肠易激综合征、纤维肌痛、慢性疲劳综合征、抑郁症、惊恐障碍、偏头痛、干燥综合征、过敏、子宫内膜异位症、哮喘、烟草使用障碍和酒精滥用进行校正后，分层Cox比例风险回归显示，患有OSA的受试者发生BPS/IC的风险比是对照对象的3.71倍（95%CI = 1.81 - 7.62，P < 0.001）。
本研究提供了OSA与后续BPS/IC诊断之间存在关联的流行病学证据。我们建议治疗OSA患者的临床医生对该人群中的泌尿系统症状保持警惕。
