Miyazaki Takashi, Kojima Sunao, Yamamuro Megumi, Sakamoto Kenji, Izumiya Yasuhiro, Tsujita Kenichi, Yamamoto Eiichiro, Tanaka Tomoko, Kaikita Koichi, Hokimoto Seiji, Ogawa Hisao
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.
Circ J. 2015;79(12):2632-40. doi: 10.1253/circj.CJ-15-0654. Epub 2015 Oct 19.
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.
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).
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.
睡眠呼吸暂停是一种常见病症，也是心血管危险因素。持续气道正压通气（CPAP）可减少心血管事件及与睡眠呼吸暂停相关的症状，尤其在阻塞性睡眠呼吸暂停（OSA）患者中，这些患者偶尔会出现夜尿症，这在老年个体中是一个常见问题。
本研究是一项前瞻性观察性研究，纳入了1429例连续的心血管疾病（CVD）患者。进行了关于夜尿症的问卷调查并进行了夜间脉搏血氧饱和度测定。中重度睡眠呼吸障碍（SDB）患者接受多导睡眠图检查，OSA患者接受CPAP治疗。在纳入分析的666例患者中，有561例观察到夜尿症。多因素逻辑回归分析显示，夜尿症与定义为氧饱和度下降3%的氧去饱和相关（P = 0.0335），独立于年龄（P < 0.0001）、男性（P = 0.0078）、高血压（P = 0.0139）和B型利钠肽（BNP）水平（P = 0.0185）。继续接受CPAP治疗的患者夜尿症减少，并且他们的呼吸暂停低通气指数也有所下降（45.3±13.6次/小时对2.5±3.7次/小时，P < 0.0001），收缩压（121.6±11.9 mmHg对113.4±8.8 mmHg，P = 0.0002）以及BNP水平（57.7 [15.0 - 144.4]对27.4 [8.5 - 111.7] pg/ml，P = 0.0006）。
CPAP有降低夜尿症以及SDB危险因素（如血压升高和BNP水平升高）的潜力，这可能对患有CVD和OSA的老年男性有益。
