Tsou Yung-An, Chou Eric Chieh-Lung, Shie Dung-Yun, Lee Ming-Jeng, Chang Wen-Dien
Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 40402, Taiwan.
Department of Audiology and Speech-Language Pathology, Asia University, Taichung 40402, Taiwan.
J Clin Med. 2020 Sep 25;9(10):3089. doi: 10.3390/jcm9103089.
A higher incidence rate of nocturia in patients with obstructive sleep apnea (OSA) has been observed. We investigated the differences in clinical examinations between OSA patients with and without nocturia, and further compared those with successful and unsuccessful uvulopalatopharyngoplasty (UPPP). This retrospective study enrolled 103 patients with OSA undergoing UPPP. Patients were diagnosed with OSA by following the 2018 American Academy of Sleep Medicine (AASM) Scoring Manual Version 2.5. Patients were divided into two groups depending on if they urinated more than twice per night. The medical data of body mass index (BMI), nocturia frequency per night, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), International Prostatic Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS) were analyzed before and after uvulopalatopharyngoplasty (UPPP) surgery. All of the measurements were compared between successful and unsuccessful surgery in the non-nocturia or nocturia groups, respectively. Fifty patients (41 males and nine females) without nocturia were assigned to group 1, and 53 patients (43 males and 10 females) with nocturia were assigned to group 2. Nocturia frequency and post-surgery AHI in group 2 were significantly higher than those in group 1 ( < 0.05). Significant decreases in IPSS and OABSS were observed in the successful surgery subgroup of group 2 ( < 0.05). A significant decrease in post-surgery AHI was observed between unsuccessful and successful surgery in patients with nocturia ( < 0.05), but not in the non-nocturia group ( > 0.05). Although AHI had a significant correlation to nocturia frequency in all OSA patients before UPPP, no significant correlation between AHI reduction and nocturia frequency was found. UPPP appeared to be an effective treatment for nocturia associated with OSA. OSA should be taken into consideration for patients who complain of nocturia syndrome. The relationship of AHI reduction and nocturia improvement after OSA treatment with UPPP is still unclear. In addition, it is necessary to establish the existence of nocturia in patients with OSA, as a result of its high prevalence in OSA patients. UPPP could reduce the symptoms of OSA and could also contribute to a reduction of nocturia even in the unsuccessful surgery group.
已观察到阻塞性睡眠呼吸暂停（OSA）患者夜尿症的发病率较高。我们调查了有夜尿症和无夜尿症的OSA患者在临床检查方面的差异，并进一步比较了悬雍垂腭咽成形术（UPPP）成功和失败的患者。这项回顾性研究纳入了103例接受UPPP的OSA患者。根据2018年美国睡眠医学学会（AASM）评分手册第2.5版对患者进行OSA诊断。根据患者每晚排尿是否超过两次将其分为两组。分析了悬雍垂腭咽成形术（UPPP）手术前后的体重指数（BMI）、每晚夜尿频率、呼吸暂停低通气指数（AHI）、爱泼华嗜睡量表（ESS）、国际前列腺症状评分（IPSS）和膀胱过度活动症症状评分（OABSS）等医学数据。分别在无夜尿症组或夜尿症组中比较了成功手术和失败手术之间的所有测量值。50例无夜尿症患者（41例男性和9例女性）被分配到第1组，53例有夜尿症患者（43例男性和10例女性）被分配到第2组。第2组的夜尿频率和术后AHI显著高于第1组（<0.05）。在第2组的成功手术亚组中观察到IPSS和OABSS显著降低（<0.05）。有夜尿症患者中，失败手术和成功手术之间术后AHI有显著降低（<0.05），但在无夜尿症组中无显著差异（>0.05）。尽管在UPPP手术前所有OSA患者中AHI与夜尿频率有显著相关性，但未发现AHI降低与夜尿频率之间有显著相关性。UPPP似乎是治疗与OSA相关的夜尿症的有效方法。对于主诉夜尿症综合征的患者应考虑OSA。OSA治疗UPPP后AHI降低与夜尿改善之间的关系仍不清楚。此外，由于OSA患者中夜尿症的高患病率，有必要确定OSA患者中夜尿症的存在。UPPP可以减轻OSA的症状，即使在失败手术组中也有助于减少夜尿。
