Burr Eliza F, Myer Emily N B, Kikuchi Jacqueline Y, Chen Chi Chiung Grace
From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Urogynecology (Phila). 2025 Feb 1;31(2):154-160. doi: 10.1097/SPV.0000000000001503. Epub 2024 Apr 10.
Nocturnal lower urinary tract symptoms are part of obstructive sleep apnea (OSA), and urogynecology clinics may serve as OSA screening sites.
This study's aim was to determine the accuracy of nocturia and nocturnal enuresis (NE) as screening tools for OSA in new patients at a urogynecology clinic.
Using a retrospective study design, we gathered information regarding diagnostic OSA testing, continuous positive airflow pressure use, and lower urinary tract symptoms improvement from women in a urogynecology clinic who were previously screened for OSA using validated questionnaires. Nocturia and NE were tested for sensitivity and specificity using positive OSA diagnosis by polysomnography as the gold standard.
Nocturia with a cutoff of ≥2 episodes per night had the best test characteristics-86.4% sensitivity (95% confidence interval [CI], 65.1-97.1) and 58.5% specificity (95% CI, 44.1-71.9) for an overall accuracy of 78.4% (95% CI, 67.0-89.8). Nocturnal enuresis with a cutoff of ≥1 episode per week had the best NE characteristics with 31.8% sensitivity (95% CI, 13.9-54.9) and 79.3% specificity (95% CI, 65.9-89.2) for an overall accuracy of 56.1% (95% CI, 41.2-71).
Lower urinary tract symptoms such as nocturia and NE are routinely assessed in urogynecology clinics, making them useful for OSA screening and referral. The present study found nocturia symptoms with ≥2 episodes per night to retain acceptable test characteristics in screening for OSA, whereas NE was found to have less acceptable test characteristics for OSA screening. Urogynecology clinics may utilize nocturia symptoms in clinical decision making for OSA referral.
夜间下尿路症状是阻塞性睡眠呼吸暂停（OSA）的一部分，而泌尿妇科诊所可作为OSA筛查场所。
本研究的目的是确定夜尿症和夜间遗尿（NE）作为泌尿妇科诊所新患者OSA筛查工具的准确性。
采用回顾性研究设计，我们收集了泌尿妇科诊所中曾使用经过验证的问卷进行OSA筛查的女性的诊断性OSA检测、持续气道正压通气使用情况以及下尿路症状改善方面的信息。以多导睡眠图确诊OSA为金标准，测试夜尿症和NE的敏感性和特异性。
每晚夜尿≥2次的最佳检测特征为——敏感性86.4%（95%置信区间[CI]，65.1 - 97.1），特异性58.5%（95%CI，44.1 - 71.9），总体准确率78.4%（95%CI，67.0 - 89.8）。每周NE≥1次的最佳NE特征为——敏感性31.8%（95%CI，13.9 - 54.9），特异性79.3%（95%CI，65.9 - 89.2），总体准确率56.1%（95%CI，41.2 - 71）。
泌尿妇科诊所常规评估夜尿症和NE等下尿路症状，使其有助于OSA筛查和转诊。本研究发现，每晚夜尿≥2次的症状在OSA筛查中具有可接受的检测特征，而NE在OSA筛查中的检测特征不太理想。泌尿妇科诊所可在OSA转诊的临床决策中利用夜尿症症状。
