Lu Chin-Heng, Chang Hung-Min, Chang Kuang-Hsi, Ou Yen-Chuan, Hsu Chao-Yu, Tung Min-Che, Cheau-Feng Lin Frank, Chin-Shaw Tsai Stella
Division of Urology, Department of Surgery, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan, China.
Rong Hsing Research Center for Translational Medicine, Chung Hsing University, Taichung, Taiwan, China.
Asian J Urol. 2024 Jul;11(3):486-496. doi: 10.1016/j.ajur.2023.02.003. Epub 2023 Jul 20.
Obstructive sleep apnea (OSA) is one of the etiologies of nocturia. We analyzed polysomnography (PSG) results to determine correlated factors related to nocturia in OSA patients with different severity.
Patients with suspected OSA were examined using PSG. They were divided into two groups based on the presence of nocturia. Nocturia was defined as a patient who needed to void at least once. Apnea-hypopnea index (AHI) was employed to classify patients according to degrees of severity: AHI<5 events/h, 5 events/h≤AHI<15 events/h, 15 events/h≤AHI<30 events/h, and AHI≥30 events/h, defined as normal, mild OSA, moderate OSA, and severe OSA, respectively. Demographic variables, PSG parameters, International Prostate Symptom Scores (IPSSs), and quality of life scores due to urinary symptoms were analyzed.
In total 140 patients, 114 patients had OSA (48 had mild OSA; 34 had moderate OSA; and 32 had severe OSA) and 107 patients had nocturia. The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients. With the increasing severity of OSA, more correlated factors related to nocturia were determined. In mild OSA patients, nocturia related to increased age (=0.025), minimum arterial blood oxygenation saturation (=0.046), and decreased AHI of non-rapid eye movement (=0.047), AHI of total sleep time (=0.010), and desaturation index (=0.012). In moderate OSA patients, nocturia related to increased age (<0.001), awake time (=0.025), stage 1 sleep (=0.033), and sleep latency (=0.033), and decreased height (=0.044), weight (=0.025), and sleep efficiency (=0.003). In severe OSA patients, nocturia related to increased weight (=0.011), body mass index (=0.009), awake time (=0.008), stage 1 sleep (=0.040), arousal number (=0.030), arousal index (=0.013), periodic limb movement number (=0.013), and periodic limb movement index (=0.004), and decreased baseline arterial blood oxygenation saturation (=0.046).
Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA. This study helps in clinical education and treatment for OSA patients with different severity.
阻塞性睡眠呼吸暂停（OSA）是夜尿症的病因之一。我们分析了多导睡眠图（PSG）结果，以确定不同严重程度的OSA患者中与夜尿症相关的因素。
对疑似OSA的患者进行PSG检查。根据是否存在夜尿症将他们分为两组。夜尿症定义为患者每晚至少需要排尿一次。采用呼吸暂停低通气指数（AHI）根据严重程度对患者进行分类：AHI<5次/小时、5次/小时≤AHI<15次/小时、15次/小时≤AHI<30次/小时、AHI≥30次/小时，分别定义为正常、轻度OSA、中度OSA和重度OSA。分析了人口统计学变量、PSG参数、国际前列腺症状评分（IPSS）以及因泌尿系统症状导致的生活质量评分。
总共140例患者，114例患有OSA（48例为轻度OSA；34例为中度OSA；32例为重度OSA），107例患者有夜尿症。除重度OSA患者组外，所有组中夜尿症患者的总IPSS均显著更高。随着OSA严重程度的增加，确定了更多与夜尿症相关的因素。在轻度OSA患者中，夜尿症与年龄增加（=0.025）、最低动脉血氧饱和度（=0.046）以及非快速眼动期AHI降低（=0.047）、总睡眠时间AHI降低（=0.010）和去饱和指数降低（=0.012）有关。在中度OSA患者中，夜尿症与年龄增加（<0.001）、清醒时间（=0.025）、1期睡眠（=0.033）和睡眠潜伏期（=0.033）有关，以及身高降低（=0.044）、体重降低（=0.025）和睡眠效率降低（=0.003）有关。在重度OSA患者中，夜尿症与体重增加（=0.011）、体重指数（=0.009）、清醒时间（=0.008）、1期睡眠（=0.040）、觉醒次数（=0.030）、觉醒指数（=0.013）、周期性肢体运动次数（=0.013）和周期性肢体运动指数（=0.004）有关，以及基线动脉血氧饱和度降低（=0.046）有关。
我们的研究表明，随着OSA严重程度的增加，与夜尿症相关的因素更多。本研究有助于对不同严重程度的OSA患者进行临床教育和治疗。
