Service de Médecine Physique et Réadaptation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
GHU Paris Saclay, Neuro-Uro-Andrology R. Poincare Academic Hospital, AP-HP, Hôpital Raymond Poincaré, Garches, France.
World J Urol. 2024 Sep 11;42(1):519. doi: 10.1007/s00345-024-05190-z.
To describe the prevalence of nocturia and obstructive sleep apnea (OSA) in a cohort of spinal cord injury (SCI) patients and to describe their association. Additionally, to assess clinical and urodynamic data explaining nocturia and to evaluate the effect of OSA management with continuous positive airway pressure (CPAP).
Retrospective analysis of data from patients with SCI followed in a tertiary care rehabilitation center with a specialized sleep and neuro-urology units. All adult SCI patients who underwent urodynamic assessment before polysomnography (PSG) between 2015 and 2023 were eligible. Subjective (nocturia) and objective data (urodynamic data, polysomnography, CPAP built-in software) were collated from the Handisom database (database register no. 20200224113128) and the medical records of SCI patients. Statistical testing used Mann-Whitney test for non-parametric variables, Fisher's exact test for contingency analysis and the Spearman correlation test to assess correlations. A p-value < 0.05 was considered significant. Statistical analyses were performed using GraphPad Prism v9.
173 patients (131 males, 42 females) were included. The majority of patients were paraplegic (n = 111 (64,2%)) and had complete lesions (n = 75 (43,4%)). A total of 100 patients had nocturia (57,5%). The prevalence of OSA (Apnea Hypopnea Index (AHI) ≥ 15/h) in the studied population was 61,9%. No correlation was found between nocturia and OSA. A significant difference was observed between patients with and without nocturia in terms of the presence of neurogenic detrusor overactivity (p = 0,049), volume at the first detrusor contraction (p = 0,004) and the bladder functional capacity (p < 0,001).
Nocturia and OSA are highly prevalent in patients with SCI, but no statistical association was found between these two disorders. A prospective study focusing on nocturnal polyuria will be needed to assess the impact of OSA on lower urinary tract symptoms in SCI patients.
描述脊髓损伤（SCI）患者群体中夜间多尿和阻塞性睡眠呼吸暂停（OSA）的患病率，并描述两者之间的关联。此外，评估解释夜间多尿的临床和尿动力学数据，并评估持续气道正压通气（CPAP）治疗 OSA 的效果。
对在一家三级康复中心接受专门的睡眠和神经泌尿科治疗的 SCI 患者进行回顾性数据分析。所有在 2015 年至 2023 年期间接受过尿动力学评估，随后进行多导睡眠图（PSG）检查的成年 SCI 患者均符合入选标准。主观（夜间多尿）和客观数据（尿动力学数据、多导睡眠图、CPAP 内置软件）均来自 Handisom 数据库（数据库登记号 20200224113128）和 SCI 患者的病历。非参数变量采用 Mann-Whitney 检验进行统计检验，对离散变量采用 Fisher 确切检验，对相关性采用 Spearman 相关检验进行评估。p 值<0.05 被认为具有统计学意义。统计分析使用 GraphPad Prism v9 进行。
共纳入 173 名患者（131 名男性，42 名女性）。大多数患者为截瘫（n=111（64.2%））且完全性损伤（n=75（43.4%））。共有 100 名患者有夜间多尿（57.5%）。研究人群中 OSA（呼吸暂停低通气指数（AHI）≥15/h）的患病率为 61.9%。夜间多尿与 OSA 之间未发现相关性。有夜间多尿和无夜间多尿的患者在存在神经源性逼尿肌过度活动（p=0.049）、第一次逼尿肌收缩时的容量（p=0.004）和膀胱功能容量（p<0.001）方面存在显著差异。
夜间多尿和 OSA 在 SCI 患者中非常常见，但这两种疾病之间未发现统计学关联。需要进行一项前瞻性研究，以评估 OSA 对 SCI 患者下尿路症状的影响。
