OSA Syndrome Linked to Nocturia in Adults

By Will Boggs MD

June 16, 2020

NEW YORK (Reuters Health) - Obstructive sleep apnea syndrome (OSAS) is associated with nocturia in adults under age 65 years, researchers in Japan report.

In cases where "relatively young adults complain of nocturnal urine frequency but lack any urological disorders, we need to suspect OSAS and to refer them to the appropriate department," Dr. Yasuyuki Miyauchi of Kagawa University Faculty of Medicine, in Kagawa, told Reuters Health by email.

Dr. Miyauchi and colleagues previously reported that OSAS is associated with nocturia and deterioration of lower-urinary-tract symptom (LUTS)-related quality of life and that both were improved by continuous positive airway pressure (CPAP) treatment.

In the current secondary analysis of the earlier study, the team evaluated the impact of OSAS on nocturia, with a focus on differences between young (<65 years) and older (65 years and older) adults.

The study included 65 young adults (median age, 51.0 years) and 25 older adults (median age, 70.0 years).

In multiple linear regression analyses, nocturnal urine volume and total International Prostate Symptom Score (IPSS) were significant predictors of nocturnal urinary frequency.

In young patients, nocturnal frequency was significantly associated with apnea-hypopnea index (AHI), nocturnal volume and total IPSS, the researchers report in Urology.

Nocturnal frequency and urinary sodium content increased significantly with OSAS severity in younger people. By contrast, among older patients, nocturnal frequency was not associated with demographic or polysomnographic characteristics, and there was no significant association between OSAS severity and nocturnal frequency or urinary sodium content.

This does not necessarily mean that nocturia is insignificant as a symptom of OSAS in older people, the authors note. Instead, nocturia in this group has multiple other causes, including overactive bladder, benign prostatic hyperplasia and other age-related structural changes in urinary organs.

"When a younger patient complains of nocturia, urologists should keep in mind OSAS as a potential cause of nocturia, rather than treating them as pathological LUTS indiscriminately," Dr. Miyauchi said. "Thereby, it will be beneficial in avoiding severe events caused by unrecognized OSAS."

SOURCE: https://bit.ly/2MuPMXd Urology, online May 28, 2020.