Objective
The purpose of this study was to corroborate the association between obstructive sleep
apnea (OSA) and nocturia in a clinical sample of urogynecologic patients and to explore
whether night-time urine concentration predicts the presence of OSA.
Study Design
Patients with nocturia and control subjects underwent a home sleep study, completed
validated nocturia questionnaires, and provided evening and morning urine specimens
that were analyzed for osmolarity.
Results
Twenty-one patients with nocturia (16 of whom also had daytime overactive bladder
[OAB] symptoms) and 10 control subjects were studied. OSA was present in 17 of 21
women (81%) with nocturia: 13 women (81%) with OAB, 4 women (80%) with nocturia/no
OAB, and 4 control subjects (40%; P < .001). The percentage of rapid eye movement sleep time was correlated inversely
with nocturic frequency (ρ = −.51; P < .004). The presence of diluted nighttime urine in a patient with nocturia was 88%
sensitive for the presence of OSA.
Conclusion
We should consider a diagnosis of OSA in all patients with nocturia, even those patients
with daytime OAB.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Urinary symptoms and incontinence in women: relationships between occurrence, age, and perceived impact.Br J Gen Pract. 1999; 49: 897-900
- Subjective sleep characteristics of 1,485 males and females aged 50-93: effects of sex and age, and factors related to self-evaluated quality of sleep.J Gerontol A Biol Sci Med Sci. 1996; 51: M108-M115
- Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment.Am J Obstet Gynecol. 2006; 194: 1399-1403
- Nocturia in sleep-disordered breathing.Sleep Med. 2006; 7: 362-367
- Polygraphic study of the episodic diurnal and nocturnal (hypnic and respiratory) manifestations of the Pickwick syndrome.Brain Res. 1966; 1: 167-186
- Obstructive sleep apnea, nocturia and polyuria in older adults.Sleep. 2004; 27: 139-144
- Sleep disordered breathing and nocturnal polyuria: nocturia and enuresis.Sleep Med Rev. 2003; 7: 403-411
- Biochemistry of natriuretic peptides.J Intern Med. 1994; 235: 561-576
- Subjective efficacy of nasal CPAP therapy in obstructive sleep apnoea syndrome: a prospective controlled study.Eur Respir J. 1999; 13: 1086-1090
- Enuresis and obstructive sleep apnea in adults.Chest. 1998; 114: 634-637
- A non-urologic cause of nocturia and enuresis: obstructive sleep apnea syndrome (OSAS).Scand J Urol Nephrol. 1996; 30: 135-137
- A prospective study of nocturia and the quality of life in elderly patients with obstructive sleep apnea or sleep onset insomnia.J Psychosomat Res. 2004; 56: 511-515
- Diurnal variation in the levels of antidiuretic hormone in the elderly.J Intern Med. 1991; 229: 131-134
- The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society.Neurourol Urodyn. 2002; 21: 179-183
- Development and validation of a quality-of-life measure for men with nocturia.Urology. 2004; 63: 481-486
- Two-year incidence, remission, and change patterns of urinary incontinence in noninstitutionalized older adults.J Gerontol. 1990; 45: M67-M74
- The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.Neurourol Urodyn. 2002; 21: 167-178
- Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography.Sleep. 2006; 29: 367-374
- Using a wrist-worn device based on peripheral arterial tonometry to diagnose obstructive sleep apnea: in-laboratory and ambulatory validation.Sleep. 2004; 27: 923-933
- An automatic ambulatory device for detection of AASM defined arousals from sleep: the WP100.Sleep Med. 2003; 4: 207-212
- Evaluation of a portable device based on peripheral arterial tone for unattended home sleep studies.Chest. 2003; 123: 695-703
- Continuous positive airway pressure reduces nocturia in patients with obstructive sleep apnea.Urology. 2006; 67: 974-977
- Obstructive sleep apnea, nocturia and polyuria in older adults.Sleep. 2004; 27: 139-144
- Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr.Am J Respir Crit Care Med. 2001; 163: 685-689
- The occurrence of sleep-disordered breathing among middle-aged adults.N Engl J Med. 1993; 328: 1230-1235
- Nighttime dosing with tolterodine reduces overactive bladder-related nocturnal micturitions in patients with overactive bladder and nocturia.Urology. 2006; 67: 731-736
- Nocturnal polyuria and nocturia relief in patients treated with solifenacin for overactive bladder symptoms.Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 737-741
- Renal function in patients with obstructive sleep apnea: effects of nasal continuous positive airway pressure.Arch Intern Med. 1988; 148: 1337-1340
- Slow wave sleep rebound and REM rebound following the first night of treatment with CPAP for sleep apnea: correlation with subjective improvement in sleep quality.Sleep Med. 2001; 2: 215-223
Article Info
Footnotes
Support for this research was provided by the Internal Loyola Research Fund.
Cite this article as: Lowenstein L, Kenton K, Brubaker L, et al. The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women. Am J Obstet Gynecol 2008;198:598.e1-598.e5.
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
