Nocturia, the need to urinate at night, is a common symptom in patients with obstructive sleep apnoea (OSA). Continuous positive airway pressure treatment can reduce nocturia in some patients, but the underlying mechanisms are complex and not fully understood. OSA affects the autonomic nervous system, oxidative stress and endothelial damage. Furthermore, the commonly held theory attributing polyuria to a false signal of cardiac overload and response natriuresis has limitations. A comprehensive approach to the management of nocturia in OSA, considering factors such as comorbidities, medication use, alcohol consumption and lifestyle, is needed. Effective management of nocturia in OSA requires a multidisciplinary approach, and urologists should be aware of the potential effect of OSA on physiology and refer patients for further testing at a sleep centre. In addition to continuous positive airway pressure, other interventions such as oral appliances and surgical obstruction treatment could be beneficial for some patients. Overall, understanding the complex interplay between OSA and nocturia is crucial for optimizing patient outcomes.
Nature reviews. Urology. 2024 May 23 [Epub ahead of print]
Olaf P J Vrooman, Philip E V van Kerrebroeck, Michael R van Balken, Gommert A van Koeveringe, Mohammad S Rahnama'i
Department of Urology, Hospital Rijnstate Arnhem, Arnhem, Netherlands. ., Department of Urology, University Hospital Maastricht, Maastricht, Netherlands., Department of Urology, Rijnstate Hospital, Arnhem, Netherlands., Department of Urology Nij Smellinghe Hospital, Drachten, Netherlands.