To examine the influence of obstructive sleep apnea (OSA) on nocturia, controlling for their shared co-morbidities, in a population of community-based middle aged to elderly men.
Participants were drawn from a randomly-selected, community-dwelling cohort of men in Adelaide, Australia. 708 men (mean:60.7 [41.6-88.2] years) who had PSG recordings, complete LUTS measures (IPSS), without prostate or bladder cancer and/or surgery, and no prior OSA diagnosis were selected. Nocturia was defined as ≥2 voids per main sleep. Unadjusted and multi-adjusted regression models of nocturia were combined with OSA, wake after sleep onset (WASO), total sleep period, excessive daytime sleepiness (EDS), and sleep quality (SQ) data, together with socio-demographic, and health-related factors.
Men with nocturia were found to have higher levels of OSA (32.2%(n=65)), WASO time (97.2±52.9 mins), sleep period (467.3±58.4mins), EDS (18.2%(n=37)), and poorer SQ (54.3%(n=108)). Multiple-adjusted models showed nocturia was positively associated with OSA (OR:1.64, 95%CI [1.03,2.55]), EDS (1.72[1.01,2.93]) and poorer SQ (1.65[1.10,2.48]). Including other storage and voiding LUTS attenuated the effect of OSA and strengthened the association with EDS (2.44[1.45,4.10)]& 2.24[1.19,4.22]), while voiding LUTS also strengthened the association with poorer SQ (2.61[1.63,4.17]). Men with increasing nocturic frequency spent less time in N2 and REM stage sleep.
Nocturia is strongly associated with OSA in community-based men. Nocturia also reduces SE/SQ, N2 and REM sleep time, while increasing EDS. Other LUTS increase EDS through non-OSA means.
Urology. 2016 Jun 24 [Epub ahead of print]
Sean A Martin, Sarah L Appleton, Robert J Adams, Anne W Taylor, Peter G Catcheside, Andrew Vakulin, R Douglas McEvoy, Nick A Antic, Gary A Wittert
Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia. Electronic address: ., The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia., The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia., Population Research and Outcome Studies, University of Adelaide, Adelaide, South Australia., Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia., Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia; The NHMRC Centres of Research Excellence, CIRUS and NEUROSLEEP, Woolcock Institute of Medical Research, Central Clinical School, University of Sydney, New South Wales, Australia., Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia., Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia., Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia.