MP21-03 CLINICAL PREDICTORS OF NOCTURIA IN THE SLEEP APNEA POPULATION

Abstract

You have accessJournal of UrologyBladder and Urethra: Anatomy, Physiology and Pharmacology II1 Apr 2015MP21-03 CLINICAL PREDICTORS OF NOCTURIA IN THE SLEEP APNEA POPULATION Omer Raheem, Ryan Orosco, Terence Davidson, and Charles Lakin Omer RaheemOmer Raheem More articles by this author , Ryan OroscoRyan Orosco More articles by this author , Terence DavidsonTerence Davidson More articles by this author , and Charles LakinCharles Lakin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.955AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nocturia is a key feature of lower urinary tract symptoms (LUTS) that are often attributable to an underlying Benign Prostatic Hyperplasia (BPH). However, nocturia can signify possible contribution of numerous systematic health-related disorders, including Obstructive sleep apnea (OSA). There is paucity of data detailing nocturia and OSA and recent studies have linked nocturia as a predictive symptom of OSA and established the effective role of the Continuous Positive Airway Pressure on nocturia symptoms in patients with OSA. This study aims o evaluate clinical predictors of nocturia in patients with OSA. METHODS A total of 200 patients with OSA were randomly included. Group I contained 100 patients with OSA and no nocturia, and Group II included 100 patients with OSA and nocturia. Bivariate logistic analyses were used to identify variables most likely to contribute to nocturia. Multivariate logistic regression of age, waist circumference, STOP score (Snore, Tired, Obstruction and Pressure), and Apnea-Hypopnea Index (AHI) was performed to evaluate predictors of nocturia. RESULTS Median nocturia episodes were 2.2 in Group II. Patients were younger in Group I, with a mean age of 45 vs 50 years (P = 0.008). Mean BMI of 30 was similar in both groups, but there were more overweight patients in Group II (28% vs 18%). AHI approached significance between groups-18 vs 23 in group I and II, respectively (P = 0.071). In multivariate analysis, age over 70 years and moderate AHI were statistically significant predictors of nocturia (coefficients 0.6 and -0.2 with P = 0.003 and 0.03, respectively). CONCLUSIONS This study identifies age and AHI score as predictors of nocturia in patients with OSA. This may indicate the usefulness of incorporating nocturia in the screening of patients with OSA. Future studies are needed to further evaluate mechanism of action, clinical significance, and effect of treatment for nocturia in patients with OSA. Table 1. Bivariate logistic analyses of OSA variables most likely to contribute to nocturia Patient characteristics OSA (Group I) OSA + nocturia (Group II) p-value Age (years) 44.5 49.7 0.008∗ Gender (M/F) 59/41 60/40 0.400 BMI 30.0 30.4 0.665 Number of patient per group <25 22 18 25-29 35 30 30-34 18 28 35+ 25 24 Systolic pressure (mmHg) 129.2 128.7 0.794 Diastolic pressure (mmHg) 78.2 76.3 0.196 Neck circumference male (inch) 16.8 17.5 0.226 female (inch) 14.8 15.5 0.206 Waist circumference (inch) 38.3 39.9 0.090∗ Mallampati 3.1 3.1 0.857 Number of patient per group 1 1 3 2 19 21 3 50 38 4 30 38 Uvula size 1.82 1.82 1.000 Number of patient per group 0 2 1 1 28 30 2 56 55 3 14 14 Snoring score 2.18 2.18 1.000 Number of patient per group 1 2 2 2 78 78 3 20 20 STOP questionnaire 1.27 1.46 0.005∗ Number of patient per group 1 73 54 2 27 46 Apnea Hypopnea Index (AHI) 18.1 23.2 0.071∗ Number of patient per group 0 to 4 26 26 5 to 14 19 18 15 to 29 37 29 30+ 18 27 Desaturation (%) 87.1 87 0.889 Nocturia (number per night) -- 2.18 -- ∗ Statistically significant Table 2. Multivariate logistic regression of age, waist circumference, STOP questionnaire and Apnea Hypopnea Index (AHI) Covariate coefficient p-value 95% confidence interval Age <30 - - - - 30-49 0.1 0.558 -0.2 0.3 40-69 0.1 0.221 -0.1 0.4 70+ 0.6 0.003∗ 0.2 1.0 STOP score 1 - - - - 2 0.1 0.159 0.0 0.3 Apnea Hypopnea Index (AHI) <5 - - - - 5-14 -0.1 0.430 -0.3 0.1 15-29 -0.2 0.030∗ -0.4 0.0 30+ -0.1 0.598 -0.3 0.2 Waist circumference <40 - - - - ≥40 0.1 0.176 0.0 0.2 ∗ Statistically significant © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e233 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Omer Raheem More articles by this author Ryan Orosco More articles by this author Terence Davidson More articles by this author Charles Lakin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...