MP80-14 SLEEP POSTURE COULD PREDICT THE SIDE OF UNILATERAL UROLITHIASIS FORMATION

Abstract

You have accessJournal of UrologyStone Disease: Evaluation II1 Apr 2015MP80-14 SLEEP POSTURE COULD PREDICT THE SIDE OF UNILATERAL UROLITHIASIS FORMATION Wei-Ming Cheng, Tuz-Hao Huang, Yu-Hua Fan, Alex T.L. Lin, Kuang-Kuo Chen, and Shi-Chuan Chang Wei-Ming ChengWei-Ming Cheng More articles by this author , Tuz-Hao HuangTuz-Hao Huang More articles by this author , Yu-Hua FanYu-Hua Fan More articles by this author , Alex T.L. LinAlex T.L. Lin More articles by this author , Kuang-Kuo ChenKuang-Kuo Chen More articles by this author , and Shi-Chuan ChangShi-Chuan Chang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2850AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most urolithiasis forms unilaterally. The published data suggest that sleep posture may alter renal hemodynamics during sleep and promote stone formation. In the present study, we investigated the correlation of sleep posture with stone formation sites in patients with unilateral urolithiasis. METHODS We retrospectively reviewed the archives of polysomnography for evaluation of obstructive sleep apnea (OSA) between January 1st 2011 and August 31st 2014 and enrolled the patients who experienced extracorporeal shock wave lithotripsy or ureteroscopic lithotripsy for unilateral renal or ureteral stones. Supine, right and left decubitus, and prone sleep postures were defined when patients stayed in the posture for more than 50% of the time during sleep. Others were categorized as rotisserie-like posture. We analyzed the correlation between sleep posture and urolithiasis site. RESULTS A total of 67 patients were included. 63 (94.0%) were males. Mean age was 51.0 ± 11.8 years. Mean body mass index (BMI) was 29.0 ± 6.7 kg/m2. Sleep postures correlated to urolithiasis sites were showed in the Table. Right decubitus posture was prone to right side urolithiasis (88.9% versus 41.4%, p = 0.011). Furthermore, patients with right side urolithiasis present with less rapid eye movement (REM) ratio (6.9 ± 4.2% versus 10.9 ± 6.9%, p = 0.014). Both right decubitus posture and lower REM ratio remained to be significantly correlated to right side urolithiasis on multivariate analysis (95% CI 0.009 - 0.720, p = 0.024; 95% CI 1.032 - 1.253, p = 0.009, respectively). In patients with optimal sleep efficacy on polysomnography, which was defined as the duration of sleep divided by the duration in bed over 85%, lower stage I ratio (6.6 ± 4.1% versus 26.1 ± 17.7%, p = 0.016), higher stage III ratio (11.89 ± 3.1% versus 3.4 ± 4.9%, p = 0.048), and less sleep stage change among stage I to III and REM (90.0 ± 18.4 times versus 222.7 ± 108.3 times, p = 0.008) were significant predictive factors for formation of ipsilateral stone as sleep posture. Age, gender, BMI, or other polysomnographic parameters were failed to show association with urinary stone sites. CONCLUSIONS Unilateral urolithiasis formation is correlated to sleep posture. Deeper sleep stage with less sleep stage change may consolidate such correlation. Sleep posture Right stones (% in sleep posture) Left stones (% in sleep posture) Total Positive predictive value Supine 23 (44.2%) 29 (55.8%) 52 Right decubitus 8 (88.9%) 1 (11.1%) 9 88.9% Left decubitus 1 (50%) 1 (50%) 2 50% Rotisserie-like 0 (0%) 4 (100%) 4 Total 32 35 67 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1024-e1025 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wei-Ming Cheng More articles by this author Tuz-Hao Huang More articles by this author Yu-Hua Fan More articles by this author Alex T.L. Lin More articles by this author Kuang-Kuo Chen More articles by this author Shi-Chuan Chang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...