睡眠生理監測中不同程度的阻塞型睡眠呼吸中止對於夜尿病患之影響

Effect of Nocturia in Patients with Different Severity of Obstructive Sleep Apnea on Polysomnography

莊毓峰¹、呂謹亨¹、歐宴泉¹、許兆畬¹、童敏哲^1,2

童綜合醫院 外科部泌尿科¹；仁德醫護管理專科學校 護理科²

Yu-Feng Chuang¹, Chin-Heng Lu¹, Yen-Chuan Ou¹Chao-Yu Hsu¹, Min-Che Tung^1,2

¹ Divisions of Urology, Department of Surgery, Tungs’ Taichung Metroharbor Hospital

² Department of Nursing, Jen‑Teh Junior College of Medicine and Management, Hou‑Loung Town, Miaoli, Taiwan

Purpose:

Obstructive sleep apnea (OSA) is one of the major cause of nocturia. How nocturia affect patients with and without OSA on polysomnography (PSG) has not been well established. To clarify the association between nocturia and OSA, we analyzed PSG results of patients with different lower urinary tract symptoms and severity of OSA.  

Methods:

141 male patients with suspected OSA received PSG examination. All patients were divided into 2 groups according to the present of nocturia. The International Prostate Symptom Score (IPSS) questionnaire, age, body mass index (BMI) and PSG parameters including whole-night total sleep time (TST), sleep efficiency (SE), Apnea/Hypopnea Index (AHI), and other factors of these patients were reviewed and analyzed between the two groups. Patients with AHI ≥5 was defined as OSA. Patients with AHI ≥15 and ≥30 was defined moderate and severe OSA respectively.

Results:

In 140 male patients, there were 114 patients with OSA. 48 patients had mild OSA, 34 patients had moderate OSA and 32 patients had severe OSA. In all patients, nocturia patients have higher frequency (P=0.035), worse quality of life (P<0.0001) and decreased baseline SaO2 (P=0.038) significantly. Nocturia did not affect quality of life (P=0.097) and baseline SaO2 (P=0.325) significantly in patients without OSA. In OSA patients, nocturia patients have higher frequency (P=0.028), worse quality of life (P<0.0001) and decreased baseline SaO2 (P=0.037) significantly. In mild OSA patients, frequency (P=0.748), quality of life (P=0.473) and baseline SaO2 (P=0.397) was not affected by nocturia significantly. In moderate OSA patients, nocturia patients have quality of life significantly (P=0.02) and no statistic different in baseline SaO2 (P=0.112). In severe OSA patients, nocturia patients have quality of life (P=0.042) and decreased baseline SaO2 (P=0.039) significantly.

Conclusions:

Nocturia decreases baseline SaO2 and quality of life significantly in patients with suspected OSA especially in severe OSA groups. Nocturia did not affect baseline SaO2 and quality of life in patients with mild or without OSA. For suspected OSA patients, especially for severe OSA group, more urological evaluation and treatment for nocturia is required.