Nocturia Improvement With Surgical Correction of Sleep Apnea

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate changes in nocturia after surgical correction of obstructive sleep apnea (OSA).
Methods: A total of 66 patients were included in the present study. All had been diagnosed with OSA syndrome by polysomnography and underwent uvulopalatopharyngoplasty (UPPP). Preoperative and postoperative lower urinary tract symptoms (LUTS), quality of life (QoL), and nocturia episodes were evaluated using the International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) questionnaires. Three months postoperatively, telephone interviews were performed to determine the success of surgery, current LUTS, and nocturia episodes. Patients were divided into surgical success and failure groups. Surgical success was defined as snoring decrease more than 50% based on the patient’s subjective judgment.
Results: The response rate was 56% and success rate was 73%. In all patients, nocturia episodes significantly decreased from 1.7±1.1 to 0.8±1.2 (P=0.002). Mean IPSS score, OABSS score, and QoL scores were also significantly improved. The success group showed a significant decrease in nocturia episodes, and total IPSS, OABSS, and QoL scores. However, the failure group did not show significant changes in all parameters.
Conclusions: OSA correction improved nocturia as well as other LUTS. These improvements were not observed in the failure group. This study shows that OSA is a cause of nocturia and that other LUTS and nocturia can be improved by surgical correction of OSA.

참고문헌 (Reference)

1 Fitzgerald MP, "The association of nocturia with cardiac disease, diabetes, body mass index, age and diuretic use: results from the BACH survey" 177 : 1385-1389, 2007

2 Caples SM, "Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis" 33 : 1396-1407, 2010

3 Middelkoop HA, "Subjective sleep characteristics of 1,485males and females aged 50-93: effects of sex and age, and factors related to self-evaluated quality of sleep" 51 : M108-M115, 1996

4 Endeshaw YW, "Sleep-disordered breathing and nocturia in older adults" 52 : 957-960, 2004

5 Kakkar RK, "Positive airway pressure treatment for obstructive sleep apnea" 132 : 1057-1072, 2007

6 Irwin DE, "Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries:results of the EPIC study" 50 : 1306-1314, 2006

7 Umlauf MG, "Obstructive sleep apnea, nocturia and polyuria in older adults" 27 : 139-144, 2004

8 Zou D, "Obstructive apneic events induce alpha-receptor mediated digital vasoconstriction" 27 : 485-489, 2004

9 Fitzgerald MP, "Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment" 194 : 1399-1403, 2006

10 Stewart RB, "Nocturia: a risk factor for falls in the elderly" 40 : 1217-1220, 1992

11 Oztura I, "Nocturia in sleep-disordered breathing" 7 : 362-367, 2006

12 Barker JC, "Mitteness LS. Nocturia in the elderly" 28 : 99-104, 1988

13 Speakman M, "Efficacy and safety of tamsulosin OCAS" 98 (98): 13-17, 2006

14 최지호, "Effect of Isolated Uvulopalatopharyngoplasty on Subjective Obstructive Sleep Apnea Symptoms" 대한이비인후과학회 6 (6): 161-165, 2013

15 박형근, "Current Evaluation and Treatment of Nocturia" 대한비뇨기과학회 54 (54): 492-498, 2013

16 Margel D, "Continuous positive airway pressure reduces nocturia in patients with obstructive sleep apnea" 67 : 974-977, 2006

17 Epstein LJ, "Clinical guideline for the evaluation, management and longterm care of obstructive sleep apnea in adults" 5 : 263-276, 2009

18 Lindberg E, "CPAP treatment of a population-based sample--what are the benefits and the treatment compliance?" 7 : 553-560, 2006