J Sleep Med.  2020 Jun;17(1):78-83. 10.13078/jsm.200009.

Sleep and Nocturia in Under Age 50 Male Patients with Obstructive Sleep Apnea Syndrome

• Chung YH
• Choi SJ
• Kim JR
• Park J
• Joo EY

• KMID: 2504411
• DOI: http://doi.org/10.13078/jsm.200009

Abstract

Objectives
To investigate the prevalence of nocturia in young patients with obstructive sleep apnea syndrome (OSAS) and to find out the risk factors of nocturia in the patients.
Methods
We enrolled 415 untreated male OSAS patients (apnea-hypopnea index, AHI ≥5/h on polysomnography) who were under 50 years old (mean age 37.5±8.0 years). Participants completed Korean version of Beck depression inventory II (K-BDI-II), Pittsburgh sleep quality index-Korean (PSQI-K), insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Participants were classified into nocturia and non-nocturia group according to the following question “Do you find yourself waking up to urinate more than twice each night?” All information was compared between two groups.
Results
22.7% (94/415) of patients reported to have nocturia. Patients with nocturia had higher score of K-BDI-II, PSQI-K, ISI, and ESS although their age and the proportion of consumption of alcohol or caffeine and metabolic diseases were not different from patients without nocturia. AHI was not significantly higher in nocturia group (38.0±29.2/h) than non-nocturia group (32.8±25.7/h, p=0.118), however, parameters indicating sleep quality were worse in nocturia group, i.e. lesser non-rapid eye movement sleep stage 3 (N3) sleep % and higher arousal index, total apnea index, and 90% oxygen desaturation index (ODI). 90% ODI and N3 sleep % were revealed to be independent factors associated with nocturia.
Conclusions
Considerable numbers of male OSAS patients who are under 50 years suffer from nocturia and they have worse sleep quality compared to non-nocturia patients. Higher oxygen desaturation and lesser N3 sleep % are highly predictive factors for nocturia rather than AHI in these patients.