The Impact of Obstructive Sleep Apnea Syndrome on Nocturnal Urine Production in Older Men With Nocturia - 26/09/14

Doi : 10.1016/j.urology.2014.02.073

Fumiaki Hoshiyama ^a, Akihide Hirayama ^b,^⁎ , Masahiro Tanaka ^a, Mitsutaka Taniguchi ^c, Motoharu Ohi ^c, Hitoshi Momose ^d, Takahito Nakamura ^e, Shuhei Ogawa ^f, Kazumasa Torimoto ^b, Nobumichi Tanaka ^b, Kiyohide Fujimoto ^b
^a Department of Urology, Osaka Kaisei Hospital, Osaka, Japan
^b Department of Urology, Nara Medical University, Kashihara, Japan
^c Osaka Kaisei Hospital Sleep Medicine Center, Osaka, Japan
^d Department of Urology, Hoshigaoka Koseinenkin Hospital, Hirakata, Japan
^e Department of Respiratory, Hoshigaoka Koseinenkin Hospital, Hirakata, Japan
^f Ogawa Clinic, Katano, Japan

^∗Reprint requests: Akihide Hirayama, M.D., Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.

Abstract

Objective

To investigate the impact of obstructive sleep apnea syndrome (OSAS) on night-time secretion of brain natriuretic peptide (BNP) and antidiuretic hormone (ADH) in older men with nocturia accompanied by nocturnal polyuria.

Materials and Methods

One hundred six men with nocturia aged ≥60 years underwent full-night polysomnography to determine whether they had OSAS. Blood count, standard chemistry panel, BNP, urinary ADH, urinary creatinine (u-Cre), and urinary osmolarity were measured at 6:00 AM, and a frequency volume chart was recorded on the same day that polysomnography was performed.

Results

We evaluated 83 patients after excluding 18 with mild OSAS and 5 with nocturnal polyuria index <0.35. Participants with OSAS had higher apnea-hypopnea index (P <.0001) than those without OSAS. Body mass index and systolic blood pressure were higher in OSAS patients than those in the control group. BNP was higher in the OSAS patients than in the control patients (48.6 ± 41.4 vs 30.7 ± 31.5; P = .0006). On urinalysis, OSAS patients showed higher urinary sodium and u-Cre secretion than controls (24.7 ± 11.3 vs 16.2 ± 5.1; P <.0001). Urine osmolarity was also higher in OSAS patients than in the control patients (616 ± 172 vs 516 ± 174; P = .0285). There was no significant difference in urinary ADH and u-Cre (6.7 ± 10.4 vs 6.8 ± 7.8; P = .3617) between the 2 groups.

Conclusion

Our results indicated that older men with nocturnal polyuria and OSAS did not compensate their fluid imbalance presented with decreased secretion of ADH but increased BNP level.

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