Skip to main content
Top
Published in: International Urogynecology Journal 6/2015

01-06-2015 | Original Article

Prevalence of obstructive sleep apnea detected by the Berlin Questionnaire in patients with nocturia attending a urogynecology unit

Authors: Salomon Zebede, Danny Lovatsis, May Alarab, Harold Drutz

Published in: International Urogynecology Journal | Issue 6/2015

Login to get access

Abstract

Introduction and hypothesis

Nocturia has been associated with several chronic conditions including obstructive sleep apnea (OSA). The pathophysiological link between nocturia and OSA has been well delineated, but the prevalence of this condition in patients with nocturia is unknown. The aim of this study was to determine the prevalence of sleep apnea in patients with nocturia compared with patients without nocturia in a group of women referred to a urogynecology unit.

Methods

After ethics approval, a cross-sectional case control study including 81 cases and 79 controls was conducted. The sample size of 72 patients was required for each arm to detect a 23 % difference in the prevalence of OSA with a 95 % confident interval (CI) and statistical power of 80 %. All patients completed the Nocturia, Nocturia Enuresis and Sleep Interruption Questionnaire (NNES-Q) and the Berlin OSA Questionnaire. The NNES-Q was used to define cases and controls. The Berlin Questionnaire was used to classify patients as being at a high or a low risk of having OSA. Univariate analysis was first performed, followed by logistic regression to assess the association between nocturia and OSA, as well as other possible variables associated with nocturia.

Results

Fifty of the cases (61.7 %) were classified as being at a high risk of having OSA compared with only 19 (24.1 %) in the control group (OR 2.9, 95 % CI 1.29–6.52, p = 0.01). Other variables found to be statistically significant by logistic regression were high BMI, overactive bladder, and low bladder capacity (<300 cc).

Conclusion

Patients with nocturia showed a significantly higher risk of having OSA. Patients with nocturia should be screened for OSA.
Literature
1.
go back to reference Van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):179–183CrossRefPubMed Van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):179–183CrossRefPubMed
2.
go back to reference Swithinbank LV, Donovan JL, de Heaume JC, Rogers CA, James MC, Yang Q et al (1999) Urinary symptoms and incontinence in women: relationships between occurrence, age, and perceived impact. Br J Gen Pract 49:897–900PubMedCentralPubMed Swithinbank LV, Donovan JL, de Heaume JC, Rogers CA, James MC, Yang Q et al (1999) Urinary symptoms and incontinence in women: relationships between occurrence, age, and perceived impact. Br J Gen Pract 49:897–900PubMedCentralPubMed
3.
go back to reference Asplund R, Aberg H (1996) Nocturnal micturition, sleep and well-being in women of ages 40–64 years. Maturitas 24:73–81CrossRefPubMed Asplund R, Aberg H (1996) Nocturnal micturition, sleep and well-being in women of ages 40–64 years. Maturitas 24:73–81CrossRefPubMed
4.
go back to reference Stewart RB, Moore MT, May FE, Marks RG, Hale WE (1992) Nocturia: a risk factor for falls in the elderly. J Am Geriatr Soc 40:1217–1220CrossRefPubMed Stewart RB, Moore MT, May FE, Marks RG, Hale WE (1992) Nocturia: a risk factor for falls in the elderly. J Am Geriatr Soc 40:1217–1220CrossRefPubMed
5.
go back to reference Asplund R (1999) Mortality in the elderly in relation to nocturnal micturition. BJU Int 84:297–301CrossRefPubMed Asplund R (1999) Mortality in the elderly in relation to nocturnal micturition. BJU Int 84:297–301CrossRefPubMed
6.
go back to reference Swithinbank LV, Donovan J, James MC, Yang Q, Abrams P (1997) Female urinary symptoms; age prevalence in a community dwelling population using a validated questionnaire. Neurourol Urodyn 16:432–434 Swithinbank LV, Donovan J, James MC, Yang Q, Abrams P (1997) Female urinary symptoms; age prevalence in a community dwelling population using a validated questionnaire. Neurourol Urodyn 16:432–434
7.
go back to reference Fitzgerald MP, Mulligan M, Parthasarathy S (2006) Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment. Am J Obstet Gynecol 194:1399–1403CrossRefPubMed Fitzgerald MP, Mulligan M, Parthasarathy S (2006) Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment. Am J Obstet Gynecol 194:1399–1403CrossRefPubMed
8.
go back to reference Oztura I, Kaynak D, Kaynak HC (2006) Nocturia in sleep-disordered breathing. Sleep Med 7(4):362–367CrossRefPubMed Oztura I, Kaynak D, Kaynak HC (2006) Nocturia in sleep-disordered breathing. Sleep Med 7(4):362–367CrossRefPubMed
9.
go back to reference Umlauf MG, Chasene ER (2003) Sleep disordered breathing and nocturnal polyuria: nocturia and enuresis. Sleep Med Rev 7(5):403–411CrossRefPubMed Umlauf MG, Chasene ER (2003) Sleep disordered breathing and nocturnal polyuria: nocturia and enuresis. Sleep Med Rev 7(5):403–411CrossRefPubMed
10.
go back to reference Umlauf MG, Chasens ER, Greevy RA, Arnold J, Burgio KL, Pillion DJ (2004) Obstructive sleep apnea nocturia and polyuria in older adults. Sleep 27(1):139–144PubMed Umlauf MG, Chasens ER, Greevy RA, Arnold J, Burgio KL, Pillion DJ (2004) Obstructive sleep apnea nocturia and polyuria in older adults. Sleep 27(1):139–144PubMed
11.
go back to reference Lowenstein L, Kenton K, Brubaker L, Pillar G, Undevia N, Mueller ER, FitzGerald MP (2008) The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women. Am J Obstet Gynecol 198(5):598.e1–598.5 Lowenstein L, Kenton K, Brubaker L, Pillar G, Undevia N, Mueller ER, FitzGerald MP (2008) The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women. Am J Obstet Gynecol 198(5):598.e1–598.5
12.
go back to reference Kang K, Park KS, Kim JE, Kim SW, Kim YT, Kim JS, Lee HW (2013) Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study. Sleep Breath 17(2):803–810CrossRefPubMed Kang K, Park KS, Kim JE, Kim SW, Kim YT, Kim JS, Lee HW (2013) Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study. Sleep Breath 17(2):803–810CrossRefPubMed
13.
go back to reference Hajduk IA, Strollo PJ Jr, Jasani RR, Atwood CW Jr, Houck PR, Sanders MH (2003) Prevalence and predictors of nocturia in obstructive sleep apnea-hypopnea syndrome—a retrospective study. Sleep 26(1):61–64PubMed Hajduk IA, Strollo PJ Jr, Jasani RR, Atwood CW Jr, Houck PR, Sanders MH (2003) Prevalence and predictors of nocturia in obstructive sleep apnea-hypopnea syndrome—a retrospective study. Sleep 26(1):61–64PubMed
14.
go back to reference Bing MH, Moller LA, Jennum P, Mortensen S, Lose G (2006) Validity and reliability of a questionnaire for evaluating nocturia, nocturnal enuresis and sleep-interruptions in an elderly population. Eur Urol 49(4):710–719CrossRefPubMed Bing MH, Moller LA, Jennum P, Mortensen S, Lose G (2006) Validity and reliability of a questionnaire for evaluating nocturia, nocturnal enuresis and sleep-interruptions in an elderly population. Eur Urol 49(4):710–719CrossRefPubMed
16.
go back to reference Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 1:5–26CrossRef Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 1:5–26CrossRef
17.
go back to reference Cornu JN, Abrams P, Chapple CR, Dmochowski RR, Lemack GR, Michel MC, Tubaro A, Madersbacher S (2012) A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management—a systematic review and meta-analysis. Eur Urol 62(5):877–890CrossRefPubMed Cornu JN, Abrams P, Chapple CR, Dmochowski RR, Lemack GR, Michel MC, Tubaro A, Madersbacher S (2012) A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management—a systematic review and meta-analysis. Eur Urol 62(5):877–890CrossRefPubMed
18.
go back to reference Weiss JP, van Kerrebroeck PE, Klein BM, Norgaard JP (2011) Excessive nocturnal urine production is a major contributing factor to the etiology of nocturia. J Urol 186:1358–1363CrossRefPubMed Weiss JP, van Kerrebroeck PE, Klein BM, Norgaard JP (2011) Excessive nocturnal urine production is a major contributing factor to the etiology of nocturia. J Urol 186:1358–1363CrossRefPubMed
19.
go back to reference Margel D, Shochat T, Getzler O, Livne PM, Pillar G (2006) Continuous positive airway pressure reduces nocturia in patients with obstructive sleep apnea. Urology 67(5):974–977CrossRefPubMed Margel D, Shochat T, Getzler O, Livne PM, Pillar G (2006) Continuous positive airway pressure reduces nocturia in patients with obstructive sleep apnea. Urology 67(5):974–977CrossRefPubMed
20.
go back to reference Guilleminault C, Lin CM, Goncalves MA, Ramos E (2004) A prospective study of nocturia and the quality of life of elderly patients with obstructive sleep apnea or sleep onset insomnia. J Psychosom Res 56(5):511–515CrossRefPubMed Guilleminault C, Lin CM, Goncalves MA, Ramos E (2004) A prospective study of nocturia and the quality of life of elderly patients with obstructive sleep apnea or sleep onset insomnia. J Psychosom Res 56(5):511–515CrossRefPubMed
21.
go back to reference Kiely JL, Murphy M, McNicholas WT (1999) Subjective efficacy of nasal CPAP therapy in obstructive sleep apnoea syndrome: a prospective controlled study. Eur Respir J 13(5):1086–1090CrossRefPubMed Kiely JL, Murphy M, McNicholas WT (1999) Subjective efficacy of nasal CPAP therapy in obstructive sleep apnoea syndrome: a prospective controlled study. Eur Respir J 13(5):1086–1090CrossRefPubMed
22.
go back to reference Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263PubMed Epstein LJ, Kristo D, Strollo PJ Jr et al (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263PubMed
24.
go back to reference Smith A, Wein A (2013) Current pharmacotherapy of nocturia. Expert Opin Pharmacother 14(7):885–894CrossRefPubMed Smith A, Wein A (2013) Current pharmacotherapy of nocturia. Expert Opin Pharmacother 14(7):885–894CrossRefPubMed
25.
go back to reference Chen CY, Hsu CC, Pei YZ, Yu CC, Chen YZ, Chen CL (2011) Nocturia is an independent predictor of sever obstructive sleep apnea in patients with ischemic stroke. J Neurol 258(2):189–194CrossRefPubMed Chen CY, Hsu CC, Pei YZ, Yu CC, Chen YZ, Chen CL (2011) Nocturia is an independent predictor of sever obstructive sleep apnea in patients with ischemic stroke. J Neurol 258(2):189–194CrossRefPubMed
26.
go back to reference Romero E, Krakow K, Haynes P, Ulibarri V (2010) Nocturia and snoring: predictive symptoms for obstructive sleep apnea. Sleep Breath 14(4):337–343CrossRefPubMed Romero E, Krakow K, Haynes P, Ulibarri V (2010) Nocturia and snoring: predictive symptoms for obstructive sleep apnea. Sleep Breath 14(4):337–343CrossRefPubMed
27.
go back to reference Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342(19):1378–1384CrossRefPubMed Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342(19):1378–1384CrossRefPubMed
28.
Metadata
Title
Prevalence of obstructive sleep apnea detected by the Berlin Questionnaire in patients with nocturia attending a urogynecology unit
Authors
Salomon Zebede
Danny Lovatsis
May Alarab
Harold Drutz
Publication date
01-06-2015
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 6/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-014-2618-0

Other articles of this Issue 6/2015

International Urogynecology Journal 6/2015 Go to the issue