1/21/2024 0 Comments Nocturia and nocturnal polyuria![]() The combination therapy significantly decreased episodes of nocturia and improved sleep quality. Thus, nocturia in OSA patients should not be underdiagnosed in clinical settings, considering its importance in the prevention and management of cardiovascular diseases.Ī single-therapy group of tamsulosin hydrochloride, an alpha-1-blocker, and a combination-therapy group of tamsulosin hydrochloride and meloxicam, a cyclooxygenase inhibitor-2, were compared to evaluate their effectiveness in improving sleep quality in BPH patients with nocturia. More studies are pointing to the importance of the relationship between coronary heart disease and nocturia. ![]() SDB patients with nocturia who were responsive to CPAP therapy all showed positive outcomes, with decreased systolic blood pressure B-type natriuretic peptide. More significantly, nocturia was predictive of hypertension in OSA patients, and CPAP therapy was recommended as relieving both nocturia and hypertension in one study. Nocturia frequency decreased in terms of urine volume, which largely affected quality of life in OSA patients. CPAP effectively improved daytime sleepiness, depression, and quality of life in OSA patients with nocturia. With one-year treatment of CPAP, most urologic parameters, including nocturia episodes, nocturnal polyuria prevalence, and detrusor overactivity all demonstrated significant improvements. In the findings that attest to the fixed relationship between nocturia and OSA, the effectiveness of continuous positive airway pressure (CPAP) in relieving nocturia has been replicated. Another report with polysomnography (PSG) data reported a higher risk, with a 2.4-fold increase of incidence of severe OSA in patients with a nocturia history. Indeed, when assessed with the Berlin Questionnaire, there was an approximately 3-fold increase in the events classified as high risk of OSA in the nocturia group over those for the controls. According to the aforementioned meta-analysis, such a risk was not changed by the methods implemented to diagnose OSA. ![]() In a recent meta-analysis on the relationship between OSA and nocturia, there was a 1.5-fold increase in the risk of nocturia in men, but no significant relationship was noted in women. The purported mechanism for the frequent nocturia observed in OSA patients is hypoxia induced by OSA and the resultant sequential events of negative pressure breathing and atrial natriuretic peptide secretion, which ultimately lead to nocturia episodes. The relationships between OSA, nocturia, and resultant sleep disturbance have been reported in many previous studies. We will mainly discuss common comorbid conditions of nocturia that clinicians face in clinical settings and their relationships to sleep and OSA. Increments in intra-abdominal pressure, increased atrial natriuretic peptide secretions, and arousals due to OSA may be mechanisms that result in nocturia and resultant poor sleep quality ( Fig. Indeed, mounting evidence emphasizes nocturia as an important clinical indicator of OSA. In explaining the association between sleep and nocturia, much of the recent evidence has centered on the relationship between obstructive sleep apnea (OSA) and sleep. Despite its clinical importance, history taking, proper evaluation, and management of nocturia are frequently dismissed by sleep clinicians. The exact mechanisms underlying the bidirectionality between the two clinical constructs remain elusive. Furthermore, it is usually a challenge for sleep specialists to evaluate whether nocturia precedes insomnia or vice versa. Moreover, detrimental effects on daytime functions and increased prevalence of excessive daytime sleepiness were noted in patients with nocturia. Nocturia is a clinically notable culprit for sleep problems, with reports of a significantly proportional increase in the number of nocturnal voids and a close correlation with poorer sleep quality. In an internet-based survey on the general population aged ≥ 40 years, prevalence of nocturia was 76.1% for women and 74.0% for men. The prevalence of nocturia has been reported to be 11% to 35.2% in men aged 20–40 years, but notably escalated prevalence rates are evident in the elderly population, with rates ranging from 68.9% to 93%. It is closely related to sleep problems, and the bidirectionality of the link between sleep and nocturia is often discussed. Nocturia is a lower urinary-tract symptom (LUTS) that is defined by the International Continence Society as the sensations to void one or more time during the night.
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