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Association between obstructive sleep apnea syndrome and nocturia: a meta-analysis

  • Jiatong Zhou,
  • Shuai Xia,
  • Tao Li,
  • Ranlu Liu
The Second Hospital of Tianjin Medical University, Tianjin, China

Publication: Sleep and Breathing, January 2020

Background

The relationship between obstructive sleep apnea (OSA) and the risk of nocturia remains unclear. Therefore, we sought to identify whether or not OSA affects the incidence of nocturia.

Methods

A thorough literature search was executed in September 1st 2018 from PubMed, Web of Science database, and Embase. We used DerSimonian and Laird random-effects to calculate the pooled relative ratio (RR).

Results

Total of 13 studies met inclusion criteria and in total comprised, 406 patients and 9518 controls. There was a significant association between OSA and the risk of nocturia (RR = 1.41, 95% CI 1.26–1.59). Through subgroup analysis by different severity of OSA, we found patients who had severe OSA were at high risk of nocturia. Through another subgroup analysis, we found a statistically significant association between OSA and risk of nocturia in the men (RR = 1.487, 95% CI 1.087–2.034, P = 0.013). However, there was no significant relationship between OSA and nocturia in the women (RR = 1.537, 95% CI 0.831–2.842, P > 0.05). Subgroup analysis of different diagnostic methods indicated that OSA was significantly associated with the risk of nocturia regardless what method was used to diagnose OSA (P < 0.05).

Conclusion

The findings suggest that men with OSA have a high incidence of nocturia. A large multicenter study may be useful to explore the relationship between OSA and nocturia, in order to elucidate its causes.

Commentary by Dr. M.S. Rahnama'i

In this meta-analysis a total of 13 studies with  9518 individuals were included. There was a significant association between obstructive sleep apnea and the risk of nocturia (RR = 1.41, 95% CI 1.26-1.59). A subgroup analysis showed that the more severe the  obstructive sleep apnea the higher the risk for nocturia. Although the findings of this study once again confirm that patients with obstructive sleep apnea have a high incidence of nocturia, there are also some limitations in this study. The study only included a subgroup analysis of the severity of obstructive sleep apnea, and did not analyze the possible heterogeneity of gender, age, and race.  Furthermore , patients with obstructive sleep apnea, could have other systemic diseases, including diabetes and cardiovascular disease which can also be a source of heterogeneity.