Association between obstructive sleep apnea syndrome and nocturia: a meta-analysis
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • REVIEW
Association between obstructive sleep apnea syndrome and nocturia: a meta-analysis Jiatong Zhou 1 & Shuai Xia 1 & Tao Li 1 & Ranlu Liu 1 Received: 27 June 2019 / Revised: 13 November 2019 / Accepted: 20 November 2019 # Springer Nature Switzerland AG 2020
Abstract 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. Keywords Nocturia . Meta-analysis . Obstructive sleep apnea . Risk
Introduction OSA was related to daytime sleepiness, which occurs in the nearly 11% for adult male and 4% for adult women [1]. Patients who had OSA could have many symptoms which disturbed them, including snoring, nocturia (urination frequency ≥ 2), and insomnia. Patients with untreated OSA are in high risk for the incidence of hypertension, cardiovascular disease, heart failure, stroke, obesity, metabolic dysregulation, diabetes mellitus, daytime sleepiness, depression, accidents, and all-cause mortality [2–7]. Among the various symptoms of OSA, nocturia is now increasingly followed as an important symptom [8, 9]. The more severe the OSA, the higher the risk and frequency of nocturia [10]. Among the various hypothesis
* Ranlu Liu [email protected] 1
The Second Hospital of Tianjin Medical University, Tianjin, China
relating OSA and nocturia, the purpose of atrial natriuretic peptide (ANP) looks most reasonable. As the OSA patients’ airway obstructed during sleeping, the intrathoracic pressure is reduced, the increase in blood flow to the right atrium would stimulate the release of ANP through the right atrium, and promote urine production, resulting in nocturia. Wang et al. reported that continuous positive airway pressu
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