The impact of sleep apnoea syndrome on nocturia according to age in men

Study Type – Symptom prevalence (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Sleep apnoea syndrome (SAS) can be a risk factor for nocturia, although whether the relationship between nocturia and SAS changes according to age remains to be addressed. SAS has a modest impact on nocturia frequency and the prevalence of pathological nocturia in young adults and middle-aged men. However, SAS may not be a risk factor for nocturia in the elderly, and age-related urinary diseases and voiding dysfunctions could over-ride the influence of SAS on nocturia in the elderly. OBJECTIVE •  To assess the association between nocturia and sleep apnoea syndrome (SAS) according to age, as well as to determine the factors related to nocturia. PATIENTS AND METHODS •  A total of 1757 men who had been referred to a sleep laboratory underwent polysomnography. •  Nocturia frequency was assessed using a questionnaire, and pathological nocturia was defined as the need to void two or more times per night. •  The Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI) were applied to all study subjects. RESULTS •  Nocturia frequency was significantly correlated with age (r= 0.405, P < 0.001) and the apnoea–hypopnoea index (AHI) (r= 0.065, P < 0.01). •  In those men aged <65 years, significant correlations were found between nocturic frequency and age, AHI, BDI and PSQI. •  Multiple regression analysis showed that age (β= 0.303, P < 0.001), AHI (β= 0.107 P < 0.001) and benign prostatic hypertrophy (BPH; β= 0.069, P < 0.01) were associated with nocturia, and that the presence of pathological nocturia was predicted by BPH (odds ratio [OR], 2.77; P < 0.01), age (OR, 1.09; P < 0.001) and AHI (OR, 1.02; P < 0.001). •  However, in men aged >65 years, nocturia frequency was significantly associated with BDI and PSQI, although no relationship was found between nocturia frequency and SAS parameters. •  BPH was more frequently observed in elderly men with pathological nocturia than in those without pathological nocturia (OR, 2.18; P < 0.05). CONCLUSIONS •  In the elderly, SAS may not be a risk factor for nocturia. •  Age-related urinary diseases and voiding dysfunction may over-ride the influence of SAS.