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The role of morphometric and respiratory factors in predicting the severity and evolution of urinary symptoms in patients with obstructive sleep apnea syndrome

  • Basic Science • Original Article
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Abstract

Objectives

To assess the severity, evolution, and behaviour of several urinary symptoms in patients with obstructive sleep apnea syndrome (OSAS) before and after the treatment with continuous positive airway pressure (CPAP).

Methods

A prospective study was performed on patients with a recent diagnosis of sleep apnea confirmed by nocturnal sleep polygraphy and absence of medical urological past history. The symptom incidence was analysed seeking predictive factors for initial nocturia, nocturnal polyuria (NP), and unfavourable International Prostate Symptoms Score (IPSS) before and after a 1-year period of treatment using a CPAP device. Morphometric variables (body mass index, BMI; neck and abdominal diameter) and functional respiratory variables (FEV1, FVC, and FEV1/FVC) were analysed. A multivariate analysis was performed with a calculation of Pearson’s correlation coefficient to establish a linear relation between the variables.

Results

A total of 43 patients completed the two-step study (IPSS and bladder diary before and after the CPAP treatment). IPSS decreased by 3.58 points. Nocturia decreased to once per night. Neck diameter, FEV1, and FEV1/FVC significantly predicted the initial severity of some lower urinary tract symptoms (LUTS), (p=0.015, p=0.029, p=0.008, respectively). Neck diameter, abdominal perimeter, and FEV1/FVC significantly predicted the LUTS evolution throughout the study (p=0.023, p=0.007, p=0.05, respectively).

Conclusion

Some pre-treatment morphometry and spirometry parameters such as abdominal or neck diameter, FEV1, and FEV1/FVC were predictive of the severity and evolution of LUTS in patients with OSAS.

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Abbreviations

24hP:

24-h urine production

24hVF:

24-h voiding frequency

AVV:

Average voided volume

AHI:

Apnea/hipopnea index per hour

AASM:

American Academy of Sleep Medicine

APAP:

Automatic Positive Airway Pressure

BD:

3-day bladder diary

BMI:

Body mass index

DAVV:

Day average voided volume

DIH:

O2 desaturation index per hour

DMVV:

day maximum voided volume

CPAP:

continuous positive airway pressure

CT90:

Cumulative time percentage with SpO2 < 90%

DMVV:

Day maximum voided volume

DVF:

Day voiding frequency

FVC:

Forced vital capacity

FEV1:

Forced expiratory volume in the first second

LUTS:

Low urinary tract symptoms

MVV:

Maximum voided volume

NAVV:

Night average voided volume

NMVV:

Night maximum voided volume.

ND:

Nocturnal diuresis

NP:

Nocturnal polyuria

NPI:

Nocturnal polyuria index

NVF:

Night voiding frequency

NUV:

Nocturnal urine volume

IPSS:

International prostate symptoms score

LUTS:

Lower urinary tract symptoms

OSAS:

Obstructive sleep apnea syndrome

PSA:

Prostatic specific antigen

PVU:

Post-voidal residual urine

Qmax:

Maximal urinary flow

TUR:

Transurethral resection

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Funding

An altruistic assistance has been provided from Universidad de Oviedo in terms of statistical analysis (Unidad de Consultoría Estadística Universidad de Oviedo).

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Authors and Affiliations

  1. Urology Department, Hospital Universitario de Cabueñes, C/ de los Prados, 395, Gijón, Asturias, Spain

    Sergio S. Fernández-Pello, Luis L. Rodríguez Villamil & Rodrigo R. Gil

  2. Urology Department, Universidad de Oviedo, Oviedo, Spain

    Safwan S. Escaf

  3. Neumology Department, Hospital Universitario de Cabueñes, Gijón, Spain

    Amelia A. Alzueta

  4. Surgery Section, Universidad de León, León, Spain

    José Manuel J. M. Gonzalo-Orden

Authors
  1. Sergio S. Fernández-Pello
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  2. Luis L. Rodríguez Villamil
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  3. Rodrigo R. Gil
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  4. Safwan S. Escaf
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  5. Amelia A. Alzueta
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  6. José Manuel J. M. Gonzalo-Orden
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Contributions

Authors whose names appear on the submission have contributed sufficiently to the scientific work and therefore share collective responsibility and accountability for the results.

Corresponding author

Correspondence to Sergio S. Fernández-Pello.

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Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. It is attached as a supplement certification from the local ethical committee.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Fernández-Pello, S.S., Rodríguez Villamil, L.L., Gil, R.R. et al. The role of morphometric and respiratory factors in predicting the severity and evolution of urinary symptoms in patients with obstructive sleep apnea syndrome. Sleep Breath 26, 907–914 (2022). https://doi.org/10.1007/s11325-021-02341-z

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  • DOI: https://doi.org/10.1007/s11325-021-02341-z

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