Clinical predictors of nocturia in the sleep apnea population, "Beyond the Abstract," by Omer A. Raheem, MD, MSc Anat, MCh Urol, MRCS

BERKELEY, CA ( - Nocturia is a key feature of lower urinary tract symptoms (LUTS) that are often attributable to underlying benign prostatic hyperplasia (BPH). However, nocturia can signify a possible contribution of numerous systematic health-related disorders, including obstructive sleep apnea (OSA). Systematic literature review has shown a paucity of data in urological literature detailing nocturia and OSA. This study aimed to increase awareness of nocturia as a potentially complex comorbidity when treating patients with OSA. Particularly, practicing urologists should actively think about sleep apnea when presented with old- or young-aged patients who are complaining of nocturia.

In this systematic study, a total of 200 patients with OSA were randomly included in this study and divided into two groups - Group I contained 100 patients with OSA and no nocturia, and Group II included 100 patients with OSA and nocturia. Bivariate logistic analyses were used to identify variables most likely to contribute to nocturia. Multivariate logistic regression of age, waist circumference, STOP score (Snore, Tired, Obstruction and Pressure), and apnea-hypopnea index (AHI) was performed to evaluate predictors of nocturia. In multivariate analysis, age over 70 years and moderate AHI were statistically significant predictors of nocturia (P = 0.003 and 0.03, respectively).

This study recommends that patients seen for nocturia should be screened for OSA with the STOP score. If there is high risk for OSA, a sleep study is warranted with reflexive specialist referral for positive tests or confusing sleep disturbance symptoms. The converse is equally important. Patients with sleep apnea should be assessed for LUTS/BPH and nocturia symptoms, as they may require specialist evaluation for such. The inter-related disease processes of OSA and nocturia are only beginning to be understood, and a multidisciplinary, team-based approach is critical for the optimal care of these patients.

To conclude, this study identifies age and AHI score as predictors of nocturia in patients with OSA. This may indicate the usefulness of incorporating nocturia in the screening of patients with OSA. Future studies are needed to further evaluate mechanism of action, clinical significance, and effect of treatment for nocturia in patients with OSA.

Written by:
Omer A. Raheem, MD, MSc Anat, MCh Urol, MRCS as part of Beyond the Abstract on This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Department of Urology, University of California, San Diego, CA USA

Clinical predictors of nocturia in the sleep apnea population - Abstract

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