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Nocturnal Urinary Symptoms as Screening Tools for Obstructive Sleep Apnea.

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Nocturia (frequent nighttime urination) shows promise for screening obstructive sleep apnea (OSA) in urogynecology clinics. Nocturnal enuresis (bedwetting) was less effective for OSA screening.

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Area of Science:

  • Urogynecology
  • Sleep Medicine
  • Pulmonology

Background:

  • Nocturnal lower urinary tract symptoms (LUTS) are associated with obstructive sleep apnea (OSA).
  • Urogynecology clinics are potential sites for OSA screening due to routine LUTS assessment.

Purpose of the Study:

  • To evaluate the accuracy of nocturia and nocturnal enuresis (NE) as screening tools for OSA in new patients at a urogynecology clinic.
  • To determine the sensitivity and specificity of nocturia and NE for identifying OSA.

Main Methods:

  • Retrospective study design analyzing data from women in a urogynecology clinic.
  • Assessed diagnostic OSA testing, CPAP use, and LUTS improvement.
  • Validated questionnaires were used for OSA screening.
  • Polysomnography served as the gold standard for OSA diagnosis.

Main Results:

  • Nocturia (≥2 episodes/night) demonstrated 86.4% sensitivity and 58.5% specificity for OSA screening (overall accuracy 78.4%).
  • Nocturnal enuresis (≥1 episode/week) showed 31.8% sensitivity and 79.3% specificity (overall accuracy 56.1%).

Conclusions:

  • Nocturia is a viable screening tool for OSA in urogynecology settings, with ≥2 episodes per night showing acceptable test characteristics.
  • Nocturnal enuresis exhibited less favorable test characteristics for OSA screening.
  • Urogynecology clinics can integrate nocturia assessment into clinical decision-making for OSA referral.