Obstructive Sleep Apnea Syndrome and Overactive Bladder: Expanding the Perspective to Women-A Narrative Review

Area of Science:

• Urology
• Sleep Medicine
• Women's Health

Background:

• Obstructive sleep apnea syndrome (OSAS) is a multisystem disorder affecting the lower urinary tract, including overactive bladder (OAB).
• Existing research on OSAS and OAB predominantly features male populations, underrepresenting women's unique physiology.
• This review focuses on female-specific mechanisms linking OSAS and OAB, addressing a gap in current literature.

Purpose of the Study:

• To review female-specific pathophysiological mechanisms connecting OSAS and OAB.
• To examine emerging clinical evidence on OSAS and OAB in women.
• To discuss implications for evaluating women with OAB and potential OSAS contributions.

Main Methods:

• Literature review of studies investigating the association between OSAS and OAB.
• Focus on research highlighting female populations and specific pathophysiological pathways.
• Analysis of evidence regarding OSAS treatment effects on OAB symptoms in women.

Main Results:

• A significant association exists between OSAS and OAB, mediated by intermittent hypoxia, autonomic dysfunction, and inflammation.
• Female-specific factors like menopause and estrogen deficiency may exacerbate OAB symptoms in the context of OSAS.
• Continuous positive airway pressure (CPAP) treatment for OSAS shows potential for improving OAB symptoms, suggesting a modifiable link.

Conclusions:

• OSAS is a potential contributing factor to OAB, particularly in women with refractory symptoms or nocturia.
• A comprehensive, multidisciplinary approach is recommended for evaluating women with OAB, considering potential OSAS.
• Further prospective studies focusing on female populations are crucial to establish causality and identify optimal screening candidates.