Abstract
INTRODUCTION: Sleep disordered breathing (SDB) has been shown to increase nocturia (waking with the need to void urine) frequency. Nocturia negatively affects sleep, autonomic dysfunction, mental health and mortality. Nocturia and these co-morbidities share central control areas in the brainstem. We hypothesised that treatment of SDB would decrease nocturia frequency and impact these co-morbidities. METHODS: A prospective repeated measures study with participants ≥40 years, naïve to treatment, with an AHI ≥30/hr and experiencing ≥1 episodes of nocturia was conducted. Participants undertook two months of CPAP with before and after measures of lower urinary tract symptoms (Overactive Bladder Symptom Score (OABSS) and urine volume), sleep quality (PSQI and actigraphy), autonomic dysfunction (blood pressure and orthostatic change) and wellbeing (Nocturia quality of life score (NQoL) and the Hospital anxiety and depression scores (HADS)). RESULTS: 490 diagnostic studies screened, 36 patients met criteria, and 30 participants (57% male) were recruited. 15 patients completed treatment with 55% of completed participants meeting the required compliance of >4 hours. Significant changes in OABSS (p=0.035), nocturnal voiding frequency (p=0.007), nocturnal urine volume (p=0.013) and nocturnal diuresis (p=0.013). Improvement was observed in PSQI perceived sleep quality (p=0.018) and actigraphy derived sleep efficiency (p=0.002). NQoL global score also showed significant improvement (p=0.037).No change was observed in autonomic dysfunction measurements. CONCLUSION: With appropriate treatment of SDB an improvement was observed in nocturia frequency and associated co-morbidities in a sample of relatively healthy individuals. These results suggests that significant nocturia should prompt the assessment for and treatment of SDB.