Abstract 11525: Severity of Sleep-Disordered Breathing Has an Impact on the Prevalence of Nocturnal Enuresis in Patients With Cardiovascular Disease
Backgrounds: Enuresis is an essential factor for a tumble at nighttime in hospitalized patients with advanced age. Nocturnal pulse-oxymetry is recommended as a first assessment of respiratory balance and a spectrophotometry of oxygen saturation with a built-in memory device (PULSOX-Me300) is recently performed. We assessed the hypothesis that nocturnal enuresis was associated with apnea-hypopnea while asleep leading to a sporadic hypoxia, and explored the role of B-type natriuretic peptide (BNP) in measuring the severity of sleep-disordered breathing (SDB) assessed by 3% oxygen desaturation index (ODI).
Methods and Results: PULSOX-Me300 was performed on admission in consecutive 109 patients with cardiovascular disease who were electively hospitalized. A total of 12 patients (8 patients with artificial dialysis, 3 patients with acute heart failure and 1 patient without answering a questionnaire on nocturnal enuresis) were excluded in this study. Patients with nocturnal enuresis (n=81) had higher age (69.3±10.8 vs 43.9±20.6 years, P<0.0001), waist circumference (87.5±9.1 vs 79.2±8.8 cm, P=0.001) and hemoglobin A1c (6.2±0.9 vs 5.7±0.5%, P=0.031) and lower estimated glomerular filtration rate (66.6±17.5 vs 79.9±13.2 mL/min/1.73m2, P=0.005) than those without nocturnal enuresis (n=16). Increased 3%ODI and high BNP levels were also observed in patients with nocturnal enuresis (Figure left). Frequency of nocturnal enuresis was positively correlated with 3%ODI (Figure right). A logistic regression analysis revealed that nocturnal enuresis was associated with 3%ODI (P=0.023) independent of age (P=0.038) and sex (P=0.049).
Conclusions: Nocturnal enuresis is deeply involved in apnea-hypopnea while asleep independent of men with advanced age. Our findings may help to explain the missing link between the levels of BNP and the prevalence of enuresis in SDB patients, which may add to the indications for the treatment with continuous positive airway pressure.
- © 2013 by American Heart Association, Inc.