Abstract 12807: Severity of Sleep-Disordered Breathing Has an Impact on the Frequency of Nocturnal Enuresis ~ The Challenge With Continuous Positive Airway Pressure to Stop Nocturnal Enuresis in Cardiovascular Patients ~
Introduction: Nocturnal enuresis (NE) is an essential issue and the cause is multifactorial in patients with advanced age. Continuous positive airway pressure (CPAP) is the first-line treatment for patients with symptomatic obstructive sleep apnea (OSA).
Hypothesis: We assessed the hypothesis that NE was associated with sleep-disordered breathing (SDB) and evaluated the effect of CPAP treatment on the frequency of NE in OSA patients with cardiovascular disease.
Methods: A spectrophotometry of oxygen saturation with a built-in memory device was performed in consecutive 546 patients with cardiovascular disease who were electively hospitalized. A total of 36 patients (35 patients with artificial dialysis and 1 patient with no clinical data) were excluded in this study. The remaining 510 patients were divided into NE (n=433) and non-NE (n=77) groups.
Results: Frequency of nocturnal urination was positively correlated with 3% oxygen desaturation index (ODI), suggesting the severity of SDB (r=0.271, P<0.0001). A logistic regression analysis revealed that NE was significantly associated with 3%ODI independent of age, men, systolic blood pressure, brain natriuretic peptide (Table). A total of 98 patients suspected of OSA from 3%ODI underwent polysomnography and a CPAP therapy was introduced in 43 patients. Although the frequency of nocturnal urination was unchanging in 22 patients who discontinued a CPAP treatment, it significantly reduced in 21 patients with consecutive use of CPAP (Figure). Especially, NE was not observed in patients with CPAP therapy >4 hours during asleep almost every night.
Conclusions: NE is frequently observed in SDB patients. Our findings may help to explain the missing link between pathophysiological aggravation of NE and SDB associated cardiovascular risks such as hypertension and heart failure. These are improved by the treatment with CPAP, which may be beneficial in men with advanced age suffering from cardiovascular disease with NE.
Author Disclosures: S. Kojima: None. T. Miyazaki: None. S. Hokimoto: None. H. Ogawa: Other Research Support; Modest; AstraZeneca, Astellas, Boehringer lngelheim, Bristol-Myers Squibb, Daiichi Sankyo, Dainippon Sumitomo Pharma, Kowa, MSD, Novartis, Pfizer, Sanofi, Takeda. Other Research Support; Significant; Bayer, Chugai, Otsuka. Honoraria; Modest; AstraZeneca, Beyer, Pfizer, Sanofi, Takeda. Honoraria; Significant; Daiichi Sankyo, MSD.
- © 2014 by American Heart Association, Inc.