PT  - JOURNAL ARTICLE
AU  - Abhishek Goyal
AU  - Abhijit Pakhare
TI  - Nocturic OSA as new clinical phenotype of OSA: association of nocturia with very severe OSA
AID  - 10.1183/23120541.sleepandbreathing-2017.P3
DP  - 2017 Apr 01
TA  - ERJ Open Research
PG  - P3
VI  - 3
IP  - suppl 1
4099  - http://openres.ersjournals.com/content/3/suppl_1/P3.short
4100  - http://openres.ersjournals.com/content/3/suppl_1/P3.full
SO  - erjor2017 Apr 01; 3
AB  - Introduction Although nocturia is a known complication of OSA, but its association with OSA severity is not very well defined.Aims and objectives To find out whether nocturia is associated with OSA severityMaterial & methods In a prospective study done in OSA patients diagnosed in sleep lab, detailed sleep history, examination & Level I PSG was done. We divided OSA into three categories: mild to moderate (AHI 5-30), severe(AHI 30-60) & very severe OSA(AHI›60).Nocturia was defined as ›1urine void/night.Results Out of 172 OSA patients,87(50.5%) patients had nocturia and 137 patients (79.5%) woke up at least once during night for urination. Median urination frequency was 1, 1 & 3 in mild-mod(n=60), severe(n=42) and very severe OSA(n=70).On multivariate analysis, for predictors of OSA severity, waist circumference{Odds Ratio (OR) 1.11 (C.I. 1.01-1.23);p=0.037)}, history of apnea{O.R. 3.452(C.I. 1.55-7.66)p=0.002} & history of nocturia(O.R. 2.43 (C.I. 1.08-5.43){p=0.031})were found to be significant in very severe OSA group v/s mild-mod group. Patients with Nocturia were older (p=0.012),had higher AHI (64.8±35.9 v/s43.9±29.1; p<0.001),higher STOPBANG scores (p=0.002),more fatigued during day(p=0.001),higher ESS (p= 0.052),higher BMI (p=0.030),higher waist and hip circumference (p< 0.001 & 0.023 respectively)and lower nadir spO2 during sleep (p=0.002) compared to non nocturics.Conclusion Nocturia(>1/night) is an independent predictor of very severe OSA. Nocturic OSA patients have more severe OSA than non nocturics and it is probably a separate phenotype of OSA. It would be interesting to see whether nocturia can be used as screening question for OSA in community settings.