Association of obstructive sleep apnea risk factors with nocturnal enuresis in postmenopausal women.
Association of obstructive sleep apnea risk factors with nocturnal enuresis in postmenopausal women.
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DOI:
10.1097/gme.0000000000000517
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发表时间:
2016-02
期刊:
影响因子:
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通讯作者:
Eaton CB
中科院分区:
文献类型:
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作者:
Koo P;McCool FD;Hale L;Stone K;Eaton CB
The prevalence of obstructive sleep apnea (OSA) in women increases significantly after menopause. However, identifying at-risk women in this population is difficult because they tend to underreport symptoms and their complaints may differ from those traditionally associated with OSA. We investigated whether OSA risk factors are associated with the presence of a “non-traditional” complaint such as nocturnal enuresis in postmenopausal women. A cross-sectional study of postmenopausal women ages 50–79, who participated in the Women Health Initiative Observational and Clinical Trial Studies (1993–2005) at 40 Clinical Centers in the United States, was performed. Multiple variable logistic regression analysis was employed to determine the association of OSA risk factors with nocturnal enuresis. A cohort of 2,789 women (1.7%) reported having nocturnal enuresis. Obesity (Odds ratio (OR)=2.29, 95% Confidence Interval (CI) 2.00–2.62), snoring (OR=2.01, 95% CI 1.74–2.32), poor sleep quality (OR=1.70, 95% CI 1.52–1.91), sleep fragmentation (OR=2.44, 95% CI 2.14–2.79), daytime sleepiness (OR=1.50, 95% CI 1.33–1.68), and hypertension (OR=1.13, 95% CI 1.01–1.26) were associated with nocturnal enuresis. Each additional OSA risk factor in a predefined OSA score significantly increased the odds of having nocturnal enuresis in a dose-response fashion (OR=1.38, 2.00, 2.80, 3.87, 5.10, and 7.02 for scores of 1–6, respectively) compared to no risk factors. OSA risk factors are associated with nocturnal enuresis in postmenopausal women. Mechanisms relating nocturnal enuresis to OSA may include apnea-associated changes of intra-thoracic pressure leading to increased urine output. Questioning at-risk postmenopausal women presenting with nocturnal enuresis about other OSA risk factors should be considered.