Satoshi Hamada1, Yasuharu Tabara2, Kimihiko Murase3, Takeshi Matsumoto4, Kazuya Setoh5, Tomoko Wakamura6, Takahisa Kawaguchi5, Shinji Kosugi7, Takeo Nakayama8, Toyohiro Hirai9, Fumihiko Matsuda10, Kazuo Chin3. 1. Department of Advanced Medicine for Respiratory Failure, Kyoto University Graduate School of Medicine, Kyoto, Japan. 2. Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; Research Support Center, Shizuoka General Hospital, Aoi-ku, Shizuoka, Japan. Electronic address: tabara@genome.med.kyoto-u.ac.jp. 3. Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. 4. Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Respiratory Medicine, Saiseikai-Noe Hospital, Osaka, Japan. 5. Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. 6. Department of Nursing Science, Kyoto University Graduate School of Medicine, Kyoto, Japan. 7. Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan. 8. Research Support Center, Shizuoka General Hospital, Aoi-ku, Shizuoka, Japan; Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan. 9. Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. 10. Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; Research Support Center, Shizuoka General Hospital, Aoi-ku, Shizuoka, Japan.
Abstract
AIMS: Sleep-disordered breathing (SDB) is a well-known risk factor for cardiovascular outcomes. Studies of patients with SDB have identified frequent night-time urination as a manifestation related to SDB. We aimed to clarify whether night-time frequency of urination is independently associated with SDB in a general population. We also investigated whether night-time frequency of urination can help presumptive diagnose SDB. METHODS: Study participants consisted of 7151 community residents. Oxygen saturation during sleep was measured for four nights using a pulse oximeter. SDB was defined as ≥15 events per hour in which oxygen desaturation exceeded or equal to 3% during an actigraphy-determined sleep period. Night-time frequency of urination was recorded for one week using a sleep diary. RESULTS: Significant positive correlations were evident between night-time frequency of urination and SDB (none, 5.8%; once/night, 14.1%; twice/night, 20.1%; thrice/night, 28.7%; >thrice/night, 44.1%, P < 0.001). This association was independent of possible covariates, including sleep duration (adjusted odds ratio: once/night = 1.50, twice/night = 2.15, thrice/night = 3.07, >thrice/night = 3.73, P < 0.001). Other factors significantly associated with SDB were age, sex, obesity, observation of sleep apnea, and short sleep duration. The area under the curve of the risk score for SDB consisting of these conventional six items (0.834) significantly improved (0.842, P = 0.001) when night-time frequency of urination was considered as a risk score item. CONCLUSION: Night-time frequency of urination was associated with SDB. Our findings suggest that the urination frequency should be considered a manifestation of SDB even in a general population.
AIMS: Sleep-disordered breathing (SDB) is a well-known risk factor for cardiovascular outcomes. Studies of patients with SDB have identified frequent night-time urination as a manifestation related to SDB. We aimed to clarify whether night-time frequency of urination is independently associated with SDB in a general population. We also investigated whether night-time frequency of urination can help presumptive diagnose SDB. METHODS: Study participants consisted of 7151 community residents. Oxygen saturation during sleep was measured for four nights using a pulse oximeter. SDB was defined as ≥15 events per hour in which oxygen desaturation exceeded or equal to 3% during an actigraphy-determined sleep period. Night-time frequency of urination was recorded for one week using a sleep diary. RESULTS: Significant positive correlations were evident between night-time frequency of urination and SDB (none, 5.8%; once/night, 14.1%; twice/night, 20.1%; thrice/night, 28.7%; >thrice/night, 44.1%, P < 0.001). This association was independent of possible covariates, including sleep duration (adjusted odds ratio: once/night = 1.50, twice/night = 2.15, thrice/night = 3.07, >thrice/night = 3.73, P < 0.001). Other factors significantly associated with SDB were age, sex, obesity, observation of sleep apnea, and short sleep duration. The area under the curve of the risk score for SDB consisting of these conventional six items (0.834) significantly improved (0.842, P = 0.001) when night-time frequency of urination was considered as a risk score item. CONCLUSION: Night-time frequency of urination was associated with SDB. Our findings suggest that the urination frequency should be considered a manifestation of SDB even in a general population.