Nocturnal urination is associated with the presence of higher ventilatory chemosensitivity in patients with obstructive sleep apnea.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2024-10-01 Epub Date: 2024-06-17 DOI:10.1007/s11325-024-03084-3

Lu Dai, Junwei Guo, Xiaona Wang, Jinmei Luo, Rong Huang, Yi Xiao

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Abstract

Purpose: Chemosensitivity is an essential part of the pathophysiological mechanisms of obstructive sleep apnea (OSA). This study aims to use the rebreathing method to assess hypercapnic ventilatory response (HCVR) and analyze the association between chemosensitivity and certain symptoms in patients with OSA.

Methods: A total of 104 male patients with diagnosed OSA were enrolled. The HCVR was assessed using rebreathing methods under hypoxia exposure to reflect the overall chemosensitivity. Univariate and multivariate linear regression were used to explore the association with chemosensitivity. Participants were enrolled in the cluster analysis using certain symptoms, basic characteristics, and polysomnographic indices.

Results: At similar baseline values, the high chemosensitivity group (n = 39) demonstrated more severe levels of OSA and nocturnal hypoxia than the low chemosensitivity group (n = 65). After screening the possible associated factors, nocturnal urination, rather than OSA severity, was found to be positively associated with the level of chemosensitivity. Cluster analysis revealed three distinct groups: Cluster 1 (n = 32, 34.0%) held younger, obese individuals with nocturnal urination, elevated chemosensitivity level, and very severe OSA; Cluster 2 (41, 43.6%) included middle-aged overweighted patients with nocturnal urination, increased chemosensitivity level, but moderate-severe OSA; and Cluster 3 (n = 21, 22.3%) contained middle-aged overweighted patients without nocturnal urination, with a lowered chemosensitivity level and only moderate OSA.

Conclusion: The presence of nocturnal urination in male patients with OSA may be a sign of higher levels of ventilatory chemosensitivity, requiring early therapy efforts independent of AHI levels.

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夜尿与阻塞性睡眠呼吸暂停患者存在较高的通气化学敏感性有关。

目的：化学敏感性是阻塞性睡眠呼吸暂停（OSA）病理生理机制的重要组成部分。本研究旨在使用再呼吸法评估高碳酸通气反应（HCVR），并分析化疗敏感性与 OSA 患者某些症状之间的关联：方法：共招募了 104 名确诊为 OSA 的男性患者。方法：共招募了 104 名确诊为 OSA 的男性患者，在低氧暴露条件下使用再呼吸法评估 HCVR，以反映整体化疗敏感性。采用单变量和多变量线性回归探讨与化疗敏感性的关系。根据某些症状、基本特征和多导睡眠图指标对参与者进行聚类分析：结果：在基线值相似的情况下，高化疗敏感性组（n = 39）的 OSA 和夜间缺氧程度比低化疗敏感性组（n = 65）更严重。在对可能的相关因素进行筛选后，发现夜尿与化疗敏感度呈正相关，而非 OSA 严重程度。聚类分析显示出三个不同的组别：聚类 1（n = 32，34.0%）包括有夜尿、化学敏感性水平升高和非常严重 OSA 的年轻肥胖患者；聚类 2（41，43.6%）包括有夜尿、化学敏感性水平升高但中度严重 OSA 的中年超重患者；聚类 3（n = 21，22.3%）包括没有夜尿、化学敏感性水平降低和仅中度 OSA 的中年超重患者：结论：男性 OSA 患者出现夜尿可能是通气化疗敏感性较高的表现，需要尽早治疗，与 AHI 水平无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.