02907nas a2200325 4500008004100000022001400041245010000055210006900155260000900224300001100233490000600244520199600250653000902246653002802255653002802283653001102311653001102322653000902333653001602342653001302358653002002371653002602391100002602417700002402443700002202467700001602489700002002505700002002525856003602545 2012 eng d a1932-620300aNocturia, sleep-disordered breathing, and cardiovascular morbidity in a community-based cohort.0 aNocturia sleepdisordered breathing and cardiovascular morbidity  c2012 ae309690 v73 a

BACKGROUND: Nocturia has been independently associated with cardiovascular morbidity and all-cause mortality, but such studies did not adjust for sleep-disordered breathing (SDB), which may have mediated such a relationship. Our aims were to determine whether an association between nocturia and cardiovascular morbidity exists that is independent of SDB. We also determined whether nocturia is independently associated with SDB.

METHODOLOGY/PRINCIPAL FINDINGS: In order to accomplish these aims we performed a cross-sectional analysis of the Sleep Heart Health Study that contained information regarding SDB, nocturia, and cardiovascular morbidity in a middle-age to elderly community-based population. In 6342 participants (age 63±11 [SD] years, 53% women), after adjusting for known confounders such as age, body mass index, diuretic use, diabetes mellitus, alpha-blocker use, nocturia was independently associated with SDB (measured as Apnea Hypopnea index >15 per hour; OR 1.3; 95%CI, 1.2-1.5). After adjusting for SDB and other known confounders, nocturia was independently associated with prevalent hypertension (OR 1.23; 95%CI 1.08-1.40; P = 0.002), cardiovascular disease (OR 1.26; 95%CI 1.05-1.52; P = 0.02) and stroke (OR 1.62; 95%CI 1.14-2.30; P = 0.007). Moreover, nocturia was also associated with adverse objective alterations of sleep as measured by polysomnography and self-reported excessive daytime sleepiness (P<0.05).

CONCLUSIONS/SIGNIFICANCE: Nocturia is independently associated with sleep-disordered breathing. After adjusting for SDB, there remained an association between nocturia and cardiovascular morbidity. Such results support screening for SDB in patients with nocturia, but the mechanisms underlying the relationship between nocturia and cardiovascular morbidity requires further study. MeSH terms: Nocturia, sleep-disordered breathing, obstructive sleep apnea, sleep apnea, polysomnography, hypertension.

10aAged10aCardiovascular Diseases10aCross-Sectional Studies10aFemale10aHumans10aMale10aMiddle Aged10aNocturia10aPolysomnography10aSleep Apnea Syndromes1 aParthasarathy, Sairam1 aFitzgerald, MaryPat1 aGoodwin, James, L1 aUnruh, Mark1 aGuerra, Stefano1 aQuan, Stuart, F uhttps://chs-nhlbi.org/node/1558