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Nocturia is an independent predictor of severe obstructive sleep apnea in patients with ischemic stroke

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Abstract

Severe obstructive sleep apnea (OSA) increases the risk of stroke recurrence and mortality after stroke. Since nocturia is common in post-stroke patients with OSA, this study explored the predictive role of nocturia for severe OSA in patients with ischemic stroke. This was a cross-sectional, prospective study involving 65 consecutive patients with ischemic stroke admitted to rehabilitation ward. All participants received polysomnography and clinical assessments, including a 3-day urinary frequency–volume recording. Differences in study variables between patients with and without severe OSA were compared, and logistic regression analyses with backward selection procedures were used to assess the relationship between OSA severity and nocturia. Patients with severe OSA were older (69.6 ± 9.9 vs. 62.6 ± 11.5 year), had a significantly higher desaturation index (37.9 ± 16.1 vs. 8.8 ± 6.1 episodes/night) and had a higher frequency of nocturia (2.2 ± 1.0 vs. 1.5 ± 0.8 episodes/night) than those without. In addition, men with severe OSA had a larger neck circumference (409 ± 26 vs. 381 ± 32 mm) than those without. The frequency of nocturia, age, sex, and interaction between sex and neck circumference remained significant in the final regression model for severe OSA. In this model, the area under the receiver operating characteristic curve was 0.87 (95% CI 0.79–0.96; P < 0.001) with sensitivity and specificity of 80.6 and 82.8%, respectively. The odds ratio of nocturia was highest (3.5) among the four variables. Nocturia is an independent predictor for severe OSA, and the final prediction model might be used when screening for severe OSA in patients with ischemic stroke.

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Acknowledgments

This work was funded by the Chang Gung Medical Research Council (CMRPG260581). The authors declare that they have no conflict of interest. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chung-Yao Chen, Chih-Chin Hsu & Ying-Syuan Chen

  2. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chung-Chieh Yu

  3. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, 5 Fu-Hsing, St. Kwei-Shan, Tao-Yuan, 333, Taiwan

    Yu-Cheng Pei & Chia-Ling Chen

  4. Department of Physical Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chung-Yao Chen, Chih-Chin Hsu, Yu-Cheng Pei, Chung-Chieh Yu, Ying-Syuan Chen & Chia-Ling Chen

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  1. Chung-Yao Chen
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Correspondence to Chia-Ling Chen.

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Chen, CY., Hsu, CC., Pei, YC. et al. Nocturia is an independent predictor of severe obstructive sleep apnea in patients with ischemic stroke. J Neurol 258, 189–194 (2011). https://doi.org/10.1007/s00415-010-5705-2

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  • DOI: https://doi.org/10.1007/s00415-010-5705-2

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