| 原 文 |
題 目 |
Obstructive sleep apnea syndrome is associated with overactive bladder and urgency incontinence in men. |
| 作 者 |
Kemmer H, Mathes AM, Dilk O, Gröschel A, Grass C, Stöckle M. |
| 出 處 |
Sleep |
| 出版日期 |
2009 Feb;32(2):271-5. |
| 評 論 |
阻塞性睡眠呼吸中止症[Obstructive sleep apnea syndrome (OSAS)] 也就是俗稱的嚴重打呼的情形 尤其在肥胖的男性發生率較高，不僅使得枕邊人感到不適外，病患有這些呼吸暫停、睡眠中斷，無法有深度睡眠，會造成白天嗜睡的症狀，以致影響工作注意力或社交活動，甚至引起車禍。阻塞性睡眠呼吸中止症(OSAS) 亦會增加高血壓、心臟衰竭、心肌梗塞或中風的危險。這篇重要的研究探討OSAS首次針對下泌尿道症狀[Lower Urinary Tract Symptom(LUTS)]是否會受到阻塞性睡眠呼吸中止症(OSAS)的影響。這個嚴謹的研究先排除有神經學異常包括多發性硬化症、中風、糖尿病及脊椎疾患之病人後分析阻塞性睡眠呼吸中止症(OSAS)嚴重度與膀胱過動症及急迫性尿失禁嚴重度之相關性。 確實發現有約四成的阻塞性睡眠呼吸中止症(OSAS)病人也有膀胱過動症之症狀， 而且與嚴重度有很明顯的相關。 對泌尿科醫師的啟示來說， 當在門診遇到膀胱過動症的病人需積極地針對病人睡眠情形做更清楚地詢問，或許日後會有研究證實積極的治療阻塞性睡眠呼吸中止症(OSAS)會改善膀胱過動之症狀且改善生活品質。
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| abstract |
STUDY OBJECTIVE: To investigate the incidence of overactive bladder (OAB) and urgency incontinence (UI) in men with obstructive sleep apnea syndrome (OSAS). DESIGN: Prospective questionnaire study SETTING: Saarland University Hospital PATIENTS: All male patients who underwent full-night in-laboratory polysomnography between November 2006 and April 2007. INTERVENTIONS : Overactive bladder symptom score (OABSS) and International Consultation on Incontinence Questionnaire, Short-Form (ICIQ-SF). MEASUREMENTS AND RESULTS: OSAS severity was assessed according to the apnea-hypopnea-index (AHI). Return rate of questionnaires was 100% (n=100). Patients with upper airway resistance syndrome (UARS) served as controls. Evaluation of OABSS revealed that patients with moderate and severe OSAS presented with a significantly higher incidence of symptoms of OAB than patients with mild OSAS and UARS (P<0.05). Further, the ICIQ-SF revealed a higher occurrence of UI in patients with severe OSAS than in those with mild OSAS and UARS (P<.05). CONCLUSIONS: Increasing severity of OSAS appears to be associated with an increasing occurrence of overactive bladder and urgency incontinence in men. This relationship may have clinical implications for the treatment of affected patients.
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