Nocturia Clinical Trial
Official title:
Prospective, Randomized, Double-blind Trial of Desmopressin on Nocturia in Obstructive Sleep Apnoea Patients
The purpose of the study is to evaluate the efficacy of desmopressin on symptoms of nocturia in patients with Obstructive Sleep Apnoea (OSA). The improvement of sleep quality and the quality of life will be measured.
Nocturia is one of the commonest urinary symptoms in elderly and in patients with
obstructive sleep apnoea (OSA). According to the International Continence Society (ICS)
definition, nocturia is defined as "the complaint that the individual has to wake at night
one or more times to void" . It implies a continuum beginning from what might be considered
normal, to a bothersome state. Bothersome nocturia is a common and age-dependent condition.
A prevalence ranging from 48.6% to 77% were reported in the literature. Pathogenesis of
nocturia is multi-factorial, and has closely related to OSA. OSA patients generate negative
intrathoracic pressure during sleep, this leads to increased venous return and distension of
the right atrium. This leads to an increase of hormone secretion, namely Atrial Natriuretic
Peptide (ANP). ANP causes increased sodium and water excretion, and inhibits the secretion
of antidiuretic hormone. All of the above factors results in an increased nocturnal urine
production and nocturia.
Middle-aged men with OSA always present to urology clinic with lower urinary tract symptoms
with predominant nocturia. Many a time they were treated as benign prostatic hyperplasia
with multiple medications with suboptimal response. The underlying genuine pathology of
OSA-related nocturia is overlooked.
Desmopressin is an analogue of antidiuretic hormone, it is the pharmacological therapy of
choice for patients with nocturia where night-time polyuria is present.
In this study, the investigators would like to evaluate the efficacy of desmopressin on
symptoms of nocturia in patients with Obstructive Sleep Apnoea (OSA). The improvement of
sleep quality and the quality of life will be measured.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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