Polysomnographic and urodynamic changes in a case of obstructive sleep apnea syndrome with enuresis

A 53-year-old female patient with obstructive sleep apnea syndrome was repo rted. She had complained of anuresis as well as a 15-year history of snorin g, but she had no complaint of sleep and awake disturbance. Polysomnographi c study showed repeated obstructive apnea and hypopnea with an apnea/hypopn ea index of 52.6, and severe oxygen desaturation during sleep. On cystometo graphy during sleep, the changing amplitude of the spike wave corresponds t o the changes of respiratory efforts against a closed upper airway. The pat ient was treated successfully with imipramine and acetazolamide for the obs tructive sleep apnea and enuresis. Apnea/hypopnea index, nocturnal oxygen d esaturation, and sleep architecture were improved, and enuresis completely disappeared. Cystometrography during sleep showed that the average amplitud e of the spike wave tended to be low. Percentage urinary volume during slee p compared with 24 h Volume was significantly reduced. We considered that t he enuresis was mainly related to increased intra-abdominal pressure produc ed by respiratory efforts and enhanced nocturnal urine production.