Nocturia, enuresis and snoring: an unusual combination in an adult?

Dushianthan, A. and Ebden, P. (2010) Nocturia, enuresis and snoring: an unusual combination in an adult? British Journal of Hospital Medicine, 71 (9), 532-533. (doi:10.12968/hmed.2010.71.9.78168).

Record type: Article

Abstract

A 41-year-old man was seen in a respiratory clinic with symptoms of snoring, sleepiness during the day, enuresis and nocturia. He was waking up a minimum of 6–7 times to micturate every night. He had a past medical history of hypertension. His medication included lisinopril, omeprazole and simvastatin. He denied significant alcohol intake. On examination he was obese with a body mass index of 32 kg/m2, his blood pressure was raised at 170/120 mmHg. Chest examination revealed clear lung fields and otherwise unremarkable general examination. His collar size was 45 cm. His blood tests suggested normal renal, thyroid, calcium and blood sugar profiles. The mid-stream urine did not show any evidence of urinary tract infection. He had an elevated score of 15/24 on the Epworth Sleepiness scale (a questionnaire tool to assess daytime sleepiness).

He subsequently had an overnight oximetry, which showed 4% oxygenation desaturation index of 80.6 per hour (Figure 1). This is consistent with severe obstructive sleep apnoea hypopnoea syndrome. He was commenced on continuous positive airway pressure with substantial improvement in his sleep apnoea symptoms, including nocturic frequency, and his enuresis is completely resolved.

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