A case of severe obstructive sleep apnea hypopnea syndrome with urinary and anal incontinence
10.11817/j.issn.1672-7347.2018.03.016
- VernacularTitle:重度阻塞性睡眠呼吸暂停低通气综合征并发大小便失禁Ⅰ例
- Author:
Li ZHOU
1
;
Ruoyun OUYANG
;
Ping CHEN
;
Hong LUO
;
Hanmei LIU
;
Guiqian LIU
Author Information
1. 中南大学湘雅二医院呼吸内科
- Keywords:
nocturnal urinary and anal incontinence;
obstructive sleep apnea hypopnea syndrome;
clinical features
- From:
Journal of Central South University(Medical Sciences)
2018;43(3):333-336
- CountryChina
- Language:Chinese
-
Abstract:
A case of a young male patient,who came to the Second Xiangya Hospital,Central South University because of snoring for 10 years and nocturnal gatism for half month,was analyzed retrospectively.He was diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) finally.The patient had been diagnosed and treated as stroke in the local hospital,while urinary and anal incontinence were not relieved.It was a dilemma for him to be properly diagnosed and treated.Polysomnography in our hospital revealed apnea hypopnea index (AHI) at 44.7 events/h,oxygen desaturation index (ODI) at 70.8 events/h and the longest apnea time at 185 seconds while the lowest blood oxygen saturation reduced to 31％.In addition,413 events of apnea accounted for 61.2％ of the sleep time and the minimal heart rate was 23 times/min.The patient was diagnosed as severe OSAHS with hypoxia metabolic brain disease,moderate pulmonary arterial hypertension,secondary polycythemia and obesity hypoventilation syndrome finally.He received the treatment of positive airway pressure non-invasive ventilator with an average pressure at 11.7 cmH2O with reduced AHI and increased blood oxygen saturation.The urinary and anal incontinence disappeared during the first night of treatment and it has been totally resolved so far.We considered that gatism was secondary to OSAHS with severe hypoxia resulted from attenuated regulation of primary defecation in the night.Physicians should pay attention to OSAHS when accepting obese patients with nocturnal incontinence,obvious daytime sleepiness and night snoring.Urinary and anal incontinence could be completely disappeared under therapy of positive airway pressure.
