Abstract: Obstructive sleep apnea (OSA) and nocturia/nocturnal enuresis frequently co-occur in the elderly population, significantly impairing quality of life and elevating risks such as falls and fractures. This article aims to systematically review the underlying mechanisms and therapeutic strategies for this comorbidity from an integrated Traditional Chinese and Western Medicine perspective. From a pathophysiological perspective, intermittent hypoxia and intrathoracic pressure fluctuations induced by OSA collectively contribute to nocturnal polyuria and abnormal bladder storage function through multiple pathways. These include dysregulation of the neuro-humoral axis, direct renal injury, and bladder dysfunction. Traditional Chinese Medicine (TCM) posits that the core pathogenesis involves a root deficiency with superficial excess. This encompasses impaired transformation and transportation functions of the triple energizer (Sanjiao), deficiency of the lung, spleen, and kidney leading to water metabolism disorder, as well as malnourishment of the heart-spirit and emptiness of the marrow-sea, resulting in the loss of "mental control" over urination. In terms of treatment, Western medicine employs methods such as continuous positive airway pressure, pharmacotherapy, and surgery, while TCM utilizes approaches including herbal medicine and acupuncture for holistic regulation. This article emphasizes the critical importance of screening for OSA in elderly patients presenting with nocturia and suggests that future efforts should focus on establishing an integrated diagnostic and therapeutic model combining TCM and Western medicine to optimize patient management.   

Key words: obstructive sleep apnea, nocturia, nocturnal enuresis, pathophysiological mechanisms, treatment