Vaughan Camille P, Fung Constance H, Huang Alison J, Johnson Theodore M, Markland Alayne D
Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama; Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, Georgia; Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia.
Department of Medicine, University of California Los Angeles, North Hills, California; Department of Veterans Affairs Greater Los Angeles Geriatric Research, Education, and Clinical Center, North Hills, California.
Clin Ther. 2016 Nov;38(11):2386-2393.e1. doi: 10.1016/j.clinthera.2016.09.009. Epub 2016 Oct 15.
Nocturia is associated with poor sleep quality; however, little is known about the relationship between nocturia and sleep quality across different workforce-relevant age groups of adults. This has implications for developing new treatment strategies that are well tolerated across populations.
We conducted a cross-sectional study involving merged data from the 2005-2006 and 2007-2008 waves of the National Health and Nutrition Examination Survey. Participants responded to validated questions on nocturia frequency and sleep from the Functional Outcomes of Sleep Questionnaire General Productivity subscale (FOSQ-gp, range 1-4). Analyses included multivariable linear regression with stratification by gender to examine associations between nocturia frequency (higher worse) and the FOSQ-gp scores (lower scores indicating worse daytime function related to sleep disturbance).
Of 10,512 adults aged ≥20 years who completed the survey, 9148 (87%) had complete nocturia and FOSQ-gp data. The population age-adjusted prevalence of nocturia at least twice nightly was 21.1% among men and 26.6% among women (P < 0.001), and nocturia increased with age (P < 0.001). Compared with those with no or 1 episode of nocturia, those with nocturia at least twice nightly reported lower mean FOSQ-gp scores (3.65; 95% CI, 3.61-3.69 vs 3.19; 95% CI, 3.09-3.31 for men and 3.52; 95% CI, 3.48-3.56 vs 3.09; 95% CI, 3.02-3.16 for women). Older adults (aged >65 years) with greater nocturia frequency reported worse FOSQ-gp scores compared with younger adults with similar nocturia frequency (P < 0.001 among men and women).
In a population-based sample of community-dwelling men and women, the association between nocturia and worsened functional outcomes of sleep was greater among adults older than 65 years-a group more vulnerable to drug side effects, and in whom nocturia is typically multifactorial. Additionally, these analyses found that the association between nocturia and functional outcomes of sleep is stronger with increasing age among men. Effective treatment strategies that are well tolerated by older adults, such as multicomponent treatments that simultaneously address the combined effects of lower urinary tract and sleep dysfunction, are needed.
夜尿症与睡眠质量差有关；然而，对于不同与劳动力相关的成年年龄组中夜尿症与睡眠质量之间的关系知之甚少。这对于制定在各人群中耐受性良好的新治疗策略具有重要意义。
我们进行了一项横断面研究，涉及合并来自2005 - 2006年和2007 - 2008年国家健康与营养检查调查的数据。参与者回答了关于夜尿频率和睡眠的经过验证的问题，这些问题来自睡眠问卷总体生产力子量表（FOSQ - gp，范围为1 - 4）。分析包括按性别分层的多变量线性回归，以检查夜尿频率（频率越高越差）与FOSQ - gp分数之间的关联（分数越低表明与睡眠障碍相关的日间功能越差）。
在完成调查的10512名年龄≥20岁的成年人中，9148名（87%）有完整的夜尿症和FOSQ - gp数据。每晚至少夜尿两次的人群年龄调整患病率在男性中为21.1%，在女性中为26.6%（P < 0.001），且夜尿症随年龄增加而增加（P < 0.001）。与无夜尿或仅有1次夜尿发作的人相比，每晚至少夜尿两次的人报告的FOSQ - gp平均分数较低（男性为3.65；95%置信区间，3.61 - 3.69，而每晚至少夜尿两次的男性为3.19；95%置信区间，3.09 - 3.31；女性为3.52；95%置信区间，3.48 - 3.56，而每晚至少夜尿两次的女性为3.09；95%置信区间，3.02 - 3.16）。与夜尿频率相似的年轻成年人相比，夜尿频率更高的老年人（年龄>65岁）报告的FOSQ - gp分数更差（男性和女性中P < 0.001）。
在一个以社区为基础的居住男性和女性样本中，65岁以上成年人中夜尿症与睡眠功能恶化结果之间的关联更大——这一群体更容易受到药物副作用影响，且夜尿症通常是多因素的。此外，这些分析发现男性中夜尿症与睡眠功能结果之间的关联随年龄增长更强。需要有效的、老年人耐受性良好的治疗策略，例如同时解决下尿路和睡眠功能障碍综合影响的多组分治疗。
