Departments of Obstetrics, Gynecology, & Reproductive Sciences and Medicine, University of California, San Francisco, San Francisco, California; the Department of Population Health Sciences, University of Utah, Salt Lake City, Utah; the Departments of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, University of Alabama at Birmingham, Birmingham, Alabama, University of Iowa, Iowa City, Iowa, Dell Medical School, University of Texas at Austin, Austin, Texas, Brown University, Providence, Rhode Island, Mount Auburn Hospital/Harvard Medical School, Boston, Massachusetts, Oregon Health Sciences University, Portland, Oregon, and Stanford University School of Medicine, Stanford, California; the Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee; the Department of Urology, University of Texas Health Science at San Antonio, San Antonio, Texas; and California Pacific Medical Center Research Institute, San Francisco, California.
Obstet Gynecol. 2018 Feb;131(2):204-211. doi: 10.1097/AOG.0000000000002443.
To evaluate the association between pharmacologic therapy for urgency urinary incontinence (UUI) and sleep quality.
We conducted a planned secondary data analysis of sleep outcomes in a previously conducted multicenter, double-blind, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence among community-dwelling women self-diagnosed using the 3-Incontinence Questions questionnaire. Participants (N=645) were assigned randomly to 4-8 mg antimuscarinic therapy daily or placebo. At baseline and 12 weeks, participants completed a validated voiding diary to evaluate incontinence and voiding symptoms, the Pittsburgh Sleep Quality Index to evaluate sleep quality, and the Epworth Sleepiness Scale to evaluate daytime sleepiness.
Mean (SD) age was 56 (±14) years, 68% were white, and 57% had poor sleep quality (Pittsburgh Sleep Quality Index score greater than 5). Mean frequency of any urinary incontinence and UUI was 4.6 and 3.9 episodes/d, respectively. After 12 weeks, women randomized to the antimuscarinic group reported greater decrease compared with the placebo group in UUI frequency (0.9 episodes/d; P<.001) and diurnal and nocturnal voiding frequency (P<.05). As compared with the placebo group, women in the antimuscarinic group also reported greater improvement in sleep quality (total Pittsburgh Sleep Quality Index score 0.48; P=.02) with greater improvement in sleep duration and sleep efficiency subscales (P<.05). The intervention did not affect daytime sleepiness.
Pharmacologic treatment of UUI is associated with decreased incontinence frequency and nocturia and improvement in overall sleep quality, sleep duration, and sleep efficiency.
ClinicalTrials.gov, NCT00862745.
评估急迫性尿失禁（UUI）药物治疗与睡眠质量之间的关系。
我们对先前进行的一项多中心、双盲、12 周随机试验进行了计划中的二次数据分析，该试验评估了社区居住的自填 3 个尿失禁问题问卷自我诊断为急迫性尿失禁的女性患者接受以抗毒蕈碱药物治疗的效果。参与者（N=645）随机分为每天接受 4-8 毫克抗毒蕈碱药物治疗或安慰剂治疗。在基线和 12 周时，参与者使用经过验证的排尿日记评估失禁和排尿症状，使用匹兹堡睡眠质量指数评估睡眠质量，使用埃普沃思嗜睡量表评估白天嗜睡。
参与者的平均（SD）年龄为 56（±14）岁，68%为白人，57%的睡眠质量较差（匹兹堡睡眠质量指数评分大于 5）。平均任何尿失禁和 UUI 的频率分别为 4.6 次/d 和 3.9 次/d。12 周后，与安慰剂组相比，接受抗毒蕈碱药物治疗的女性 UUI 频率（0.9 次/d；P<.001）和白天和夜间排尿频率的下降幅度更大（P<.05）。与安慰剂组相比，接受抗毒蕈碱药物治疗的女性睡眠质量（匹兹堡睡眠质量指数总分 0.48；P=.02）也得到了更大的改善，睡眠持续时间和睡眠效率子量表的改善更为显著（P<.05）。干预措施并未影响白天嗜睡。
UUI 的药物治疗与减少尿失禁频率、夜间多尿以及整体睡眠质量、睡眠持续时间和睡眠效率的提高有关。
ClinicalTrials.gov，NCT00862745。
