Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Eur Urol Focus. 2022 Jan;8(1):42-51. doi: 10.1016/j.euf.2021.12.011. Epub 2022 Jan 10.
Sleep disorders affect responsiveness to sensory information and can cause nocturnal polyuria and reduced sleep depth; hence, these are potentially influential in understanding the mechanism of nocturia.
To report the systematic review (SR) and expert consensus for primary care management of nocturia in sleep disorders.
Four databases were searched from January to April 2020. A total of 1658 titles and abstracts were screened, and 23 studies potentially applicable were included for full-text screening. The nominal group technique (NGT) was used to derive a consensus on recommendations for management using an expert panel with public involvement.
Thirteen studies met the SR inclusion criteria, all of which studied obstructive sleep apnoea (OSA), with ten evaluating the effect of continuous positive airway pressure. The NGT consensus discussed the assessment of OSA with other key sleep disorders, notably insomnia, restless legs syndrome/periodic limb movements of sleep, and parasomnias, including non-rapid eye movement (non-REM) parasomnias and REM sleep behaviour disorder (RBD). The NGT considered that the use of screening questions to reach a clinical diagnosis is a sufficient basis for offering conservative therapy within primary care. Reasons for referral to a sleep clinic are suspected sleep disorder with substantially impaired daytime function despite conservative treatment. Suspected RBD should be referred, and if confirmed, neurology opinion is indicated. Referrals should follow local guidelines. Persisting nocturia is not currently considered an indication for referral to a sleep clinic.
Sleep disorders are potentially highly influential in nocturia, but are often overlooked.
People with sleep disorders can experience nocturia due to easy waking or increased bladder filling. We looked at published research, and information was limited to one form of sleep disturbance-obstructive sleep apnoea. We assembled a group of experts, to develop practical approaches for assessing and treating nocturia in the potentially relevant sleep disorders.
睡眠障碍会影响对感觉信息的反应能力，并可能导致夜间多尿和睡眠深度降低；因此，这些因素可能对理解夜尿症的发病机制有影响。
报告睡眠障碍患者夜尿症的初级保健管理的系统评价（SR）和专家共识。
从 2020 年 1 月至 4 月，四个数据库进行了搜索。共筛选了 1658 篇标题和摘要，并纳入了 23 项可能适用的研究进行全文筛选。名义群体技术（NGT）用于通过具有公众参与的专家小组就管理建议达成共识。
13 项研究符合 SR 纳入标准，均研究阻塞性睡眠呼吸暂停（OSA），其中 10 项评估了持续气道正压通气的效果。NGT 共识讨论了 OSA 与其他关键睡眠障碍（特别是失眠、不宁腿综合征/睡眠周期性肢体运动和睡眠障碍，包括非快速眼动（非 REM）睡眠障碍和 REM 睡眠行为障碍（RBD））的评估。NGT 认为，使用筛选问题来做出临床诊断是在初级保健中提供保守治疗的充分依据。有理由怀疑睡眠障碍并尽管保守治疗日间功能仍严重受损时应转至睡眠诊所。怀疑 RBD 应转至睡眠诊所，如果确诊，需要神经科医生的意见。转诊应遵循当地指南。持续的夜尿症目前不被认为是转诊至睡眠诊所的指征。
睡眠障碍可能对夜尿症有很大影响，但往往被忽视。
患有睡眠障碍的人可能会因容易醒来或膀胱充盈增加而出现夜尿症。我们查阅了已发表的研究，信息仅限于一种睡眠障碍-阻塞性睡眠呼吸暂停。我们召集了一组专家，制定了在潜在相关睡眠障碍中评估和治疗夜尿症的实用方法。
