Department of Urology, Nara Medical University Hospital, Kashihara, Japan.
Neurourol Urodyn. 2024 Sep;43(7):1559-1565. doi: 10.1002/nau.25476. Epub 2024 Apr 12.
To investigate changes in subjective and objective sleep quality after desmopressin administration in patients with nocturia due to nocturnal polyuria (NP) using electroencephalography (EEG) and the Pittsburgh sleep quality index (PSQI).
Twenty male patients (≥65 years old) with NP participated in this study. The inclusion criteria were nocturnal frequency ≥ 2, NP index (NPi) ≥ 0.33, first uninterrupted sleep period (FUSP) ≤ 2.5 h, serum sodium concentration ≥ 135 mEq/L, and estimated glomerular filtration rate ≥ 50 mL/min/1.73 m. Participants were given 50 μg of desmopressin to be taken orally once daily before bed. The primary endpoint was the change in the duration of slow-wave sleep (nonrapid eye movement sleep stages 3 and 4), as evaluated by EEG 28 days from the baseline. The visual analog scale (VAS) was used as an additional indicator of sleep quality.
Analysis of data from 15 participants (median age: 74.0 [70.5, 76.0] years) revealed that from before to after desmopressin administration, significant decreases occurred in the median nocturnal frequency (3.0 [2.0, 4.0] to 1.5 [1.0, 2.0]) and NPi (0.445 [0.380, 0.475] to 0.360 [0.250, 0.430]). Furthermore, FUSP was significantly prolonged from 120.0 (94.0, 150.0) min to 210.0 (203.8, 311.3) min. Although the VAS scores improved, slow-wave sleep duration and the PSQI global score showed no significant differences (68.50 [47.50, 75.50] and 48.00 [38.00, 66.50]; 5.0 [5.0, 10.0] and 7.0 [5.0, 9.0] min, respectively).
Oral administration of 50 μg desmopressin improved nocturnal frequency and FUSP in older individuals with NP but did not significantly enhance sleep quality. In older adults, decreased nighttime urinary frequency may enhance quality of life; however, its influence on objective sleep quality may be limited.
使用脑电图（EEG）和匹兹堡睡眠质量指数（PSQI）评估去氨加压素治疗夜间多尿性夜尿症（NP）患者的主观和客观睡眠质量变化。
本研究纳入 20 名年龄均≥65 岁的 NP 男性患者。纳入标准为夜间排尿次数≥2 次，NP 指数（NPi）≥0.33，首次无中断睡眠期（FUSP）≤2.5 h，血清钠浓度≥135 mEq/L，估算肾小球滤过率≥50 mL/min/1.73 m。所有患者均在睡前口服 50 μg 去氨加压素。主要终点为 EEG 评估的慢波睡眠（非快速眼动睡眠阶段 3 和 4）持续时间从基线开始 28 天的变化。使用视觉模拟量表（VAS）作为睡眠质量的额外指标。
对 15 名参与者（中位年龄：74.0[70.5，76.0]岁）的数据进行分析，结果显示，与治疗前相比，去氨加压素治疗后夜间排尿次数（3.0[2.0，4.0]次至 1.5[1.0，2.0]次）和 NPi（0.445[0.380，0.475]至 0.360[0.250，0.430]）中位数显著下降。此外，FUSP 从 120.0（94.0，150.0）min 显著延长至 210.0（203.8，311.3）min。尽管 VAS 评分有所改善，但慢波睡眠持续时间和 PSQI 总分没有显著差异（68.50[47.50，75.50]和 48.00[38.00，66.50]；5.0[5.0，10.0]和 7.0[5.0，9.0]min）。
口服 50μg 去氨加压素可改善老年 NP 患者的夜间排尿频率和 FUSP，但对睡眠质量无显著改善。在老年人中，夜间排尿次数减少可能会提高生活质量；然而，其对客观睡眠质量的影响可能有限。
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