背景:睡眠障碍会影响对感觉信息的反应,并可导致夜间多尿和睡眠深度降低;因此,这些对理解夜尿症的机制有潜在影响。
目的:报告睡眠障碍夜尿症初级保健管理的系统评价(SR)和专家共识。
方法:从2020年1月至4月检索了四个数据库。总共筛选了1658个标题和摘要,纳入了可能适用的23项研究用于全文筛查.名义组技术(NGT)用于通过公众参与的专家小组就管理建议达成共识。
结果:13项研究符合SR纳入标准,所有这些都研究了阻塞性睡眠呼吸暂停(OSA),10例评估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的评估,尤其是失眠,不宁腿综合征/睡眠的周期性肢体运动,和parasomnias,包括非快速眼动(非快速眼动)和睡眠行为障碍(RBD)。NGT认为,使用筛查问题来达到临床诊断是在初级保健中提供保守治疗的充分基础。转诊到睡眠诊所的原因是怀疑睡眠障碍,尽管进行了保守治疗,但白天功能仍受到严重损害。可疑RBD应转介,如果得到确认,表明了神经病学的意见。推荐应遵循当地指南。持续的夜尿症目前不被认为是转诊到睡眠诊所的指征。
结论:睡眠障碍可能对夜尿症有很大影响,但经常被忽视。
结果:患有睡眠障碍的人由于容易醒来或膀胱充盈增加而可能会出现夜尿症。我们查看了已发表的研究,信息仅限于一种形式的睡眠障碍-阻塞性睡眠呼吸暂停。我们召集了一组专家,开发实用的方法来评估和治疗潜在相关睡眠障碍的夜尿症。
BACKGROUND: 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.
OBJECTIVE: To report the systematic review (SR) and expert
consensus for primary care management of nocturia in sleep disorders.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Sleep disorders are potentially highly influential in nocturia, but are often overlooked.
RESULTS: 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.