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.
European urology focus. 2022 Jan 10 [Epub ahead of print]
Emma Papworth, Shoba Dawson, Emily J Henderson, Sofia H Eriksson, Hugh Selsick, Jonathan Rees, Amy Gimson, Edward Strong, Nikki Cotterill, Alyson L Huntley, Marcus J Drake
Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK., Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Older Person's Unit, Royal United Hospital NHS Foundation Trust Bath, Combe Park, Bath, UK., Department of Clinical and Experiential Epilepsy, UCL Institute of Neurology, University College London, London, UK., Insomnia and Behavioural Sleep Medicine, University College London Hospitals, London, UK., Tyntesfield Medical Group, North Somerset, Bristol, UK., Southmead Hospital, North Bristol NHS Trust, Bristol, UK., Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK; School of Health and Social Wellbeing, University of the West of England, Bristol, UK., Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: .