Nocturnal overactive bladder and sleep disruption in middle-aged and older women

项目摘要 膀胱过度活动症（OAB）是一种由反复强烈的排尿冲动、频繁前往 浴室，在某些情况下，不自主的尿液泄漏，影响多达五分之一的成年女性，症状 随着女性年龄的增长变得更加频繁和严重。OAB可以减少的主要方法之一 生活质量是通过扰乱睡眠，高达75%的患者报告与排尿有关的冲动， 晚上醒来小便（A.K.A. Escherichia）。在最有可能患OAB的老年妇女中， 夜间膀胱症状和睡眠中断之间的关系可能是复杂的和双向的， 失眠症可能既是睡眠质量差的原因，也是睡眠质量差的结果。然而，先前的研究表明， OAB对睡眠影响尚未使用睡眠持续时间或中断的客观测量或检查 膀胱症状和睡眠结果之间的关系，在前瞻性的基础上，逐夜评估 夜间觉醒的程度是由排尿的冲动促成的。 为了更深入地了解夜间OAB症状与 睡眠结果，我们安排了40岁女性的多种辅助睡眠措施， 年龄较大的参与了一项正在进行的，NIH资助的，行为慢节奏呼吸的随机试验 干预OAB。利用睡眠日记、问卷调查和活动记录仪的数据，我们将评估是否 夜间膀胱症状与睡眠持续时间减少、睡眠中断程度加重或更严重有关 这一人群的睡眠质量。我们将研究患有这种疾病的女性夜间觉醒的程度 OAB可归因于夜间排尿冲动，而不是其他临床和背景因素。我们还将 评估与实验性慢节奏呼吸干预相关的睡眠结果变化 并探讨对睡眠的干预效果是否通过膀胱症状的变化来介导。这 辅助研究旨在有效利用R03小额赠款计划，以实现重要的 关于老年人夜间OAB症状和睡眠障碍之间关系的科学目的 并评估起搏呼吸作为睡眠不良的行为管理策略的潜力， 这一人口，同时使用有限的额外资源。

PROJECT SUMMARY Overactive bladder (OAB), a syndrome defined by recurrent strong urges to urinate, frequent trips to the bathroom, and in some cases involuntary urine leakage, affects up to one in five adult women, with symptoms becoming more frequent and severe as women age. One of the principal ways in which OAB can decrease quality of life is by disrupting sleep, with up to 75% of patients reporting urges to urinate associated with waking up to urinate at night (a.k.a. nocturia). Among older women who are most likely to suffer from OAB, the relationship between nocturnal bladder symptoms and sleep disruption may be complex and bidirectional, such that nocturia may be both a cause and a consequence of poor sleep quality. However, prior studies of the impact of OAB on sleep have not used objective measures of sleep duration or disruption or examined relationships between bladder symptoms and sleep outcomes on a prospective, night-by-night basis to assess the extent to which nocturnal awakenings are precipitated by urges to urinate. To gain a deeper insight into the strength and direction of relationships between nocturnal OAB symptoms and sleep outcomes, we have arranged to administer multiple ancillary sleep measures in women aged 40 years and older enrolled in an ongoing, NIH-funded, randomized trial of a behavioral slow-paced respiration intervention for OAB. Using data from sleep diaries, questionnaires, and actigraphy, we will assess whether nocturnal bladder symptoms are associated with decreased sleep duration, greater sleep disruption, or worse sleep quality in this population. We will examine the extent to which nocturnal awakenings among women with OAB are attributable to nocturnal urges to void as opposed to other clinical and contextual factors. We will also assess for changes in sleep outcomes associated with the experimental slow-paced respiration intervention and explore whether intervention effects on sleep are mediated by changes in bladder symptoms. This ancillary research is designed to make efficient use of the R03 small grant program to achieve important scientific aims regarding relationships between nocturnal OAB symptoms and sleep disturbance in older women and evaluate the potential of paced respiration as a behavioral management strategy for poor sleep in this population, while using limited additional resources.