Nonpharmacologic Therapy Ups Sleep Quality in Women With Nocturia
At least half of women using tibial nerve stimulation or pelvic floor muscle training experienced fewer night awakenings, according to a new study.
Both tibial nerve stimulation (TNS) and pelvic floor muscle training (PFMT) can improve sleep quality in women with nocturia, according to new study findings.
In a randomized trial, 40 women with self-reported nocturia were blindly assigned to transcutaneous electrical TNS or PFMT with behavioral therapy for 30 minutes each week for 3 months. PFMT inhibits detrusor contraction, and TNS eases lower urinary tract symptoms. Women with neurogenic bladder or on antimuscarinic or antidiuretic therapy were among the excluded patients.
Sleep quality improved equally for both groups, Patricia Driusso, PhD, of Federal University of São Carlos in Brazil and colleagues reported online in the International Urogynecology Journal. Compared with baseline, Pittsburgh Sleep Quality Index (PSQI) score declined significantly from 9 to 7 in the TNS group and from 8 to 5 in the PFMT group; scores of 0 to 4 indicate good sleep. Although overall quality of life related to urinary incontinence did not improve on the King's Health Questionnaire, the sleep/energy domain scores also significantly declined from 66.7 to 16.7 for TNS patients and from 66.7 to 0 in PFMT patients, indicating clinically meaningful improvement. Half of the TNS group and three quarters of the PFMT group reduced their episodes of night awakenings.
“Given that both interventions are relatively easy to perform, and that a great number of patients had positive responses, both TNS and PFMT can be considered as an alternative to improve quality of sleep of women with nocturia,” Dr Driusso's team concluded.
While successful in the short-term, the interventions still need to be tested in larger samples of women for longer periods.
Furtado-Albanezi D, Pilon Jürgensen S, Arias Avila M, Nascimento Correia G, and Driusso P. Effects of two nonpharmacological treatments on the sleep quality of women with nocturia: a randomized controlled clinical trial. Intl Urogyn J. doi: 10.1007/s00192-018-3584-8