夜間頻尿診療ガイドライン

目次
巻頭言...................................................................................................................................................................... iii

1診療アルゴリズム................................................................................................................................ 12

夜間頻尿とは.......................................................................................................................................... 10
1. 夜間頻尿の定義......................................................................................................................................... 102. 夜間頻尿に関連する用語..................................................................................................................... 10
3. 遺尿症との区別......................................................................................................................................... 113

病因と発症機序.................................................................................................................................... 13
1. 多尿，夜間多尿......................................................................................................................................... 131）多尿の原因.............................................................................................................................................. 132）夜間多尿の原因.................................................................................................................................... 15

2. 膀胱蓄尿障害.............................................................................................................................................. 191）前立腺肥大症（BPH）......................................................................................................................... 192）過活動膀胱（OAB）............................................................................................................................. 193）間質性膀胱炎（IC）.............................................................................................................................. 20

3. 睡眠障害........................................................................................................................................................ 21

4

疫 学........................................................................................................................................................... 235

夜間頻尿と QOL. ................................................................................................................................ 29
1. QOL の定義................................................................................................................................................. 29
2. QOL の評価方法....................................................................................................................................... 29
3. 夜間頻尿の QOL に対する影響....................................................................................................... 30
4. 夜間頻尿の QOL 評価質問票. ........................................................................................................... 31vi

目次

診 断........................................................................................................................................................... 3661. 多 尿............................................................................................................................................................. 36
多尿の鑑別診断.................................................................................................................................... 37
2. 夜間多尿........................................................................................................................................................ 40
背景疾患の検索.................................................................................................................................... 413. 膀胱蓄尿障害.............................................................................................................................................. 431）前立腺肥大症（BPH）......................................................................................................................... 432）過活動膀胱（OAB）............................................................................................................................. 443）間質性膀胱炎（IC）.............................................................................................................................. 44

4. 睡眠障害........................................................................................................................................................ 451）生活習慣や睡眠環境による不眠（生理学的不眠）............................................................... 45
2）心理学的不眠......................................................................................................................................... 46
3）精神疾患による不眠.......................................................................................................................... 47
4）身体疾患による不眠.......................................................................................................................... 47
5）薬剤による不眠.................................................................................................................................... 47
6）むずむず脚症候群............................................................................................................................... 47
7）周期性四肢運動障害.......................................................................................................................... 478）睡眠時無呼吸症候群.......................................................................................................................... 47

治7療........................................................................................................................................................... 49

1. 多尿，夜間多尿......................................................................................................................................... 49
1）生活指導，行動療法.......................................................................................................................... 492）夜間多尿に対する薬物療法............................................................................................................ 50
3）高血圧に対する治療.......................................................................................................................... 55

2. 膀胱蓄尿障害.............................................................................................................................................. 59
1）過活動膀胱（OAB）に伴う夜間頻尿.......................................................................................... 592）前立腺肥大症（BPH）に伴う夜間頻尿.................................................................................... 67

3. 不 眠............................................................................................................................................................. 751）不眠に対する治療法.......................................................................................................................... 752）BZ 系睡眠薬の選択および使用法............................................................................................... 753）BZ 系睡眠薬の使用上の注意点.................................................................................................... 78

索引..................................................................................................................................................................... 80
夜間頻尿診療ガイドラインvii