BACKGROUND AND PURPOSE:

• An important complication of urgency urinary incontinence is sleep disruption
• Approximately 20 to 45% of reproductive-age woman void ≥1 per night, with this number increasing to 75% in women 70 years of age and above
• Limited data as to whether improving UUI also positively impacts sleep
• Warsi et al. (Obstetrics & Gynecology, 2018) studied the impact on UUI treatment and sleep quality

METHODS:

• A secondary analysis of a multicenter, double-blind, 12-week randomized trial
• Women were self-diagnosed for UUI frequency and UI subtypes (urgency, stress, other) of any urinary incontinence and based on the 3-Incontinence Questions questionnaire
• Patients were assigned randomly to
  • 4–8 mg fesoterodine (antimuscarinic) therapy daily
  • Placebo
• At baseline and 12 weeks, participants completed:
  • A validated voiding diary to evaluate incontinence and voiding symptoms
  • The Pittsburgh Sleep Quality Index to evaluate sleep quality
  • The Epworth Sleepiness Scale to evaluate daytime sleepiness

 RESULTS:

• Data was collected from 645 subjects
• 322 women were randomized to antimuscarinic and 323 to placebo
• Follow-up data was availabe for 303 (94.4%) women in the antimuscarinic group and 301 (93.2%) in the placebo group
• Mean (SD) age was 56 (±14) years, 68% were white, and 57% had poor sleep quality
• Mean frequency of any urinary incontinence and UUI was 4.6 and 3.9 episodes per day, respectively
• After 12 weeks, the anti-muscarinic group compared to placebo reported
  • A greater decrease in UUI frequency of 0.88 episodes/d (P<.001)
  • A greater decrease in diurnal and nocturnal voiding frequency (P<.05)
• A greater improvement in sleep quality (total Pittsburgh Sleep Quality Index score 0.48; P=.02)
• A greater improvement in sleep duration and sleep efficiency subscales (P<.05)
• The intervention did not affect daytime sleepiness

CONCLUSION:

• UUI medical treatment leads to decreased incontinence frequency, nocturia, and improved sleep quality

Learn More – Primary Sources:

Association of Pharmacologic Treatment of Urgency Urinary Incontinence With Sleep Quality and Daytime Sleepiness

Related ObG Topics:

AUGS Statement on Anticholinergic Medications for Overactive Bladder and Dementia Risk

Urinary Incontinence – How to Make the Diagnosis in Your Office and When to Refer

Treating Urinary Incontinence Without Surgery: Options and Pearls