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

Abstract

Objective To evaluate the association between pharmacological therapy for urgency urinary incontinence (UUI) and sleep quality. Methods It is a planned secondary data analysis of sleep outcomes in a previously conducted multicenter, double-blinded, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence among community dwelling women self-diagnosed using the 3-Incontinence Questions (3-IQ) questionnaire. Participants (N = 645) were assigned randomly to antimuscarinic therapy 4–8 mg daily or placebo. At baseline and 12 weeks, participants completed a validated voiding diary to evaluate incontinence/voiding symptoms, the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, and the Epworth Sleepiness Scale to evaluate daytime sleepiness. Results Mean (SD) age was 56 (±14) years, 68% were white race, and 57% had poor sleep quality (PSQI score > 5). Mean frequency of any UI and UUI was 4.6 and 3.9 episodes per day, respectively. After 12-weeks, women randomized to the antimuscarinic group reported greater decrease compared to the placebo group in UUI frequency (0.9 episodes per day; P<0.001) and diurnal and nocturnal voiding frequency (P<0.05). As compared to the placebo group, women in the antimuscarinic group also reported greater improvement in sleep quality (total PSQI score 0.48; p=0.02), with greater improvement in sleep duration and sleep efficiency subscales (P<0.05). The intervention did not affect daytime sleepiness. Conclusions Pharmacological treatment of UUI is associated with decreased incontinence frequency and nocturia and improvement in overall sleep quality, sleep duration, and sleep efficiency. Clinical Trial Registration Clinical Trials.gov, NCT00862745.

Predicting outcomes after intradetrusor onabotulinumtoxina for non‐neurogenic urgency incontinence in women

“…2 The economic burden associated with UUI is tremendous, and its negative impact on quality of life is substantial; UUI is associated with increased rates of depression, falls, fractures, and decreased sleep quality. [3][4][5][6] Given the high side effect burden and discontinuation rates for medications, as well as the high failure rate for behavioral therapy, many women ultimately opt for third-line therapy, including intradetrusor injection of onabotulinumtoxinA (BoNT-A). 7 The ideal BoNT-A dose that will simultaneously optimize efficacy for the longest duration and minimize complications for non-neurogenic UUI is unclear.…”

“…It is a common condition, impacting up to 30% of women older than 30 years old, with a projected increase in prevalence as the population ages 2 . The economic burden associated with UUI is tremendous, and its negative impact on quality of life is substantial; UUI is associated with increased rates of depression, falls, fractures, and decreased sleep quality 3–6 . Given the high side effect burden and discontinuation rates for medications, as well as the high failure rate for behavioral therapy, many women ultimately opt for third‐line therapy, including intradetrusor injection of onabotulinumtoxinA (BoNT‐A) 7 …”

Sleep quality and urinary incontinence in elderly female exercise practitioners

“…Most participants reported the daily use of at least one medication, a finding that might be related to the presence of UI. One study 23 showed that pharmacological treatment of UI improved related symptoms as well as the participants’ sleep quality, demonstrating the relationship between medication use and these two variables. Another study found an association between the development of UI and the use of sleep medications 24 .…”