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Randomized Controlled Trial
. 2018 Feb;131(2):204-211.
doi: 10.1097/AOG.0000000000002443.

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

Qurratul A Warsi  1 , Alison J Huang, Rachel Hess, Lily A Arya, Holly E Richter, Catherine S Bradley, Rebecca G Rogers, Deborah L Myers, Karen C Johnson, William D Winkelman, W Thomas Gregory, Stephen R Kraus, Michael Schembri, Jeanette S Brown, Katie L Stone, Leslee L Subak
Affiliations
Randomized Controlled Trial

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

Qurratul A Warsi et al. Obstet Gynecol. 2018 Feb.

Abstract

Objective: To evaluate the association between pharmacologic therapy for urgency urinary incontinence (UUI) and sleep quality.

Methods: We conducted a planned secondary data analysis of sleep outcomes in a previously conducted multicenter, double-blind, 12-week randomized trial of pharmacologic therapy for urgency-predominant incontinence among community-dwelling women self-diagnosed using the 3-Incontinence Questions questionnaire. Participants (N=645) were assigned randomly to 4-8 mg antimuscarinic therapy daily or 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, and the Epworth Sleepiness Scale to evaluate daytime sleepiness.

Results: Mean (SD) age was 56 (±14) years, 68% were white, and 57% had poor sleep quality (Pittsburgh Sleep Quality Index score greater than 5). Mean frequency of any urinary incontinence and UUI was 4.6 and 3.9 episodes/d, respectively. After 12 weeks, women randomized to the antimuscarinic group reported greater decrease compared with the placebo group in UUI frequency (0.9 episodes/d; P<.001) and diurnal and nocturnal voiding frequency (P<.05). As compared with the placebo group, women in the antimuscarinic group also reported greater improvement in sleep quality (total Pittsburgh Sleep Quality Index score 0.48; P=.02) with greater improvement in sleep duration and sleep efficiency subscales (P<.05). The intervention did not affect daytime sleepiness.

Conclusion: Pharmacologic 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: ClinicalTrials.gov, NCT00862745.

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Conflict of interest statement

Financial Disclosure: The other authors did not report any potential conflicts of interest.

Figures

Figure 1
Figure 1. Recruitment, randomization, and retention in the BRIDGES trial
Recruitment, randomization, and retention in the Bringing Simple Urge Incontinence Diagnosis and Treatment to Providers (BRIDGES) trial. 3-IQ-3, 3-Incontinence Questions. *Not mutually exclusive.
See this image and copyright information in PMC

Comment in

  • In Search of More Sleep.
    Amundsen CL, Preud'Homme XA. Amundsen CL, et al. Obstet Gynecol. 2018 Feb;131(2):201-203. doi: 10.1097/AOG.0000000000002470. Obstet Gynecol. 2018. PMID: 29324616 No abstract available.

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