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

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

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.

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.

Pharmacologic treatment of UUI is associated with decreased incontinence frequency and nocturia and improvement in overall sleep quality, sleep duration, and sleep efficiency.

ClinicalTrials.gov, NCT00862745.

Obstetrics and gynecology. 2018 Jan 09 [Epub ahead of print]

Qurratul A Warsi, 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

Departments of Obstetrics, Gynecology, & Reproductive Sciences and Medicine, University of California, San Francisco, San Francisco, California; the Department of Population Health Sciences, University of Utah, Salt Lake City, Utah; the Departments of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, University of Alabama at Birmingham, Birmingham, Alabama, University of Iowa, Iowa City, Iowa, Dell Medical School, University of Texas at Austin, Austin, Texas, Brown University, Providence, Rhode Island, Mount Auburn Hospital/Harvard Medical School, Boston, Massachusetts, Oregon Health Sciences University, Portland, Oregon, and Stanford University School of Medicine, Stanford, California; the Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee; the Department of Urology, University of Texas Health Science at San Antonio, San Antonio, Texas; and California Pacific Medical Center Research Institute, San Francisco, California.

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