We examined whether accelerometer-derived rest-activity rhythms (RAR) and multidimensional sleep metrics are associated with overactive bladder (OAB) and whether depression may partially account for this relationship.
This cross-sectional study included 6,603 adults from the National Health and Nutrition Examination Survey (2011-2014). OAB was defined by an Overactive Bladder Symptom Score ≥ 3. Nonparametric RAR metrics-interdaily stability (IS), intradaily variability (IV), and relative amplitude (RA)-and sleep parameters were extracted from 7-day wrist-worn accelerometry. Depression was evaluated with the Patient Health Questionnaire-9. Survey-weighted logistic regression examined associations between RAR and sleep exposures and OAB. Mediation analysis quantified the potential indirect pathway through depression severity.
Weighted OAB prevalence was 21.4%. After full adjustment, each 0.1-unit increase in RA was associated with 17% lower odds of OAB (OR 0.83, 95% CI 0.79-0.88), while each 0.1-unit increase in IV was associated with 5% higher odds (OR 1.05, 95% CI 1.02-1.08). Higher sleep efficiency (OR 0.81 per 10% increase, 95% CI 0.73-0.90) and longer sleep duration (OR 0.95 per hour, 95% CI 0.91-0.99) were also inversely associated with OAB. IS, social jetlag and catch-up sleep showed no independent associations. Depression partially accounted for the RA-OAB relationship.
Weaker rest-activity rhythms and poorer sleep health are cross-sectionally associated with higher OAB prevalence, and depression may partially explain this relationship. These observational findings require prospective validation.
Neurourology and urodynamics. 2026 Jul 17 [Epub ahead of print]
Renjie Huang, Miao Huang, Rui Zhang
Department of Andrology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, China., Department of Neurology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, China.