Breaking News
March 24, 2019 - Practices for Reducing COPD Hospital Readmissions Explored
March 24, 2019 - Could an eye doctor diagnose Alzheimer’s before you have symptoms?
March 24, 2019 - Enzyme inhibitor stops inflammation and neurodevelopmental disorders in mouse models
March 24, 2019 - Walk, Dance, Clean: Even a Little Activity Helps You Live Longer
March 24, 2019 - Americans used less eye care in 2014 versus 2008
March 24, 2019 - Study finds link between depression in 20s linked to memory loss in 50s
March 24, 2019 - New tool helps physiotherapy students to master complex fine motor skills
March 24, 2019 - The AMR Centre secures £2.3m funding boost
March 24, 2019 - Study examines effects of taking ondansetron during first trimester of pregnancy
March 24, 2019 - Researchers identify a more effective treatment for cancer
March 24, 2019 - Open-source solution for multiparametric optical mapping of the heart’s electrical activity
March 24, 2019 - New nanotechnology approach shows promise in treating triple negative breast cancer
March 24, 2019 - Trevena Announces Publication of APOLLO-1 Results in The Journal of Pain Research Highlighting Oliceridine’s Potential for Management of Moderate-to-Severe Acute Pain
March 24, 2019 - Maternal deaths following C-section 50 times higher in Africa compared to high-income countries
March 24, 2019 - Apple watch could detect irregular heart beat says study
March 24, 2019 - Queen Mary University of London’s BCI boosts radionuclide imaging capabilities with MILabs VECTor technology
March 24, 2019 - Girls should be encouraged to gain more ball skills, shows study
March 24, 2019 - Acute doses of synthetic cannabinoid can impair critical thinking and memory
March 24, 2019 - Presence of bacteria in urine does not always point to infection, shows study
March 24, 2019 - Scientists identify a new role for nerve-supporting cells
March 24, 2019 - Hidden differences between pathology of CTE and Alzheimer’s disease discovered
March 24, 2019 - Knowing causative genes of osteoporosis may open door to more effective treatments
March 24, 2019 - Toilet-seat based cardiovascular monitoring system getting ready to begin commercialization
March 24, 2019 - New model for intensive care identifies factors that send ill patients to ICU
March 24, 2019 - Recommendations Issued for HSCT in Multiple Myeloma
March 24, 2019 - Deep brain stimulation provides sustained relief for severe depression
March 24, 2019 - “Statistical significance” may soon be a thing of past?
March 24, 2019 - Researchers track effects of epigenetic marks carried by sperm chromosomes
March 24, 2019 - AHA News: Family Adopts Three Children With Three Different Heart Conditions
March 24, 2019 - Research into opioid painkillers could provide clues for safer drug development
March 23, 2019 - Lung cancer survivor recounts her lifetime struggles
March 23, 2019 - Radial and femoral approach for PCI achieve similar results in terms of survival
March 23, 2019 - Study sheds light on the optimal timing of coronary angiography in NSTEMI patients
March 23, 2019 - Excess hormones could cause a condition that can lead to blindness in women, study finds
March 23, 2019 - Dramatic shifts in first-time opioid prescriptions bring hope, concern
March 23, 2019 - Antidepressant drugs may not work when neurons are out of shape
March 23, 2019 - TTUHSC El Paso to establish endowed chair in neurology through a major grant
March 23, 2019 - New device approved by FDA for treating patients with moderate-to-severe heart failure
March 23, 2019 - People with peripheral artery disease have lower Omega-3 Index, shows research
March 23, 2019 - Trigger warnings have minimal impact on how people respond to content, shows research
March 23, 2019 - Gilead Announces Data From Two Studies Supporting Further Development of GS-6207, a Novel, Investigational HIV-1 Capsid Inhibitor as a Component of Future Long-Acting HIV Therapies
March 23, 2019 - Selfish genetic elements amplify inflammation and age-related diseases
March 23, 2019 - Study provides new understanding of how the brain recovers from damage caused by stroke
March 23, 2019 - CRISPR/Cas libraries could revolutionize drug discovery
March 23, 2019 - Allergic reaction during pregnancy may alter sexual-development in offspring’s brain
March 23, 2019 - Seeing through a robot’s eyes helps those with profound motor impairments
March 23, 2019 - Recent research shows that ease of breastfeeding after C-section differs culturally
March 23, 2019 - Newly discovered parameters offer more control over efficient release of drugs
March 23, 2019 - ‘De-tabooing’ of abortion- Women would like more support from health care community
March 23, 2019 - Anti-TB drugs can increase susceptibility to Mtb reinfection
March 23, 2019 - New survey indicates need of attention to neglected tropical diseases
March 23, 2019 - Innovative in vitro method to develop easy-to-swallow medicine for children and older people
March 23, 2019 - Sugary drinks could raise risk of early deaths finds study
March 23, 2019 - Lian wins ENGINE grant for stem-cell-based therapy to treat Type 1 diabetes
March 23, 2019 - Overall, Physicians Are Happy and Enjoy Their Lives
March 23, 2019 - Researchers discover how blood vessels protect the brain during inflammation
March 23, 2019 - CDC study shows modest improvement in optimal hospital breastfeeding policy
March 23, 2019 - Family-based prevention program to reduce alcohol use among older teens
March 23, 2019 - Remote monitoring of implanted defibrillators in heart failure patients prevents hospitalizations
March 23, 2019 - Appropriate doffing of personal protective equipment may reduce healthcare worker contamination
March 23, 2019 - Window screens can suppress mosquito populations, reduce malaria in Tanzania
March 23, 2019 - Researchers discover new biomarker for postoperative liver dysfunction
March 23, 2019 - Pregnancy history may be linked to cognitive function in older women, finds study
March 23, 2019 - Study shows ticagrelor is equally safe and effective as clopidogrel after heart attack
March 23, 2019 - FDA Approves First Drug for Postpartum Depression, Zulresso (brexanolone)
March 23, 2019 - New guidelines outline new treatment management for psoriasis
March 23, 2019 - Thermally abused cooking oil may promote progression of breast cancer
March 23, 2019 - High-fructose corn syrup fuels growth of colon tumors in mice
March 23, 2019 - Partnership aims at establishing best practices to promote diversity in clinical trials
March 23, 2019 - New study examines presence of microbes in tap water from residences, office buildings
March 23, 2019 - Early life trauma may affect brain structure, contribute to major depressive disorder
March 23, 2019 - NIH starts clinical trial of drug to treat cravings associated with opioid use disorder
March 23, 2019 - Cervix bacteria, immune factors could be a warning signal of premature birth, reports new research
March 23, 2019 - Worst-ever emergency care performance figures underscore the need to focus on staffing
March 23, 2019 - The Current issue of “The view from here” is concerned with Cancer
March 23, 2019 - Mouse model validates how ‘good’ and ‘bad’ bacteria affect acne
March 23, 2019 - Individual amygdala neurons respond to touch, imagery and sounds
March 23, 2019 - Combination of two topical creams can prevent cancer
March 23, 2019 - Study suggests depression screening when assessing African-Americans for schizophrenia
March 23, 2019 - New electronic support system for choosing drug treatment based on patient’s genotype
Sleep quality improves with help of incontinence drug

Sleep quality improves with help of incontinence drug

image_pdfDownload PDFimage_print
Researchers found that a drug that helps curb who study urinary incontinence can also help women sleep better. Credit: Pixelheadphoto-Digitalskillet/Shutterstock

A drug used to curtail episodes of urinary incontinence in women also improves quality of sleep, a researcher at the Stanford University School of Medicine reports.

People who experience urinary incontinence, especially at night, often have trouble maintaining normal sleep cycles. Now, the Stanford researcher sees promise in using one drug to help remedy both problems.

“Two of the biggest quality-of-life factors for older women are poor sleep quality and incontinence, and the older you get, the more prevalent both conditions are, and they do seem to be correlated,” said Leslee Subak, MD, professor and chair of obstetrics and gynecology. “And so, if we can find a drug to treat one and effectively decrease the other too, that could be big for improving quality of life.”

A paper describing the study was published online Jan. 11 in Obstetrics & Gynecology. Subak is the senior author. Qurratul Ann Warsi, MD, a former clinical research scholar at the University of California-San Francisco, is the lead author.

In 2012, Subak, who was then on the faculty of UCSF, and her colleagues conducted a study called Bringing Simple Urge Incontinence Diagnosis and Treatment to Providers, or BRIDGES, which analyzed a specific drug’s around-the-clock efficacy in curbing urgency incontinence, a condition characterized by a sudden urge to urinate and sometimes accidental leakage. The researchers conducted the study in women, as urgency incontinence is five to 10 times more common in women than it is in men.

The drug, fesoterodine, decreased accidental urination in study participants. The researchers also observed that it produced a handful of secondary beneficial effects, including less nighttime wakefulness caused by an urge to urinate.

Given the drug’s success in diminishing urgency incontinence, including while sleeping, Subak followed up with a new question: Could this drug simultaneously help women catch extra shut-eye? Self-reported data from 645 female participants indicated that the answer was yes.

Two birds with one drug

In the initial 12-week BRIDGES study, Subak and her team recruited 645 female participants from 13 sites in the United States, whose average age was 56, and used a standardized evaluation of urgency incontinence to determine which participants would be best-suited for the trial. To qualify, participants had to indicate that they had experienced problems over the previous three months with accidental urination, occurring with a sudden urge to urinate.

Fesoterodine belongs to a larger class of drugs known as antimuscarinics. These agents help control accidental urination by blocking receptors in the bladder that, when activated, tell it to contract, a key physiological part of urination.

To determine if the drug also improved sleep quality, the researchers gave participants a standardized sleep evaluation, called the Pittsburgh Sleep Quality Index. The self-reported evaluation measures seven sleep-associated aspects, such as sleep duration, daytime sleepiness and how long it takes for an individual to fall asleep. Each category is scored on a scale from 0- 3; at the end, the score is tallied—the higher the score, the poorer the sleep quality. According to the Pittsburgh Sleep Quality Index, a score of 5 or more indicates poor sleep, and for the 57 percent of the cohort who reported poor sleep, the average score was a 6.4.

Women in the study recorded their baseline sleep patterns, the majority reporting that they were getting up one to two times per night to urinate. Those numbers may not seem bad on paper, but Subak said disrupting the sleep cycle more than once every night can start to take a toll.

“Getting up one time per night is acceptable for most people, but twice really starts to be disruptive and is associated with poorer quality of life and more daytime sleepiness,” Subak said.

Women in the study who took the drug reported better sleep: Instead of having to empty their bladder once or twice a night, the group, on average, reported urinating just once per night, or not at all. Subak points out that finding a drug that can simultaneously address urinary incontinence and poor sleep is crucial for women, especially as they get older.

“As age increases, so do the prevalence and frequency of nighttime urination, and that especially poses risks for someone who is older,” Subak said.

Thinking holistically

About a quarter of reproductive-age women, about half of menopausal women and about 80 percent of women who are 80 and older experience urgency incontinence. The older a woman is, the more dramatic the effect incontinence has on her quality of life.

Subak recalls a patient from the study telling her that incontinence doesn’t kill you, but it takes your life away. “Patients might end up secluding themselves socially because they’re worried about their bladder,” she said. “But far worse, urinary incontinence is also one of the biggest factors for falling and fracturing for older women, especially those who have osteoporosis. That’s why addressing 24-hour incontinence, especially in the geriatric population, is so critical.”

Drugs such as fesoterodine empower physicians to think through the most well-rounded treatments for patients, Subak said, and there are many other similar pharmaceutical options that could work in the same way, too.

“It’s a reminder to us as physicians to look at many co-morbid conditions that are synergistic. If an older person is saying ‘I’m having trouble sleeping,’ ask about nighttime urination; ask about urgency incontinence,” Subak said. “It’s important to look holistically at a patient, and especially at older women who have many of these problems co-existing. We have an opportunity to really look at how treating one can improve the others too.”


Explore further:
Behavioral treatment can help control incontinence

More information:
Qurratul A. Warsi et al. Association of Pharmacologic Treatment of Urgency Urinary Incontinence With Sleep Quality and Daytime Sleepiness, Obstetrics & Gynecology (2018). DOI: 10.1097/AOG.0000000000002443

Journal reference:
Obstetrics & Gynecology

Provided by:
Stanford University Medical Center

Tagged with:

About author

Related Articles