TY - JOUR
T1 - Sleep Quality and Daytime Sleepiness among Women with Urgency Predominant Urinary Incontinence
AU - Winkelman, William D.
AU - Warsi, Ann
AU - Huang, Alison J.
AU - Schembri, Michael
AU - Rogers, Rebecca G.
AU - Richter, Holly E.
AU - Myers, Deborah L.
AU - Kraus, Stephen R.
AU - Johnson, Karen C.
AU - Hess, Rachel
AU - Gregory, Thomas
AU - Bradley, Catherine S.
AU - Arya, Lily A.
AU - Brown, Jeanette S.
AU - Stone, Katie L.
AU - Subak, Leslee L.
N1 - Funding Information:
L.L.S., J.S.B., and A.J.H. have received a University of California San Francisco research grant from Pfizer, Inc, to conduct research related to urinary incontinence. Pfizer, Inc, provided funding for the study and the study medication but did not provide other input into the design of the study; collection, analysis, or interpretation of data; writing of the report; or the decision to submit the paper for publication. L.L.S. is additionally supported by NIDDK K24 DK080775. L.L.S. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. No article preparation assistance was provided by the study funders.
Funding Information:
Pfizer, Inc, provided funding for the study and the study medication but did not provide other input into the design of the study; collection, analysis, or interpretation of data; writing of the report; or the decision to submit the paper for publication. L.L.S. was additionally supported by grant 2K24DK080775-06 from the US National Institutes of Health; however, the views expressed in this article do not necessarily represent those of the National Institutes of Health.
Funding Information:
L.L.S. and A.J.H. receive investigator-initiated trial funding from Astellas, Inc. A.J.H. was additionally supported by grants RR024130 and 1K23AG038335-01A1 and L.L.S. from 2K24DK080775-06 from the US National Institutes of Health; however, the views expressed in this article do not necessarily represent those of the National Institutes of Health. L.A.A. has received a research grant from Pfizer, Inc. H.E.R. has received a research grant and is a consultant for Pelvalon and receives royalties from UptoDate. C.S.B. has served as a consultant for Astellas and for GlaxoSmithKline. S.R.K. has served as a consultant for Pfizer, Inc, and Allergan and has been a course director and teaching faculty member for Laborie. R.G.R. receives royalties from UptoDate and served as the DSMB chair for the Treatment of Fecal Incontinence Using the TOPAS Sling System For Women trial sponsored by American Medical Systems.
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Objective The objective of this study was to examine the strength and direction of the association between urinary symptoms and both poor quality sleep and daytime sleepiness among women with urgency urinary incontinence. Methods A planned secondary analysis of baseline characteristics of participants in a multicenter, double-blinded, 12-week randomized controlled trial of pharmacologic therapy for urgency-predominant urinary incontinence in ambulatory women self-diagnosed by the 3 Incontinence Questions was performed. Urinary symptoms were assessed by 3-day voiding diaries. Quality of sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness using the Epworth Sleepiness Scale. Results Of the 640 participants, mean (SD) age was 56 (±14) years and 68% were white. Participants reported an average of 3.9 (±3.0) urgency incontinence episodes per day and 1.3 (±1.3) episodes of nocturia per night. At baseline, 57% had poor sleep quality (PSQI score, >5) and 17% reported daytime sleepiness (Epworth Sleepiness Scale score, >10). Most women (69%) did not use sleeping medication during the prior month, whereas 13% reported use of sleeping medication 3 or more times per week. An increase in total daily incontinence episodes, total daily urgency incontinence episodes, total daily micturitions, and moderate to severe urge sensations were all associated with higher self-report of poor sleep quality according to the PSQI (all P ≤ 0.01). Higher scores on the Bother Scale and the Health-Related Quality of Life for overactive bladder on the Overactive Bladder Questionnaire were similarly associated with higher rates of poor sleep quality (both P ≤ 0.01). In subgroup analysis of those who took sleeping medications less than twice a week, there was still a significant relationship between incontinence measures and quality of sleep as measured by the PSQI. In multivariable analyses, greater frequency of nighttime urgency incontinence was associated with poor sleep quality (P = 0.03). Conclusions Among ambulatory women with urgency urinary incontinence, poor sleep quality is common and greater frequency of incontinence is associated with a greater degree of sleep dysfunction. Women seeking urgency urinary incontinence treatment should be queried about their sleeping habits so that they can be offered appropriate interventions.
AB - Objective The objective of this study was to examine the strength and direction of the association between urinary symptoms and both poor quality sleep and daytime sleepiness among women with urgency urinary incontinence. Methods A planned secondary analysis of baseline characteristics of participants in a multicenter, double-blinded, 12-week randomized controlled trial of pharmacologic therapy for urgency-predominant urinary incontinence in ambulatory women self-diagnosed by the 3 Incontinence Questions was performed. Urinary symptoms were assessed by 3-day voiding diaries. Quality of sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness using the Epworth Sleepiness Scale. Results Of the 640 participants, mean (SD) age was 56 (±14) years and 68% were white. Participants reported an average of 3.9 (±3.0) urgency incontinence episodes per day and 1.3 (±1.3) episodes of nocturia per night. At baseline, 57% had poor sleep quality (PSQI score, >5) and 17% reported daytime sleepiness (Epworth Sleepiness Scale score, >10). Most women (69%) did not use sleeping medication during the prior month, whereas 13% reported use of sleeping medication 3 or more times per week. An increase in total daily incontinence episodes, total daily urgency incontinence episodes, total daily micturitions, and moderate to severe urge sensations were all associated with higher self-report of poor sleep quality according to the PSQI (all P ≤ 0.01). Higher scores on the Bother Scale and the Health-Related Quality of Life for overactive bladder on the Overactive Bladder Questionnaire were similarly associated with higher rates of poor sleep quality (both P ≤ 0.01). In subgroup analysis of those who took sleeping medications less than twice a week, there was still a significant relationship between incontinence measures and quality of sleep as measured by the PSQI. In multivariable analyses, greater frequency of nighttime urgency incontinence was associated with poor sleep quality (P = 0.03). Conclusions Among ambulatory women with urgency urinary incontinence, poor sleep quality is common and greater frequency of incontinence is associated with a greater degree of sleep dysfunction. Women seeking urgency urinary incontinence treatment should be queried about their sleeping habits so that they can be offered appropriate interventions.
KW - daytime sleepiness
KW - quality of sleep
KW - urgency urinary incontinence
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U2 - 10.1097/SPV.0000000000000547
DO - 10.1097/SPV.0000000000000547
M3 - Article
C2 - 29300259
AN - SCOPUS:85043242771
SN - 2151-8378
VL - 24
SP - 76
EP - 81
JO - Female Pelvic Medicine and Reconstructive Surgery
JF - Female Pelvic Medicine and Reconstructive Surgery
IS - 2
ER -