Restoring Balance

Overview

Overactive bladder (OAB) is more than just an inconvenience – it can significantly impact both your physical and mental wellbeing. The constant urgency, frequent trips to the bathroom, accidents, and restless nights caused by OAB can have a substantial negative effect on people’s physical and mental health⁴.

Fortunately, you can restore a healthier balance of managing OAB symptoms in a place often overlooked: your sleep.

How does sleep disruption affect our bodies?

• Increased risk of anxiety, depression, and irritability
• Reduced attention span, reaction times, and executive functioning
• Weakened immunity and ability to fight off infection
• Impairs the body’s ability to regulate hormone production
• Increased risk of high blood pressure, heart attack, and chronic health conditions
• Lack of control over bladder function due to drowsiness and impaired reflexes

What are some of the correlations between sleep and OAB symptoms?

Wetting the bed, called nocturnal enuresis, is quite common in childhood. If children who wet the bed are left without treatment, nocturnal enuresis can carry on into adolescence and early adulthood. Nocturnal enuresis can occur due to several different causes, including:

• Poor sleep quality can lead to increased stress and anxiety, which are known to ramp up the intensity of OAB symptoms
• When stress levels increase, so do cortisol levels – triggering hypersensitivity in the bladder and resulting in urges to urinate²

By improving sleep quality, we can dial down stress and reduce cortisol levels, resulting in respite from the relentless cycle of urgency¹.

More on the impacts of sleep on overactive bladder symptoms:

Studies have shown that insufficient sleep can disrupt the body’s naturally lower nocturnal blood pressure and production of a hormone called ‘arginine vasopressin’, leading to increased urine output at night³.

Research has also shown that sleep deprivation can contribute to weight gain and promote metabolic disturbances, such as type 2 diabetes, both of which are risk factors for OAB⁶.

By creating better sleep habits, we can reduce these types of disruptions and long-term health risks, providing a reprieve from nocturia and accompanying OAB symptoms with better and more informed OAB management.

{Improving sleep quality can play an important role in alleviating symptoms of OAB, offering several potential benefits that contribute to better management of the condition.{

What are the benefits of improved sleep quality for our bodies and to assist with OAB?

Improved sleep quality has a positive impact on many factors associated with OAB, such as weight, metabolic health, inflammation, mental health, hormone regulation, and blood pressure. By prioritising rest and quality sleep, you are more likely to maintain overall health and reduce the likelihood of OAB symptoms.

Additionally, better sleep sets the stage for a more active lifestyle—a crucial component in OAB management. Physical activity resulting in weight loss and including targeted exercises.  specifically pelvic floor exercises, has been shown to improve OAB symptoms⁵.

With improved sleep, people are more likely to have the energy and motivation to maintain a regular exercise routine, thereby supporting OAB management.

Our 7 Practical Tips for a better night’s sleep and quality OAB management:

1. Avoid drinking alcohol or caffeine before bedtime
2. Try and drink most of your fluid intake in the earlier part of the day, avoiding excessive fluid intake at least 2 hours before bedtime
3. If your prescribed medications cause excessive urine production (diuretics or ‘fluid tablets’), try taking them earlier in the day
4. Elevate your legs during the day or consider wearing support stockings or socks to prevent fluid build-up on lower limbs
5. If you do wake at night, try to avoid going ‘just in case’ – this may reduce your bladder’s holding capacity over time
6. Reduce the risk of falls by clearing clutter and trip hazards from the path to the toilet and consider using a night light
7. Sleep disorders and underlying health conditions which cause excessive urine production at night may require medical intervention or pharmacological therapies for treatment and management.

What to expect with better sleep patterns and OAB management:

• Reduction in stress, irritability, and anxiety
• Regulated blood pressure and hormone production
• Better control over diet and weight management
• Increased energy levels to maintain an active lifestyle
• By prioritising quality sleep, you can expect better overall health and well-being, along with improved OAB symptoms

While these benefits can be significant, it’s important to remember that OAB is a complex condition that may require additional medical interventions and lifestyle changes. If you are living with OAB, you should consult with healthcare professionals for individualised advice and treatment strategies.

References

1. Blaxton, J.M., Bergeman, C.S., Whitehead, B.R., Braun, M.E. and Payne, J.D., 2017. Relationships among nightly sleep quality, daily stress, and daily affect. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 72(3), pp.363-372.

2. Chess-Williams, R. and Sellers, D.J., 2023. Pathophysiological mechanisms involved in overactive Bladder/Detrusor overactivity. Current Bladder Dysfunction Reports, 18(2), pp.79-88.

3. Kamperis, K., Hagstroem, S., Radvanska, E., Rittig, S. and Djurhuus, J.C., 2010. Excess diuresis and natriuresis during acute sleep deprivation in healthy adults. American Journal of Physiology-Renal Physiology, 299(2), pp. F404-F411.

4. Lu, Z., Zhang, J., Lin, S., Fan, Z., He, Z. and Tang, F., 2023. Associations between overactive bladder and sleep patterns: a cross-sectional study based on 2007–2014 NHANES. BMC urology, 23(1), p.184.

5. Reisch, R., 2020. Interventions for overactive bladder: review of pelvic floor muscle training and urgency control strategies. The Journal of Women’s & Pelvic Health Physical Therapy, 44(1), pp.19-25.

6. Winkelman, W.D., Warsi, A., Huang, A.J., Schembri, M., Rogers, R.G., Richter, H.E., Myers, D.L., Kraus, S.R., Johnson, K.C., Hess, R. and Gregory, T., 2018. Sleep quality and daytime sleepiness among women with urgency predominant urinary incontinence. Urogynecology, 24(2), pp.76-81.

Jane Clarke

Continence Nurse Consultant

Jane is a Continence Nurse Consultant with over 25 years of experience. She has worked in public health, private enterprise, and industry spheres, and has achieved a Masters in both Nursing and Business Administration. Jane is passionate about health equity and education. In her spare time Jane loves spending time in nature and exploring new places with her family.