FROM OBSTETRICS & GYNECOLOGY
Treating urgency urinary incontinence in women may have the added benefit of improving their quality of sleep, according to a paper published online Jan. 9 in Obstetrics & Gynecology.
Researchers analyzed data from a multicenter, double-blind, randomized, controlled trial of daily antimuscarinic therapy (4-8 mg fesoterodine) or placebo in 645 women with urgency-predominant incontinence, which also evaluated sleep quality and daytime sleepiness.
At 12 weeks, the women treated with the antimuscarinic therapy showed a significant 12% greater decrease in urgency urinary incontinence (UUI) episodes per day and 11% greater decrease in total incontinence frequency, compared with the placebo group. They also had significantly less daytime and nighttime incontinence, and diurnal and nocturnal voiding frequency.
The antimuscarinic treatment was also associated with a significant 0.48 point improvement in Pittsburgh Sleep Quality Index score (P = .02), compared with the placebo group, as well as significant improvements in sleep duration and sleep efficiency subscales. However, there were no significant differences between the two groups in Epworth Sleepiness Scale scores.
“Both fewer voids at night and decreased urge incontinence reduce the number of awakenings during the night, which may be reflected in higher sleep efficiency and longer sleep duration,” wrote Qurratul A. Warsi, MBBS, of the University of California, San Francisco, and her coauthors.
Antimuscarinic medications such as fesoterodine may have a sedating effect, the authors noted, which could also improve the quality of sleep. The study also did not control for sleep disorders such as obstructive sleep apnea and restless leg syndrome.
“This analysis provides new data that indicate initiating pharmacologic treatment for UUI in ambulatory women is associated with improvement in important domains of sleep,” they wrote. “Among community-dwelling women with UUI, flexible-dose antimuscarinic therapy not only resulted in improvement in incontinence measures, but was also associated with significant improvements in overall quality of sleep, sleep duration, and sleep efficiency.”
Pfizer funded the study and provided the study medication. Four authors declared research grants from the pharmaceutical sector, including three who had received grants or consultancies from Pfizer. One author declared royalties and stipends from the publishing industry. No other conflicts of interest were declared.
SOURCE: Warsi Q et al. Obstet Gynecol. 2018 Feb;131(2):204-11 .