Overactive Bladder and Sleep Problems
Overactive bladder (OAB) doesn’t pay attention to your personal schedule — it tends to cause problems around the clock. So, while you may have gained control over your daytime symptoms, things can go awry once you let your guard down as your head hits the pillow.
Luckily, there are a few techniques to help you get the shut eye you need for restful nights and more comfortable days.
Balance Fluid Intake
Carrying too much liquid in the bladder is obviously a recipe for trouble, but too little fluid can lead to concentrated urine that will irritate your bladder lining. Finding the sweet spot between the two extremes can take some time, but is well worth your effort.
One of the best ways to keep a good fluid balance is by drinking plenty throughout the day, then restricting liquids at night. A consistent water intake in the daylight hours will keep your body hydrated and your urine diluted, so you can stop drinking a few hours before bed and still stay comfortable.
Time Your Medication Properly
Certain medication for OAB and other conditions are meant to be taken at specific times, and it’s crucial you stick to those schedules. Diuretic medications commonly used to treat heart disease, high blood pressure and liver or kidney disease are designed to drain water from your tissues, which means more urination — and less sleep if you take them too close to bedtime.
If you suspect one or more of your medications is complicating your bladder control, talk to your doctor about rearranging or augmenting your medications. A stronger commitment to healthy lifestyle changes can also help you ease off some bladder-disrupting medications, which can help you get a better sleep.
Don’t Let Fluid Build Up
Sometimes swelling in the extremities brings about bladder trouble, and if this is the case for you, practice some draining techniques. You can elevate your legs during the day with the help of a cushion or chair, which will keep fluid from pooling in your calves and ankles.
Compression socks or stockings are another helpful tool to ease fluid retention, since they are designed to increase circulation through your legs. Since legs and feet are generally less swollen in the morning, get into the habit of putting on your stockings right after you wake up, and wear them until you go to bed (but never sleep in them!)
Double-Void Before Hitting the Hay
The “double-voiding” technique can seem fruitless at first, but it has proven very helpful for some OAB sufferers. You probably use the bathroom soon before bed, which is always a good idea, but if you can urinate twice before falling asleep, you might be able to save yourself a nighttime trip to the bathroom.
Start your bedtime routine by visiting the bathroom, then move onto donning your pajamas, brushing your teeth, and setting the alarm clock. Right before you climb into bed, go pee again, even if you don’t feel like you need to. Sometimes draining your bladder just a bit more can go a long way toward a restful sleep.
Next page: four more solutions to help you sleep better despite OAB.
Consider a Natural Supplement
If you’re wary of pharmaceuticals, there are some natural remedies that might bring you some more nighttime bladder control. Clinical trials conducted in Japan have revealed the bladder benefits of pumpkin seed oil — it was shown to reduce nighttime incontinence by almost 70 percent.
Other plant-derived supplements include palmetto, cornsilk and bromelain (derived from pineapples). However, just like any medication, natural remedies can be powerful and could interact with your other OAB treatments, so be sure to discuss the pros and cons with your doctor before visiting your naturopath.
Avoid Your Trigger Foods
As you know, the bladder muscle is pretty sensitive to certain things. Caffeine, alcohol, citrus and spicy foods top the list of OAB triggers, but there could be other culprits hiding in your favorite dishes, too. The key is to look carefully, record frequently, and investigate any suspicious patterns to weed out the bladder irritant.
A food journal is a good tool for a better understanding of your bladder. Write down what you eat every day, and what happens after the meal.
Keep an eye on acidic foods and artificial sweeteners, which are known to cause problems. Once you know which ingredients cause you the most trouble, try to avoid them completely, or at least from noon onward.
Strengthen Your Pelvic Floor
Pelvic floor exercises (Kegel exercises) are one of the quickest and more reliable ways to strengthen the supportive muscles around your bladder, which can help you control feelings of urgency and urine flow at any time of day.
If you haven’t been practicing Kegels, start today. If you’re already familiar with the technique, get serious about your routine.
You should work in several sets of Kegels throughout each day, beginning in the morning with a set of eight to 12 pelvic floor contractions and releases. Hold each contraction for about three seconds before releasing.
Practice your Kegels at regular intervals, and when you feel a strong urge to run to the bathroom, first do a Kegel to try and calm the bladder spasm.
Try an Anticholinergic
Anticholinergics are among your best treatment options when your nighttime OAB isn’t responding to non-invasive measures. They work by relieving the bladder spasms that cause the urge to go, and can relieve nighttime symptoms as well as daytime symptoms.
The antimuscarinic drug tolterodine (sold under the brand name Detrol) also shows a lot of promise. Studies have shown that the drug can significantly reduce nighttime nocturia caused by OAB, and without many side effects at all.
Most people with OAB can bring their condition under control with a few clever changes to their diet and routine, but if you’re one of the unlucky few who can’t find relief, you may need to consider a surgical procedure.
However, don’t be too hasty: retraining your bladder takes time and patience, so be sure to commit to healthier habits and stick with them for several weeks before giving up on them.