Can’t Sleep Due to Overactive Bladder? 4 Tips for Better Sleep

1. Limit fluid intake before bedtime: Try to avoid drinking too many fluids after 6 p.m., since a full bladder can make you more prone to getting up during the night to urinate.
2. Avoid bladder-irritating foods and beverages: Certain foods and beverages act as diuretics, meaning they increase the secretion of water from the body through urine. These include:
   1. Caffeine
   2. Alcohol
   3. Citrus juices
   4. Spicy foods
   5. Acidic foods
   6. Chocolates
   7. Artificial sweeteners
3. Urinate twice before bedtime: Experts suggest that urinating twice before bedtime can help you prevent an overactive bladder from disrupting your sleep.
4. Do Kegel exercises: If done regularly, Kegel exercises can help strengthen your pelvic muscles and improve symptoms of an overactive bladder. Kegel exercises involve contracting and releasing the muscles around the opening of the urethra by starting and stopping the urine stream. These can be done 3-4 times a week.

Overactive bladder (OAB) is a group of urinary symptoms including a frequent and strong urge to urinate, waking up at night to urinate, and incontinence.

The most common symptoms of overactive bladder (OAB) include:

• Sudden, strong, and uncontrolled urge to urinate
• Urine leakage (urge incontinence)
• Increased frequency of urination
• Nocturia (increased frequency of urination at night)

Normally, when your bladder is full, your brain signals the bladder muscles to contract, and this results in the opening of the urethral sphincter. This forces the urine out through the urethra, and a partially full or empty bladder is relaxed. 

Overactive bladder occurs when there is an impairment of normal functioning of the nerve signals between the bladder and the brain. This dysfunction can pass the signals to the bladder to void the urine, even if it is not full. In addition, OAB is caused by the hyperactivity of the bladder muscles that makes them contract to pass urine before the bladder is full. This, in turn, causes a sudden, strong need to urinate (urgency).

The amount of urine production usually decreases and becomes more concentrated at night, letting you sleep at least 6-8 hours without having to get up to use the bathroom more than once. However, people with OAB often need to get up to urinate several times a night, disrupting their normal sleep pattern and making them exhausted and sometimes leading to bedwetting.

Risk factors for OAB include:

• Pelvic muscle weakness and spasms
• Hormonal changes, such as menopause
• Being overweight
• Urinary tract infections (UTIs)
• Neurologic disorders
• Pelvic surgeries
• Herniated discs
• Damage to the signals between the brain and bladder
• Diseases that affect the brain or the spinal cord, such as stroke, Parkinson’s disease, and multiple sclerosis
• Side effects of medications
• Alcohol or caffeine consumption

Urologists can diagnose overactive bladder (OAB) by assessing symptoms and conducting certain tests. Diagnosis may involve:

• Medical history: Involves the analysis of health history, experiences, past and current health problems, diet, and current medications.
• Physical examination: Involves the examination of the abdomen and organs in the pelvis and rectum.
• Urine test: Tests a sample of urine for infection.
• Ultrasound of the bladder: Helps evaluate the residual amount of urine left after emptying the bladder.
• Cystoscopy or urodynamic testing: Generally not needed but recommended if the doctor suspects some other pathological issue.

Overactive bladder (OAB) is a treatable condition. Treatment options include the following:

• Behavioral or lifestyle changes:
  • Keep a log of fluid intake, number of times you urinate, and frequency of incontinence or its relation to any activities such as coughing, laughing, or sneezing
  • Monitor your diet and avoid foods that may further worsen symptoms
  • Prevent constipation by consuming fiber-rich foods
  • Exercise regularly
  • Maintain a healthy weight
  • Quit smoking
  • Avoid stress
• Medications: 
  • Medications to control muscle spasms:
    • Ditropan (Oxybutynin)
    • Detrol (Tolterodine)
    • Vesicare (Solifenacin)
    • Toviaz (Fesoterodine)
    • Enablex (Darifenacin)
    • Sanctura (Trospium)
  • Beta-3 adrenergic: Mirabegron
• Nerve stimulation (neuromodulation): A reversible treatment that involves stimulating the nerves to help improve OAB. Types include:
  • Sacral nerve stimulation
  • Percutaneous tibial nerve stimulation
  • Botox injections into the bladder muscle
• Surgical procedures: For severe cases of OAB, augmentation cystoplasty may be recommended. This is a reconstructive procedure that uses parts of the bowel to replace parts of the bladder.