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The Complete Nighttime Guide to an Overactive Bladder

If you are part of the approximately 16-18% of the population who suffers from overactive bladder syndrome (OAB), you already know how badly it can interfere with your life. From the embarrassment of an incident to the exhaustion after a poor night’s sleep, anyone experiencing the effects of OAB is likely seeking to remedy them. And that’s exactly what this nighttime guide to overactive bladder will cover!

Bladder Condition Breakdown

Before we get into nighttime prevention, it can help to understand a few things about bladder-related issues in general.

First of all, nocturia and OAB often get confused. Nocturia refers to having overactive bladder at night, and it’s more common than having full-on OAB all the time. While 16-18% of people have OAB, a full one in three adults over 30 have reported needing two or more nighttime bathroom trips.

Man with overactive bladder using the bathroom at night

There are four different types of nocturia:

  • Nocturnal polyuria: An individual’s body produces an excessive amount of urine during the night.
  • Global polyuria: An individual’s body produces too much urine during the day and [italics] night.
  • Low nocturnal bladder capacity: An individual’s bladder isn’t capable of holding as much fluid during the night.
  • Mixed nocturia: A combination of the aforementioned three types of nocturia.

It is also important to note that nocturia is different from bedwetting. One of the key signs of nocturia is that the individual is waking up more than once a night. The average healthy person can achieve six to eight hours of uninterrupted sleep, without having to get up for a bathroom break.

Sometimes nocturia results in voiding in bed if the person doesn’t wake up or make it to the restroom in time. However, some people with nocturia never wet the bed; they just deal with night after night of interrupted sleep. This compromised sleep hygiene is arguably just as bad, especially long-term!

Overactive Bladder and Sleep

“[OAB] can disrupt sleep completely, and people can be extremely overtired,” said Luis Sanz, MD, director of urogynecology and pelvic surgery at Virginia Hospital Center.

We tend to think of wet sheets as the worst potential effect of nocturia, but endless nights of interrupted sleep and the ensuing days of exhaustion can start to feel just as bad– even if you never wet the bed. Many of us tend to dismiss being “tired” as a common thing in our modern society, or even herald it as a side effect of being busy and successful, but long term sleep deprivation is a serious issue.

(Does part of your busy schedule include travel? Check out Eight Travel Tips for your Overactive Bladder!)

Not only can OAB interfere with your general wellbeing, it can interfere with your sexual wellbeing too. Losing control of your bladder as an intimate evening starts to unfold can certainly pull the plug on the moment. This is a common experience for people with OAB, because sexual activity itself is irritating to the bladder. Luckily, most of the preventative measures that help with OAB in general will also help in regard to sex!

Preventative Measures

When it comes to overactive bladder, your best offense is often a well-prepared defense. Here are some things you can do to help decrease the effects of your condition.

Bladder-Approved Nutrition

As with any health-related issue, it’s best to build the plan of attack on a sound foundation. This sound foundation includes good nutrition and avoiding the foods you shouldn’t eat if you have OAB.

Here are some of the foods and beverages known to irritate your bladder:

  • Alcohol
  • Artificial sweeteners
  • Caffeine – a diuretic that increases urine output
  • Chocolate
  • Citrus juices – since they are acidic
  • Cranberry juice – a surprising culprit that can be good for bladder health in those not affected, but is actually an irritant for individuals with OAB
  • Honey
  • Tea – if it’s caffeinated or is made with any other potential irritants
  • Tomato juice or sauce

One thing to be especially vigilant about is whether a food is okay for your condition, even if it’s a “healthy” food overall. Options like unsweetened fruit juices, tomatoes, and other acidic foods and drinks may be good for the average person, but are irritants for you and your bladder. It’s always good to do a quick internet search on which foods are acidic and to talk to your doctor about nutrition.

Bonus: Eating healthily also helps with shedding excess body weight. Having an unhealthily high body weight can put extra pressure on your bladder, which can cause leakage. So eating right and taking care of your gut health is actually a double defense!

No Smoking, Please!

Another big irritant is nicotine. You likely already know that smoking isn’t good for you, but if you do happen to smoke, this is yet another reason to quit. Remember not to be ashamed if you’ve tried to quit before and have failed. It’s not easy, but you can do it!

We recommend talking to your doctor about quitting methods and giving it another attempt. You never know if this one change will be what cures your OAB; it has definitely made a big difference for some patients in the past.

Keep Up the Kegels

If you’re a little overwhelmed by all the “don’ts,” here is a “do”!

Do Kegel exercises regularly to help control your OAB. As you might already know, Kegels are done by contracting and then releasing the muscles around your urethra’s opening. If you’ve never done one before, try stopping your urine stream next time you use the restroom. This is what a Kegel feels like.

Not only can doing Kegels regularly help you build strength over time, doing one when you have the sudden urge to go can also help you control your bladder as you seek out the next bathroom.

Daytime Hydration

This might be the least predictable tip of them all: drink water! Though hydrating too much at night is of course a bad idea (we will get further into that in the next section), drinking enough over the course of the day is a good idea. Drinking too little water will cause your urine to become more concentrated, which can then actually irritate the bladder from the inside out. Having insufficient amounts of fluid in your body can also promote bacteria growth, which can in turn trigger incontinence.

Your Evening Routine

Now that you have some tips and tricks for day-to-day life, let’s get into evening specifics. There are two simple steps that can make a big difference.

The Double Void Trick

If you’ve just started having bladder troubles, perhaps you haven’t previously thought much about when that last bathroom trip of the evening happens. Maybe it’s before brushing your teeth. Maybe when you turn off the TV or finish the dinner dishes or whatever marks the end of your day and beginning of your “winding down” routine. Perhaps you don’t go again after your nighttime routine.

Now that you are battling OAB, try the double-voiding trick instead of just urinating sometime in the evening. Double-voiding involves urinating twice right before bed. Use the restroom once, then brush your teeth and go through your routine. Use the restroom again right before going to bed, even if you don’t feel like it or your bedtime routine only took five minutes. Even squeezing out a last couple drops can help.

Your Fluid Cut-Off Time

Often, we make the mistake of forgetting to drink water during the day and then trying to catch up at night. It makes sense that people get into this habit; days are filled with work, errands, volunteering, and countless activities, while evenings are more of a time to wind down… and sip some glasses of water.

Try to be aware of your hydration timeline and whether you’ve fallen into this habit. If so, turn that routine on its head! Hydrating during the day but not drinking any liquids after 5 or 6 pm is a good idea for anyone who struggles with nocturia.

This cut-off time is a good rule of thumb for irritants as well as liquids. If you’re like most people, it probably sounds rough to never again drink a fresh squeezed fruit juice, eat pasta with tomato sauce, or enjoy a chocolate bar. On days you want to indulge, try to have that fruit juice in the morning, eat the pasta for lunch, or have your chocolate in the early afternoon. And try not to do all those things in the same day!

OAB “Safety Nets”

Perhaps you’re already taking all of those preventive measures, but still have an overactive bladder. That’s when the safety nets come into play.

OAB sufferer struggling with the urge to urinate

Absorbent Briefs

The technology that goes into absorbent briefs has come a long way, and many look as discreet as regular underwear. Slipping one on at night can do a lot to protect your mattress and ease your mind.

Plastic Sheets

Plastic sheets or vinyl covers aren’t always the most comfortable, but they can be highly effective. These options are affordable, not to mention quick and easy to wipe down.

Mattress Covers

Mattress covers and protectors can be a great option as well. Unlike the plastic options, mattress covers are often made from softer terry material and are less noticeable. They are sometimes also less affordable, but are a good investment to make in your health and hygiene, not to mention that they protect a mattress likely costing far more.

Bed Pads

If you sleep like a rock and are more vulnerable to nighttime voiding than waking up, a bed pad might be your new best friend. Bed pads tend to be an optimal match for people who don’t move much in their sleep. The waterproof pads simply slip underneath your body toward the middle of the mattress (above the sheets). If anything happens, all you need to wash is the pad. If nothing goes wrong, you can store it for the day or simply make your bed over it.

Catheter

This is probably the most extreme-sounding option, but is a great for some people. A catheter doesn’t technically require a prescription, but we do recommend talking to your doctor before trying one out. He or she will be able to advise whether or not a catheter is necessary in your specific case.

Conclusion

We hope you’ve gained some value from our nighttime guide to an overactive bladder! You are far from alone in this battle, both because it’s a fairly common issue and because researchers and physicians all over the world are working hard to treat and cure OAB. We encourage you to not ever feel ashamed, and we recommend open communication with your doctor.

If you want to take a proactive, hands-on role in your OAB treatment journey, you may also want to consider participating in an overactive bladder clinical study. The team at Accord is enrolling for an upcoming overactive bladder clinical trial and would value a few more volunteers. Participants will receive all medical treatment for free, and will be helping put an end to this upsetting condition that affects so many. To learn more or see whether or not you qualify, use the form on our OAB clinical trial page linked above or give us a ring at (386) 760-7272. We love hearing from fellow OAB warriors and there is never any pressure!

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