Sleeping Pills And Incontinence
Only a small percent of people with incontinence have a problem with bed-wetting, according to Anger, who estimates that about 10% of patients with incontinence wet the bed. However, sleeping pills may pose a problem for those with incontinence at night.
“Sleeping pills can make things worse, because people don’t wake up ,” she says.
As an alternative, cut down on caffeine so you sleep better on your own, Anger suggests.
Sleep will come more easily if you keep a regular bedtime and wake-up schedule, according to the National Sleep Foundation. You can also develop a relaxing bedtime ritual, such as reading a book or listening to soothing music.
Whats The Main Cause Of Overactive Bladder
When the urinary system is functioning normally, the kidneys create urine which drains into the bladder. As your bladder fills, nerves signal the brain that you need to urinate. Then, muscles in your pelvic floor and the urethra relax and muscles of the bladder contract to squeeze the urine out.
With overactive bladder, contractions of the bladder muscles occur even when theres little urine in the bladder. This causes you to feel the urgent need to urinate. People sometimes refer to this, inaccurately, as having a weak bladder and they wonder what causes a weak bladder. Its more accurate that the bladder isnt functioning properly, so overactive bladder is a better description.
What causes overactive bladder? There are several potential overactive bladder causes.
Addressing A Growing Problem: Dementia And Overactive Bladder Increase With Age And The Primary Medicines Used To Treat Overactive Bladder Can Cause Dementia
I recently made a presentation in Vail for OB-GYNs and other physicians titled, Overactive Bladder: The More We Learn, The Less We Know. Themore we learn part was introducing the results of recent studies on the dementia-causing side effects of medications often used as overactive bladder treatments. The less we know part was that many physicians and most patients are not aware of this connection.
Nor are they aware that alternative overactive bladder treatments can be just as effective, even more effective, than the drugs that increase the risk of dementia, which are called anticholinergic medications. And those drugs, such as Vesicare, Ditropan, Toviaz and Enablex, are heavily advertised to consumers .
My mission in this blog is to inform you about the problem and to offer alternative treatment options that dont contribute to dementia.
Overactive bladder , also called urge incontinence, is a form of urinary incontinence that involves a sudden and powerful need to urinate. This often results in leaking large amounts of urine before one can reach a bathroom. Frequent urination in the day or night is another sign of OAB, as is urinating during sleep.
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What Causes An Overactive Bladder
Overactive bladder is a condition that causes the sudden and frequent need to urinate. People with overactive bladders feel the need to urinate many times throughout the day and at night as many as eight times per day and twice at night. This urge may be hard to control and can result in whats called urgency incontinence the unintentional release of urine.
Overactive bladder can be frustrating and embarrassing. If you have the condition, you may start to avoid social functions or situations where a bathroom may be hard to find. Fortunately, there are steps you can take to get control of your overactive bladder.
Sedatives And Sleeping Pills
Using sedatives and sleeping pills can present a problem, especially if you already have incontinence. They can decrease your awareness of the need to go to the bathroom while you are sleeping.
The best way to address thissituation, Dr. Rackley says, is to take other steps to relax and improve yoursleep. Getting more exercise to make you tired, for example, can help. Itsalso important to maintain a regular bedtime and wake-up schedule. Findingother ways to relax before bed meditation, reading a book or listening tosoothing music or sound effects can also help you sleep better.
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Pharmacologic Agents That Cause Urinary Incontinence
A variety of drugs have been implicated in urinary incontinence, and attempts have been made to determine the mechanism responsible based upon current understanding of the processes involved in continence and the transmitters that play a role. Each of the processes described previously can be manipulated by pharmacologic agents to cause one or more types of incontinence.
The drugs commonly pinpointed in urinary incontinence include anticholinergics, alpha-adrenergic agonists, alpha-antagonists, diuretics, calcium channel blockers, sedative-hypnotics, ACE inhibitors, and antiparkinsonian medications. Depending upon the mode of action, the effect may be direct or indirect and can lead to any of the types of incontinence. Taking these factors into account, it is important to consider a patients drug therapy as a cause of incontinence, particularly in new-onset incontinence patients and in elderly patients, in whom polypharmacy is common.11,12
On the other hand, a pharmacologic agent or any other factor that results in chronic urinary retention can lead to a rise in intravesical pressure and a resultant trickling loss of urine. In this way, drugs that cause urinary retention can indirectly lead to overflow incontinence.2
It is useful to note that many antidepressants and antipsychotics exhibit considerable alpha1-adrenoceptor antagonist activity.1
Beta Agonists For Bladder Problems
This class of medication, mirabegron , works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder . Mirabegron is the first drug in this category.
- How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
- Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
- Allergy to this drug
- Advanced kidney disease
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To Use Oxybutynin Gel Follow These Steps:
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
What Causes Overactive Bladder
An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:
- Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
- Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
- Pelvic or back surgery.
Often, there may be no specific explanation for why this is occurring.
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Lifestyle Medications Therapies And Procedures That Can Help
Overactive bladder is a condition characterized by the sudden and frequent need to urinate that is difficult to control, often leading to leakage and incontinence. Because the exact cause of OAB is unknown, the condition can be difficult to treat and often requires a multifactorial approach involving lifestyle, medications, and specialized procedures.
Surgery is rarely recommended but may be pursued if no other options are available and the persons quality of life is severely impacted.
According to the American Urological Society, around 60% of people treated for OAB will experience the complete resolution of symptoms within a year. Although others may continue to have symptoms, their severity and frequency can usually be alleviated with treatment.
What Are The Specific Symptoms Of Overactive Bladder
Overactive bladder represents a collection of symptoms that can include:
- Urinary urgency: This is a failure to be able to postpone the need to urinate. When you feel you need to urinate, you have a limited amount of time to get to a bathroom.
- Frequency of urination: People who experience this symptom need to urinate very often. Typically its an increase in the number of times you urinate compared to what you previously experienced.
- Urge incontinence: In this case, there can be a leakage of urine when you get the urge to urinate.
- Nocturia: This symptom is characterized by the need to get up and urinate at least two times each night.
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How Should This Medicine Be Used
Topical oxybutynin comes as a gel to apply to the skin. It is usually applied once a day. Apply oxybutynin gel at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Apply oxybutynin gel exactly as directed. Do not apply more or less of it or apply it more often than prescribed by your doctor.
Oxybutynin gel may help control your symptoms but will not cure your condition. Continue to use oxybutynin gel even if you feel well. Do not stop using oxybutynin gel without talking to your doctor.
Oxybutynin gel is only for use on the skin. Do not swallow oxybutynin gel and be careful not to get the medication in your eyes. If you get oxybutynin gel in your eyes, wash them with warm, clean water right away. Call your doctor if your eyes become irritated.
You can apply oxybutynin gel anywhere on your shoulders, upper arms, stomach, or thighs. Choose a different area to apply your medication every day, and apply the entire dose to the place you choose. Do not apply oxybutynin gel to your breasts or your genital area. Do not apply the medication to skin that has recently been shaved or that has open sores, rashes, or tattoos.
Keep the area where you applied oxybutynin gel dry for at least 1 hour after you apply the medication. Do not swim, bathe, shower, exercise, or get the area wet during this time. You may apply sunscreen during your treatment with oxybutynin gel.
Absorbency Products Can Help
No matter how fast you can run, sometimes that bathroom is just a little bit too far in the distance. Dont let yourself get caught in an embarrassing situation There is a wide range of products available that are discreet and comfortable.
Incontinence products excel in their absorbency and wont leak or become lumpy when they get wet. They help control odor and minimize contact between urine and your skin, preventing the development of a rash or other irritation.
Many incontinence products are available, from discrete pads with little bulk that can be slipped into underwear, to disposable adult-sized underwear with in-built absorbency and easy-tear sides. Gender-specific products account for the different requirements of men and women, and there are many reusable and washable options available.
Common brands include Attends, Because, Tena, Tranquility, Depend, Prevail and Poise.
Recommended Reading: How Do You Get Rid Of Overactive Bladder
High Blood Pressure Drugs And Incontinence
Also called alpha-adrenergic antagonists or alpha blockers, these high blood pressure drugs — including Cardura, Minipress, and Hytrin — work by dilating blood vessels to reduce blood pressure. In fact, they are often prescribed to men to help with urination problems. In men with an enlarged prostate, a condition called benign prostatic hyperplasia, or BPH, alpha blockers can help relax the muscles in the bladder neck, letting urine flow more easily and improving symptoms of BPH.
In women, alpha blockers can relax the bladder, too. Women taking an alpha blocker who are experiencing urinary incontinence should also ask their doctor if there is an alternative medication available to treat their high blood pressure.
Seven Effective Treatments For Overactive Bladder
Overactive bladder occurs when sudden or frequent urges to urinate become hard to control, and can often lead to leakage .
In order to best treat overactive bladder, a urologist must pinpoint the underlying cause. Treatment will depend on symptom severity and the degree to which they impact someone’s quality of life. In general, there are three approaches to treatment: medication, behavioral interventions, and surgery.
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What Is Overactive Bladder Or Urge Incontinence
Overactive bladder, which is sometimes called urge urinary incontinence though that is really the most common symptom of OAB, is a complex of urinary symptoms:
- The urgent and uncontrollable need to urinate often with leaking urine at these times .
- The ongoing need to frequently urinate .
- Waking up in the middle of the night specifically to pee .
OAB makes people feel like they gotta go suddenly and much too often.
Its a common and frustrating part of life for many men and women: About 40% of women and 30% of men have OAB symptoms, reports the Urology Care Foundation. Women over age 45 are more likely to have OAB, especially if they are entering menopause.
Many of these people dont talk about it, even with their doctor. We know that women often think OAB is uncommon and are embarrassed to discuss it, or they fear that the only treatment is surgery or there is no treatment. None of that is true.
Our physicians encourage women to seek medical attention for overactive bladder because it most often can be managed. Another reason is that it could be a symptom of another medical problem, like a UTI or diabetes.
Prescription Drugs For Overactive Bladder
There are several prescription drugs for overactive bladder .
The FDA approved medications, or drugs, currently available on the U.S. market for the treatment of urinary incontinence are for a specific condition called overactive bladder . Some are also used for OAB with urge urinary incontinence . You may have seen advertisements on television or in magazines for these medications. Most of the prescription drugs for OAB partially calm the bladder muscles that cause abnormal contractions, thereby reducing the frequency and severity of the overwhelming urge to urinate. Some of these drugs may also increase the bladders capacity to hold urine and delay the initial urge to void. This class of drugs is referred to as antimuscarinics.
The currently FDA approved antimuscarinic drugs for OAB are: Oxybutynin, Tolterodine, Solifenacin, Hyoscyamine, and Darifenacin. These drugs are sold under the names of: Ditropan, Detrol, Vesicare, Enablex, Levbid, Cytospaz and Oxytrol. Most of these are oral medications and need a doctors prescription. Only one drug will be available over-the-counter as of September 2013, and it is in a skin patch form for women only.
Note: Drugs that are currently approved may be suddenly taken off the market, and new drugs are being introduced. Your healthcare provider and pharmacist can help you know which current drugs on the market may be the best for your circumstances.
Who May Need a Prescription?
Possible Side Effects
Key Points to Remember
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Other Bladder Control Medications
If symptoms of urinary incontinence are thought to be caused by an enlarged prostate, different medications can be offered to reduce these symptoms. The prostate gland wraps around the urethra , and if it is enlarged, it could squeeze the urinary passage tight, making the emptying of bladder more difficult and incomplete.
In brief, the following categories are available for the treatment of urinary symptoms caused by an enlarged prostate :
- Alpha-blockers, terazosin , doxyzosin , alfuzosin , silodosin , and tamsulosin , work by relaxing the muscles around the urethra and prostate, thus, making urination more comfortable and complete. These medications start to relieve symptoms within a few weeks, but they do not affect the prostate size.
- 5-alpha reductase inhibitors, finasteride and dutasteride , work by reducing the size of the prostate gland. They may take several months to become effective.