It’s not surprising that incontinence can make it difficult to get a proper night’s rest.
Urinary incontinence is defined as the unintentional loss of urine. Many women are used to the feeling of leaking when they laugh or cough. That’s known as stress urinary incontinence—when physical movement or activity puts pressure or stress on your bladder, causing you to leak urine.1
Stress urinary incontinence, or SUI, can lead women to feel embarrassed, limiting work or social life and choosing isolation instead. It can hamper physical and leisure activities.1 Studies have also shown that insomnia symptoms can be associated with both urinary incontinence and stress urinary incontinence.2
Since rest is key to good health, here are some tips on how to sleep with SUI.
Understanding Stress Urinary Incontinence
Why do I pee when I laugh? It’s a common question among women, since incontinence affects twice as many women as men.3 It’s believed that urine incontinence in general affects 50% of adult women, increasing up to 75% of women over 65. It may also be under-reported—despite being a common problem, it’s estimated that only 25-61% of women who experience weekly incontinence episodes discuss the problem with their doctor.4
It should be discussed with a health care provider, since physical, social and psychological well-being can be negatively impacted, along with quality of life at home and in the workplace. Some women may find it too embarrassing to discuss, while others may think it is normal for them to experience incontinence after childbirth or with aging.4 Incontinence is not a normal part of aging, and it can be treated.
There are also different kinds of urinary incontinence, with stress incontinence being much more common in women than in men.1 Other forms are urgency incontinence and overactive bladder, which is when your bladder muscle contracts, causing a sudden urge to urinate before you can get to the bathroom. Mixed incontinence is a combination of the two.
Living With Stress Urinary Incontinence
Women can relate to having incontinence, since it impacts so many of us. That’s because of the unique health events many of us experience, like pregnancy, childbirth, and menopause, that may affect the urinary tract and the surrounding muscles.3
Our pelvic floor muscles support the bladder, urethra, uterus, and bowels, and events like a vaginal childbirth may cause those muscles to become weak or damaged. The weak muscles supporting the urinary tract must work harder to hold urine. That extra stress or pressure on the bladder and urethra can cause urinary incontinence or leakage.3
The female urethra is also shorter than a man’s, so any weakness or damage is more likely to cause urinary incontinence—that’s because there is less muscle keeping the urine in.3
Stress urinary incontinence happens when an action puts pressure on the bladder and urethra, which are already working harder due to weak pelvic muscles. That means you may leak urine when you cough, sneeze, laugh, lift something heavy, exercise, have sex, or even just bend over. It can be even more likely to happen when your bladder is full.1
Contributing factors that can make it worse include illnesses that cause chronic coughing, or smoking, which can also cause frequent coughing; obesity; and high-impact activities, such as running and jumping, over many years.1
Besides possible side effects like skin rash or irritation, women with incontinence often face emotional distress, feeling embarrassed if it happens in public, or staying home to make sure it doesn’t happen in public. It can disrupt your work, social activities, relationships and even your sex life. Some women are also embarrassed that they need to wear pads or incontinence garments.1
It can also make it difficult to sleep. As we have mentioned, insomnia symptoms have been linked to both urinary incontinence and stress urinary incontinence.2
Some women face additional issues with sleeping properly:3
- pressure or spasms in the pelvic area that causes a strong urge to urinate
- going to the bathroom more than usual—more than 8 times a day or more than twice at night
- urinating while sleeping, known as bedwetting
How To Sleep With SUI
Women already face sleep issues—women are twice as likely as men to have insomnia, the inability to fall asleep and stay asleep.5 If you have problems with urine leaks, those concerns will seem even worse at night, when it disrupts your sleep.
There are two types of nighttime urinary incontinence:6
1. Adult nocturnal enuresis: which causes you to wet the bed while you’re asleep.
2. Nocturia: which wakes you up several times a night to go to the bathroom.
There are ways to limit the need to pee often during the night. You know the usual tips, like to avoid drinking water or any other fluids for a few hours before going to bed; and to avoid alcohol and caffeine in the evenings, as they can irritate your bladder.6
It’s also helpful to elevate your legs while you watch TV at night before you go to bed, and to consider using compression stockings while you elevate your legs.6 That’s because during the day, fluid pools in your extremities and then gets reabsorbed into your system once you lie down. That fluid then heads to your kidneys to be processed, causing you to “pee it out.” Propping your legs up at the level of your heart for an hour in the late afternoon or evening can help you urinate during the day, rather than at night.7
You can also try to “train your bladder” during the day. Bladder training is a form of behavior therapy that can be effective in treating urinary incontinence. The goals include increasing the amount of time between emptying your bladder and increasing the amount of fluids your bladder can hold.8 Training during the day can help with incontinence at night.
As for sleeping positions, some suggest side sleeping, but that could be because sleep apnea has been linked to overactive bladder symptoms. If you have sleep apnea and OAB, sleeping on your side may help.9
If the problem is particularly bad, you could speak to your doctor about medication that may help. A researcher at the Stanford University School of Medicine reported that a drug used to curtail episodes of urinary incontinence in women also improved their quality of sleep. The drug called fesoterodine decreased accidental urination in study participants, and researchers found it produced secondary benefits, like less nighttime wakefulness caused by an urge to urinate.10
If you still have trouble, there’s no need to feel embarrassed. You’re not alone! You can also consider wearing incontinence briefs or pads, and using a plastic mattress cover.6 There are also inserts for incontinence, but it’s best to seek the advice of a doctor before considering using them when you sleep.
What Can I Do About Stress Urinary Incontinence?
You can also take steps to address the cause of the incontinence, which in turn may help resolve any sleep issues. It’s true that you can look to medications, devices like a pessary, or even surgery. A sling procedure, for instance, is an operation by which a pelvic sling is created underneath your urethra and where the bladder connects to the urethra. The sling helps keep the urethra closed and is used to treat stress incontinence.11
However, it may be most effective to start by performing pelvic floor muscles exercises on a regular basis, which can strengthen those important pelvic floor muscles that help control urination. Also known as Kegel exercises, these techniques are especially effective for stress urinary incontinence.11
Research has shown that a dedicated program of Kegel exercises improve pelvic floor muscle strength and is effective in reducing stress urinary incontinence among women. Pelvic floor exercises can be performed as a preventive measure, or as treatment for women already suffering with stress urinary incontinence.
It’s often described that pelvic floor muscle exercises are like trying to stop your urine flow. Here’s how to do them:11
- Tighten or contract the muscles you would use to stop urinating and hold for five seconds, and then relax for five seconds.
- Work up to holding the contractions for 10 seconds at a time.
- Aim for at least three sets of 10 repetitions each day.
It’s important that you’re identifying and contracting the right muscles. Your doctor may suggest you work with a pelvic floor physical therapist or try biofeedback techniques.11
Pelvic floor muscles can be trained using tools like the INNOVO Urinary Incontinence Kit. The shorts and controller will help you perform Kegel exercises properly, in short 30-minute sessions. A clinical study guided by the FDA had amazing results: 87% of women were defined as dry after just 12 weeks, and 90% of users would recommend the therapy to others. Subscribe to the INNOVO newsletter to receive a $20 discount code for your purchase!
Don’t be embarrassed about your incontinence. Effective treatments are available, including non-invasive actions, taking charge with exercise and establishing new routines. You can return to your active and confident life.11
See a Doctor
If you’re suffering in silence due to your incontinence concerns, use our Physician Finder to find a doctor near you with expertise in women’s health. Enquire about help treating your stress urinary incontinence, and get help to have a proper night’s rest, so you can get back to an active and happy lifestyle.