NIGHTTIME URINARY-INCONTINENCE AND SLEEP DISRUPTION AMONG NURSING-HOME RESIDENTS

OBJECTIVE: To examine the relationship of urinary incontinence episode s to sleep disruption in a sample of nursing home residents. DESIGN: D escriptive, case series. SETTING: Three community nursing homes. PARTI CIPANTS: Seventy-three incontinent residents of three nursing homes pa rticipating in a trial of a behavioral intervention for nighttime urin ary incontinence. MEASUREMENTS: Data were collected during a baseline and repeat baseline period about 2 months later in nursing homes servi ng as controls for the intervention homes. Incontinence episodes were identified by incontinence pads, which were wired to detect wetness of 10 mL or more. Sleep was monitored by wireless wrist actigraphs. Nois e and light changes were monitored by bedside recording devices. MAIN RESULTS: Recordings covered 403 nights, during which 1715 awakenings f rom 10 consecutive minutes of sleep were detected as were 1168 inconti nent episodes. Only 4% of the awakenings were associated with an incon tinence episode, and only 23 % of the incontinence episodes occurred d uring periods of at least 10 consecutive minutes of sleep. Of the latt er episodes, only 12% appeared to awaken the resident. CONCLUSIONS: Ou r data raise questions about the relevance of incontinence episodes to sleep disruption among chronically incontinent nursing home residents . Our findings must be interpreted cautiously because of limitations i n the technologies and definitions we used to identify sleep, awakenin gs, and incontinence episodes. Although logistically and technically d ifficult to perform, studies using polysomnographic recordings of slee p are needed to examine further these important associations.