Botox for Sleep Effectiveness.

[IMPORTANCE] Nocturia is one of the most bothersome complaints in women with overactive bladder syndrome (OAB). Although small preliminary studies have shown that intradetrusor onabotulinum toxin A (BTX) injections reduce nocturia episodes, it is not known how reduction in nighttime urination affects sleep quality and quality of life.

[OBJECTIVES] We aimed to assess the effect of BTX on nocturia frequency, sleep quality, and quality of life.

[STUDY DESIGN] This is a prospective observation study of adult women with ≥2 nocturia episodes and OAB planning to undergo treatment with BTX injections. Participants completed a 2-day bladder/sleep diary and sleep-related questionnaires at baseline and 5 weeks post-BTX.

[RESULTS] A total of 40 participants were included with a mean age of 71 ± 12 years and most (90%) undergoing 100 units of BTX injection. At baseline, the median nocturia episodes were 3.5 (IQR, 2.5-5.0), and nearly half (43%) of participants reported mild to moderate sleep disturbance. At 5 weeks post-BTX, we found a significant decrease in nocturia episodes (-2/night) and a 59% decrease in mild to moderate sleep disturbance (P = 0.006). There were significant increases in longest sleep interval (+1.5 hours), time to first awakening (+1.6 hours) and average sleep interval (+1.3 hours), and a significant increase in nocturia-related quality of life scores (P < 0.001 for all). Sixteen (40%) of participants had nocturia resolution defined as ≤1 mean nocturia episode post-BTX.

[CONCLUSIONS] For women with OAB and >2 nocturia episodes/night, BTX injections reduce voids/night and improve sleep quality and nocturia-related quality of life.