Sleep disturbance changes in women after treatment of refractory overactive bladder with sacral neuromodulation

Purpose: The aim of this study is to evaluate changes in sleep disturbance following treatment of overactive bladder with sacral neuromodulation. Materials and Methods: This is a sub-analysis of data collected from an institutional review board approved retrospective cohort study evaluating women with Patient-Reported Outcomes Measurement Information System-Sleep Disturbance (PROMIS-SD) before and after sacral neuromodulation for overactive bladder between March 2016 and October 2017. Data collected included demographics, clinical characteristics, and additional PROMIS item banks. Within-group analysis was performed with paired t-tests. Groups based up on PROMIS-SD improvement (change <0) were then compared using Fisher's exact test, t-test, or Mann-Whitney U-test as appropriate. Results: Those with improved sleep disturbance (n=7) noted a significant mean improvement of -3.99 (95% confidence interval, -6.32, -1.65; p<0.01). Both pre- and post-procedure PROMIS-Physical Function (38.86 +/- 2.35 vs. 34.13 +/- 5.58, p=0.07 and 37.14 +/- 5.10 vs. 35.44 +/- 4.74, p=0.53), Pain Interference (60.04 +/- 6.34 vs. 65.50 +/- 6.20, p=0.13 and 57.89 +/- 5.08 vs. 64.73 +/- 7.35, p=0.07), Depression (44.2 +/- 4.73 vs. 61.29 +/- 9.53, p=0.17 and 54.29 +/- 6.25 vs. 57.96 +/- 11.42, p=0.47) t-scores were similar between sleep response groups. Conclusions: Those with improved sleep disturbance reported significant changes after sacral neuromodulation for overactive bladder. However, no significant differences were identified between those with and without improvement. Further investigation of changes in sleep disturbance and factors affecting change are needed within this population.