How to Sleep Better When You Have Interstitial Cystitis

Interstitial cystitis, or bladder pain syndrome, is characterized by bladder-centered pain. The majority of patients with IC also have urinary frequency and urgency. Most patients who have urinary frequency and urgency during the day also have it at night. Many patients can go to the toilet and go back to sleep, but many of us aren’t so lucky. What do we do if the bladder keeps us up? Or wakes us up after we’ve been asleep? Fortunately, there are a lot of tricks that can help. It’s important to know that many factors affect sleep, so we need to talk about several of them because different strategies work for different people.

Bladder Training

Bladder training can be quite effective. However, it goes against everything we’ve been taught, for example, we’re told to never hold our bladder for too long. However, bladder training is purposeful holding in your urine. We ask patients to hold their urine for 15 minutes longer each week. So, if someone can comfortably hold it for one hour, we start there. One week later, they hold it for an hour and 15 minutes and don’t allow themselves to go to the bathroom more often than that. By four weeks, they should be able to hold it for two hours, and by eight weeks, up to three hours, which is pretty normal. I don’t recommend holding urine at night if you’re awakened by your bladder, mostly because it’s very difficult to fall back asleep with the urge to urinate. But usually, daytime training can help train the bladder to hold more urine at night.

Overactive Bladder Medications

Another strategy is treating the bladder with overactive bladder medication. There are two categories of medicine. Anticholinergic medications work by blocking overactive bladder contractions, and beta-agonist medications stimulate bladder relaxation. These were originally designed to help people with urinary frequency, urgency, or urinary incontinence, but they can also be effective for patients with urinary frequency due to interstitial cystitis. The goal of these medications is to reduce nighttime urination by about half. So, someone who gets up four times a night may only get up two times a night, which is quite an improvement!

Hormonal Therapies

What about other sleep strategies that can help? For menopausal women (who have gone through menopause) or perimenopausal women (who are entering menopause), hormone replacement therapy can help. In fact, progesterone, which is an important component of hormone replacement therapy for women who have a uterus and is taken in addition to estrogen therapy, can be a great sleep aid for many women.

For people who have trouble sleeping in general, not just due to bladder urgency, there are numerous medications that your doctor can prescribe. Many supplements are also helpful, such as the very popular melatonin. Decreasing stress with supplements like Ashwagandha (also found in Femetry) can also be helpful. For others with sleep problems, cognitive behavioral therapy can be very effective. This helps by providing practical strategies for better sleep hygiene. These include trying to go to bed at a set time, not watching TV in bed, avoiding electronics before bedtime, and not using the bed for anything other than sleep (or sex).

For those who need additional assistance, there are doctors who specialize in sleep medicine who can be quite helpful.