The Long Dry Sleep
Living with a cancer diagnosis is practically a guarantee you will struggle with sleep at least occasionally. Anxiety about the “C” word is reason enough to launch insomnia!
Cancer treatments are also famous for messing with our ability to fall asleep or to maintain sleep, or it may disrupt our circadian rhythms, leading to daytime naps which interrupt our drive to sleep at night.
For those with bladder cancer, the added concern about sleeping through the night, without frequent bathroom trips or worries about leakage, just adds one more unpleasant obstacle to all the others.
But sleep is a critical ally in the fight against cancer. Sleep supports the immune system and provides time and space for healing in the body. The best case scenario for anyone with cancer is getting 8 consecutive hours of sleep every single night.
But is it possible to achieve a long, dry sleep when you have bladder cancer… even after surgery?
Keeping a dry bed when you have bladder cancer
You’re probably already applying the necessary barriers as a result of incontinence: adult diaper or pads, as well as mattress protections. The products these days are better than they’ve ever been, and they can be used safely overnight.
For some with bladder cancer—especially muscle-invasive bladder cancer — treatment may also require a cystectomy, which is the complete removal of the bladder as well as other organs that serve the important function of urination, such as parts of the ureters and adjacent lymph glands.
Men may also lose the prostate and seminal vesicle to the procedure, whereas women face removal of one or more of the reproductive organs.
But with the removal of so much of the urinary tract, the body still needs a way to dispose of waste fluid. Urine diversion procedures exist to make this possible. These solutions are effective, but concerns about preventing leakage while sleeping at night are legitimate.
The ileal conduit
This diversion procedure reroutes urine through the ureters, which transport it to a small external pouch located on the abdomen by way of a one-way opening called a stoma. There, the urine is collected in the pouch, which combines a small interior pouch made from part of the intestine with a small external bag called a urostomy pouch. Once the pouch is a third to one-half full, it should be drained.
At night, the pouch may still need to be drained. Some people who use an ileal conduit attach a catheter to the pouch that makes it easy to drain bedside into a collection vessel, eliminating the need to rise and drain it manually in the bathroom.
As its name suggests, this is a new bladder made from a small part of the intestine. It functions in much the same way the original bladder worked, releasing urine from the kidneys into the ureters and eventually out of the body using the abdominal muscles.
Those who undergo the neobladder option may expect to deal with nighttime urine leakage for up to six months following surgery, making it important to continue using incontinence products until control over the abdominal muscles to urinate has been achieved.
The Indiana pouch
This form of continent diversion is a new pouch also built from a piece of the intestine, but it remains inside the body and is accessed through a stoma, just like the ileal conduit. Urine is drained by way of a catheter inserted into the stoma.
For best results when using an Indiana pouch, it is recommended that a night drainage system is used. It can collect a larger volume of urine overnight without requiring you to empty it multiple times at night.1
Click here for diagrams illustrating each diversion.
Can sleep hygiene help?
It can’t hurt. While your body fights bladder cancer, you’ll want to protect your sleep period, and that means doing everything you can to eliminate all those nighttime trips to the bathroom. Some useful sleep hygiene practices include:
- Reducing the volume of liquids consumed at bedtime
- Avoiding alcohol prior to bedtime. It has a diuretic effect and is a well-known sleep disruptor. When alcohol is metabolized, the body undergoes a withdrawal effect that can cause unnecessary awakenings.
- Avoiding caffeine products after lunch. Caffeine has a half-life of around 4 to 5 hours, but afterward, you’ll still have its metabolites in your system. They can still be stimulating enough to interfere with sleep.