A Good Night's Sleep With an Ostomy

An ostomy for urinary diversion (a urostomy), is often created due to bladder cancer. Although other urinary tract-related issues can lead to its creation.¹

For many people with bladder cancer who require a urinary diversion (for which a urostomy is one diversion option), it is usually carried out to treat cancer that has invaded muscle tissue of the bladder or recurrent non-invasive bladder cancer where there are multiple tumors or large tumors.^2,3

There is no one with an ostomy that won’t tell you it has not changed their life. Most people who have had their ostomy for a long time will also tell you, that you adapt to living with an ostomy and can live a very normal life. The question I get asked most as a patient advocate is, “How do you sleep with an ostomy?” So here are my top tips.

Night bag or no night bag?

Whether to use a night bag or not is a personal choice. At first, I rejected its use when home from the hospital. Emotional, I wasn’t ready to use what was in my view at the time, a clinical item, which should remain in a hospital.

With time, I realized it was the key to a good night’s sleep. Most nights since my surgery 5 years ago, I can sleep 7 to 8 hours straight when using my night bag.

There is the alternative which is using a leg bag (smaller and reduced capacity but still more capacity than a standard urostomy bag) which some people choose. Or you can set your alarm for approximately 4-hour intervals to empty your standard bag.

Ensure your bag drains into your night bag

• Ensure your standard bag is about one-fourth full before you connect to the night bag to help get the urine flowing into the night bag.
• You can attach the tubing to your leg to ensure it stays in place and helps to continue the flow.
• Ensure your night bag is positioned below the height of your urostomy bag. Depending on your bed height, you may find laying the bag on the floor/in a basin or on a nightstand is the best option to achieve this.
• You can also position the bag at the bottom of the bed mattress as an alternative option.

I find that having something to support your ostomy, helps to ensure you don’t lie flat on top of it and cause it to leak. I use a 6-ft full-length body pillow, which I sleep against. This has significantly reduced my nighttime leaks/ensured the urine flows well into my night bag. A pregnancy pillow that provides support on 2 sides is also suitable (I used this initially post-surgery).

Try not to drink excessive fluids in the hour before going to bed. This can lead to excessive output at night which could lead to a full night bag before morning. It can also flush out essential minerals your body needs and can lead to dehydration which could disturb your sleep.

Have a glass of water available by your bedside, so you can easily get a drink if you wake up thirsty without getting up. Staying hydrated is very important with a urostomy.

Bag changes

Consider the timing for changing your standard bag. I recommend changing your bag in the morning, when there will be less output, making things easier.

If you work shifts or need to change your bag in the evening, try to do it at least a few hours before bed, to ensure good adhesion and no issues before bedtime.

If you feel itching/burning or you notice your bag starting to lift before bed, while you might not feel like it, it is best to change. Anytime I have risked it, a leak has followed and that is more hassle to deal with during the night.