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A Comparison of Tolterodine and Placebo Treatments on Nocturnal Frequency and Sleep Quality in Women After Menopause.

Phase 4
Terminated
Conditions
Urinary Incontinence
Interventions
Registration Number
NCT00323635
Lead Sponsor
Brigham and Women's Hospital
Brief Summary

This study is being done to compare frequency of urination during the night when women take tolterodine tablets vs. when they take placebo tablets.

We will also measure whether between these two treatment conditions there are any differences in women's sleep, mood and performance on cognitive tests.

Detailed Description

From midlife onwards, about half of women complain of poor sleep quality. One possible reason might be an increased frequency of need to urinate during the night. Women feel more frequent urges to urinate when structures that support the bladder become more lax. Tolterodine is a drug that can raise the threshold for volume of urine that accumulates in the bladder before the urge to urinate arises.

Many factors determine how people say they sleep, such as their sleep as recorded by sleep-measuring instruments, how closely they notice their night's sleep, whether they are generally prone to make positive or negative judgments or to have a lot or a few body symptoms.

In this study, women between ages 45 to 65 who are past the menopause and who are frequently bothered by the need to urinate during the night will take either tolterodine or placebo tablets for 8 weeks. During the last week they will record the hours they slept and the quality of their sleep each morning. They will wear a device on their wrist through the week that continuously records whether they are asleep or awake. During three nights of the week they will record the volume of urine whenever they urinate. At the end of the week they will complete questionnaires about their mood and take some computerized tests that measure their alertness. Thereafter they will repeat these procedures, taking the kind of tablets they did not take during the first 8-week treatment period.

We will compare the frequency of urination, sleep, mood as adjusted for the tendency to make positive or negative judgments and daytime attention level to find if any of these differ between the two treatment periods, and to explain differences between any differences that may be found.

Recruitment & Eligibility

Status
TERMINATED
Sex
Female
Target Recruitment
19
Inclusion Criteria
  1. Post-menopausal women, age 45 to 65 years old.
  2. No menses for at least 6 months before the study start.
  3. Have at least 14 episodes of nocturia per week.
  4. Have at least 4 hot flashes daily.
  5. Overall good health, as evidenced by a letter from the primary care provider.
  6. Agree not to use exogenous hormones including soy isoflavones or soybean-based shakes, or nutritional supplements that potentially reduce hot flashes.
  7. Have discontinued all hormone treatments, systemic, topical, or vaginal, at least 60 days before admission and throughout participation in the study.
Exclusion Criteria
  1. Use of anti-cholinergic, hypnotic or sedating drugs

  2. Presence of urinary retention, gastric retention, chronic severe constipation,or narrow-angled glaucoma.

  3. A urinary tract infection within a month of study start.

  4. Undiagnosed abnormal vaginal bleeding.

  5. Benign or malignant liver disease.

  6. History or presence of chronic alcoholism or medication addiction within the past 5 yrs.

  7. An acute systemic infection within seven days before the study start.

  8. Concurrent participation in another clinical trial and/or receiving an experimental medication/device in the last 30 days before admission to the study.

  9. History of shift work within the past 6 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TolterodinetolterodineTolterodine 4 mg q.d. X 8 weeks
PlacebotolterodineA capsule of identical to tolterodine in taste, smell and appearance that contains no tolterodine
Primary Outcome Measures
NameTimeMethod
Nocturnal Urinary Frequency, Recorded on an Event/Symptom Chart;2 months

Subjects note: 1. Number of nocturnal and diurnal voids; 2) level of urgency for 7 days, graded 1 to 4, beginning after the first void on the Friday morning of week 7 and week 13 of their participation; 3) Number of incontinence episodes; 4) Relationship of incontinence to urge or stress (4 grade scale); 4) Whether she used any pads.

UrgencyBeginning after the first void on the Friday morning of week 7 and week 13 of their participation;

Level of urgency for 7 days, graded 1 to 4,

Number of Incontinence Episodes;Duration of Study

Number

Relationship of Incontinence to Urge or StressDuration of study

4-grade scale

Secondary Outcome Measures
NameTimeMethod
HyperarousalAt baseline and 8 weeks later

Score on 26-item self-report Hyperarousal Scale that indicates proportion of attention allocated to visceral-somatic information vs. external sensory data.

Whether She Used Any Pads.Duration of Study

Yes/No

Psychological Self-reports, Scores on Anxiety and Depression Rating Scales;2 weeks

State and Trait scores on Spielberger State-Trait Anxiety Inventory; The score measured by the Zung Self-Rating Depression Inventory.

Quality of Life, Scores on the Women's Health Questionnaire.2 weeks

Self-reported vasomotor symptoms, other somatic symptoms, anxiety, depression, sleep and cognitive symptoms (memory, concentration and clumsiness problems), measured as category scores. Subjective sleep onset and total sleep times measured as 7-day averaged minutes.

Sleep Quality2 months
Pads UsedDuration of Study

Pads used

Cognitive FunctionTwo 20-minute sessions during 2 months

Motor speed (number of finger taps in 30 seconds); Continuous Performance (mean response time elicited by appearance of target alphabet letter presented in a series of letters on a monitor screen for 1 minute); Color-Word Stroop Test (response times to stimuli with congruent word and color)

Trial Locations

Locations (2)

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Brigham & Women's Hospital

🇺🇸

Boston, Massachusetts, United States

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