We propose to conduct a rigorous, 12-week, randomized controlled trial of two relaxation therapies in 160 ambulatory women who report an average of at least 3 urgency-associated voiding or incontinence episodes per day. Participants will be randomized in a 1:1 ratio to: 1) practice slowing their resting respiratory rate to 5 to 10 breaths per minute for at least 15 minutes/day at home using a portable guided-breathing device; or 2) use an identical-appearing device that plays relaxing music while monitoring their spontaneous breathing pattern. We do not know if either of the two types of relaxation therapies is effective in treating OAB. All women will also receive a usual care pamphlet providing basic information about other traditional self-management strategies for OAB.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
161
Participants will use a small, commercially-available guided-breathing device to practice breathing at a rate slower than 10 breaths per minute. Participants will be instructed to use their devices for at least 15 minutes per day for 12 weeks.
Participants will use an identical appearing device, programmed to play quiet, relaxing music, while monitoring spontaneous breathing. Participants will be instructed to use their devices for at least 15 minutes per day for 12 weeks.
University of California, San Francisco
San Francisco, California, United States
Change From Baseline in Frequency of Any Voiding or Incontinence Episodes Associated With At Least a Moderate Sensation of Urgency at 12 Weeks.
Self-reported on voiding diary.
Time frame: Baseline to 12 weeks
Change From Baseline in Frequency of Any Voiding or Incontinence Episodes Associated With a Severe Sensation of Urgency at 12 Weeks.
Self-reported on voiding diary
Time frame: Baseline to 12 weeks
Change From Baseline in Urgency Incontinence Episodes at 12 Weeks.
Self-reported on voiding diary
Time frame: Baseline to 12 weeks.
Change From Baseline in Total Voiding Episodes at 12 Weeks.
Self-reported on voiding diary.
Time frame: Baseline to 12 weeks
Change From Baseline in Overactive Bladder Questionnaire Score at 12 Weeks
A 33-item measure of the bothersomness and impact of multiple OAB symptoms (such as urgency, incontinence, nocturia) along a 100-point scale. Higher the score the greater the bothersome.
Time frame: Baseline to 12 weeks.
Change From Baseline Score of Urgency Severity and Impact Questionnaire (USIQ), Severity Subscale at 12 Weeks.
A 13-item measure of the severity and impact of urgency validated specifically in patients with OAB, range of 0-100. Higher the severity score, the more severe.
Time frame: Baseline to 12 weeks.
Change From Baseline Score of Urgency Severity and Impact Questionnaire (USIQ), Health-Related Quality of Life Subscale at 12 Weeks.
A 13-item measure of the severity and impact of urgency validated specifically in patients with OAB, range of 0-100. Higher the severity score, the more interference with quality of life.
Time frame: Baseline to 12 weeks
Change From Baseline in Urogenital Distress Inventory Short Form (UDI-6) Score at 12 Weeks.
A 6-item measure of the bothersomeness of multiple urinary symptoms, including urgency and incontinence; scores range from 0-100. Higher the score, the more distress.
Time frame: Baseline to 12 weeks
Change From Baseline on Patient Perception of Bladder Condition (PPBC) Score at 12 Weeks.
A single-item assessing patient's overall perception of their bladder problems using a 6-point Likert scale, score range 1-6. The higher the score the more severe.
Time frame: Baseline to 12 weeks
Change From Baseline on Spielberger State Trait Anxiety Inventory (STAI) - Trait Component Score at 12 Weeks.
A 20-item self-administered measure validated in both clinical and psychiatric populations, including patients with bladder symptoms. Scores range from 20 to 80, with higher scores indicating greater somatic anxiety.
Time frame: Baseline to 12 Weeks
Change From Baseline in Hospital Anxiety and Depression Scale (HADS) - Anxiety Subscale Score at 12 Weeks.
A validated self-administered questionnaire that includes a 7-item Anxiety Subscale shown to be sensitive to change in incontinence trials. Scores range from 0 to 21, with higher scores indicating greater anxiety.
Time frame: Baseline to 12 Weeks
Change From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D) Score at 12 Weeks.
A 20-item measure that has been widely used in clinical trials, including trials of bladder interventions, and is sensitive to change. Total scores range from 0 to 60, with higher scores indicating greater likelihood of depression.
Time frame: Baseline to 12 weeks
Change From Baseline in Perceived Stress Scale (PSS) Score at 12 Weeks.
A 10-item self-administered questionnaire assessing subjective feelings and thoughts related to perceived stress in the past month, validated in a probability sample of the United States. Scores range from 0 to 40, with higher scores indicating greater perceived stress.
Time frame: Baseline to 12 weeks
Change From Baseline in Pittsburgh Sleep Quality Index (PSQI) Overall Sleep Quality Score at 12 Weeks.
An 18-item validated questionnaire evaluating sleep quality, sleep latency, sleep efficiency, and sleep problems over a one-week period. A global sleep quality score ranging from 0 to 21 can be derived from the PSQI, with higher scores reflecting poor sleep quality.
Time frame: Baseline to 12 weeks
Change From Baseline in Respiratory Sinus Arrhythmia at 12 Weeks.
Resting (neutral) state
Time frame: Baseline to 12 weeks
Change From Baseline in Respiratory Sinus Arrhythmia (RSA) Resting (Neutral) State at 12 Weeks.
Change in autonomic control as assessed by high frequency heart rate variability (RSA)
Time frame: Baseline to 12 weeks
Change From Baseline in Respiratory Sinus Arrhythmia (RSA) Change From Rest to Dot Task at 12 Weeks.
High frequency heart rate variability
Time frame: Baseline to 12 weeks
Change From Baseline in Respiratory Sinus Arrhythmia (RSA) Change From Rest to Maze Task at 12 Weeks
high frequency heart rate variability
Time frame: Baseline to 12 weeks
Change From Baseline in Pre-ejection Period (PEP) Resting (Neutral) State at 12 Weeks.
PEP is the time period during which the left ventricle of the heart contracts while the aortic and mitral valves are still closed, is an established measure of sympathetic autonomic activity that can be measured non-invasively using impedance cardiography .
Time frame: Baseline to 12 weeks
Change From Baseline in Pre-ejection Period (PEP) Change From Rest to Dot Task at 12 Weeks.
The time period during which the left ventricle of the heart contracts while the aortic and mitral valves are still closed
Time frame: Baseline to 12 weeks
Change From Baseline in Pre-ejection Period (PEP) Change From Rest to Maze Task at 12 Weeks
The time period during which the left ventricle of the heart contracts while the aortic and mitral valves are still closed
Time frame: Baseline to 12 weeks
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