Weekend Catch-Up Sleep Linked to Lower Odds of Overactive Bladder

Adults who slept more on weekends than weekdays had lower odds of overactive bladder (OAB) and milder urinary symptoms, with the association concentrated in the first 1.5 hours of extra sleep, according to a cross-sectional analysis published in Annals of Medicine.¹

Catch-Up Sleep Offers a New Lens on Sleep and OAB

According to the CDC, about 35% of US adults do not get enough sleep. A common way to recover from short sleep during the workweek is weekend catch-up sleep (WCS), which has been associated with lower rates of depression and cardiovascular disease, as well as reduced systemic inflammation.

Past research has linked poor sleep patterns to a higher prevalence of OAB and more severe symptoms. However, the association between WCS and OAB had not been examined, according to the investigators. To address this gap, they set out to determine whether WCS, a low-cost and easy-to-adopt behavior, was also linked to OAB. Using data from the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES), the researchers calculated WCS for each participant by subtracting self-reported weekday sleep hours from weekend sleep hours, with any positive value counting as catch-up sleep.

Modest Catch-Up Sleep Linked to Lower OAB Odds and Severity

The study included 4195 adults 20 years and older. Of these, 997 (23.8%) met criteria for OAB, based on questionnaire items on urge incontinence and nocturia scored with the Overactive Bladder Symptom Score.

Compared with participants without OAB, those with OAB were more often women (63% vs 49%) and 60 years or older (50% vs 25%). They also had higher rates of hypertension (51% vs 29%) and diabetes (23% vs 9.0%). Disparities also emerged, as non-Hispanic Black adults made up 16% of the OAB group vs 9.5% of the non-OAB group, and 27% of patients with OAB had an income-to-poverty ratio below 1.3 vs 18% of those without OAB.

On average, participants with OAB also got less catch-up sleep (0.53 vs 0.74 hours). After adjusting for demographic, lifestyle, and clinical covariates, including self-reported trouble sleeping, any amount of WCS was associated with 21% lower odds of OAB (OR, 0.79; 95% CI, 0.67-0.93). WCS was also associated with lower symptom severity (β, –0.097; 95% CI, –0.178 to –0.015; P = .02). By contrast, in the fully adjusted model, the association between WCS duration and OAB severity was not statistically significant (β, –0.019; 95% CI, –0.044 to 0.006; P = .135).

The association appeared nonlinear. Spline modeling suggested a U-shaped curve, although the test for nonlinearity fell just short of significance (P = .053). A follow-up threshold analysis placed the turning point at 1.5 hours. Below it, each additional hour of WCS corresponded to 11.3% lower odds of OAB (OR, 0.887; 95% CI, 0.812-0.969). Above it, the association was no longer statistically significant (OR, 1.049; 95% CI, 0.942-1.164).

“…moderate WCS duration is associated with a lower prevalence of OAB,” the authors wrote. “Given the growing burden of OAB on public health, characterized by its impact on quality of life and health care systems, incorporating strategies that [promote] adequate [WCS] may offer a cost-effective approach to reduce its prevalence.”

Where the Results Fit in OAB Research

The study is one of several recent NHANES analyses tying OAB to modifiable, whole-body health factors. One found that sleep health was the second-largest contributor, after body mass index, to the association between cardiovascular health scores and OAB.² Another reported that higher systemic inflammation was associated with greater OAB odds, with the link strengthening at higher inflammation levels.³

However, the authors acknowledged several of the current study’s limitations, one being that its cross-sectional design prevents it from establishing causality.¹ In addition, sleep duration and nocturia were self-reported, which may introduce recall bias. As a result, the authors called for prospective studies to confirm the relationship and clarify its underlying mechanisms.

“Future research should concentrate on the inherent physiological mechanisms connecting WCS and OAB, aiming to refine sleep-based interventions and assess their long-term efficacy in diverse demographic groups,” they concluded.

References

1. Li Z, Liu X, Chen X, et al. Unraveling the protective effect of weekend catch-up sleep on overactive bladder risk. Ann Med. 2026;58(1):2702805. doi:10.1080/07853890.2026.2702805
2. Joszt L. Better cardiovascular health tied to lower overactive bladder risk. AJMC^®. September 1, 2026. Accessed September 30, 2026. https://www.ajmc.com/view/better-cardiovascular-health-tied-to-lower-overactive-bladder-risk
3. McCormick B. Inflammation tied to overactive bladder odds, partly via adiposity. AJMC. September 29, 2026. Accessed September 30, 2026. https://www.ajmc.com/view/inflammation-tied-to-overactive-bladder-odds-partly-via-adiposity