Nocturia - urinating at night

[swilson]

I had read that being on CPAP would reduce if not stop trips to the bathroom during the night. Some people even found instant relief. I did a search but could not find a thread on this. I find the searching option frustrating on this forum . My experience with nocturia has been the opposite. Before I was diagnosed with mild-moderate OSA, about 50% of the time I would wake up once to go to the bathroom. Then on CPAP I would go once every night. I was going to go to the hospital for an over night sleep study and the sleep doc. told me to not use the CPAP for one week before the study. As soon as I stopped using the machine I had to go twice a night, every night. After the hospital visit, I decided to stay off the machine to see what would happen. After another 2 weeks I started to get excessively tired during the day so I went back on the machine. It's been a week now and 60% of the time I get up once, 40% twice. What's bothering me even more now is that there is some leakage before I am aware that I need to go during the night. Has anybody else had problems with this?

[zonk]

I had read that being on CPAP would reduce if not stop trips to the bathroom during the night. Some people even found instant relief. I did a search but could not find a thread on this.

This is one of positive effect of CPAP. No more wake up to pee during the night. There is a connection between sleep apnea and nocturia - give some time and I,ll look up.

[Sleepster]

Most people report that the night-time trips to the bathroom are reduced when we go on CPAP therapy. I'm one of them. You're the first to report the opposite, that I've seen.

Nerves play a roll in this. When we're nervous we do tend to pee more often. I've noticed that since I've started CPAP therapy I go less often during the day, too. And when I do go I have a lot more in my bladder to unload.

[zonk]

Do a search in the old forum - There are few threads about nocturia
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The reasons for nocturia explained by Dr Barry Krakow
http://www.youtube.com/watch?v=x8DZAHqNj9M
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Too Many Bathroom Trips At Night? See A Sleep Doctor First
Steven Park MD
There have been numerous studies that show that a major reason why people go to the bathroom to urinate frequently are doing so not because of irritable bladders or enlarged prostates, but due to an underlying sleep-breathing problem. Here’s another study that showed that about 58% of men with nocturia had obstructive sleep apnea. When treated for sleep apnea, nocturia can be significantly improved, if not completely cured in many cases. Prescription medication for this problem can’t even come close to these results.

Another recent study showed that going to the bathroom 2 or more times per night increased the mortality rate by 50% in men and 30% in women.

It’s been shown in numerous studies that the reason why you wake up is not because your bladder is too full—it’s because you’ve stopped breathing and you think your bladder is full, but it’s not. Here’s what happens: Every time you stop breathing, blood flow to the heart diminishes, but once you start breathing again, blood rushes back in your heart which dilates the heart chambers, making your heart think that you’re fluid overloaded. The heart then makes a hormone called atrial natriuretic hormone (or peptide), which makes your kidneys make more urine. At a certain point, with even a small amount of urine, you’ll feel like you have to go but only after you’ve woken up after an apnea event. Notice too, that urine volumes are typically not that large.

The thing that get me upset about all this is that despite all that we know about urinary frequency and its’ connection to obstructive sleep apnea, PCPs and urologists haven’t changed their ways at all. They continue to place patients on medications that help to relax the bladder, shrink the prostate, or even do surgery, which is like placing a band-aid. Treating with medications may help people go to the bathroom less often, but it won’t prevent cardiovascular morbidity and mortality. Treating an underlying sleep-breathing problem will not only treat nocturia effectively, it’ll also significantly lower your chances of dying.

I’m not saying that all cases of nocturia is from sleep apnea but since it’s so common, why not rule it out before looking at the more traditional options that require medications? (The same argument can be made for ADHD, depression, anxiety, heart disease, diabetes, etc.) If you have sleep apnea, treat that first, and if you still have symptoms, get checked by a urologist. What do you think about this idea?

[big_dave]

I was waking up every hour or two to go to the bathroom. My bladder really was full--multiple full bladders nightly. I was prescribed Lisinopril/HCTZ for high blood pressure in mid March, which reduced the bathroom trips to one a night. (HCTZ is a diuretic, and is taken in the morning.) Now after starting CPAP in mid April, I hardly ever have to get out of bed to go to the bathroom. My blood pressure also was further reduced by using CPAP.

[swilson]

Thanks for responding. The point that I am trying to get across is that I am on CPAP and that I went to the bathroom much less often before I was diagnoised with Sleep Apnea. The problem is that mynocturia has gotten worst on CPAP. Yes, it could be anxiety. I was just reading a post on the internet that this woman went to a Urologist for a few years and nothing helped. Then another doctor diagnosed her as having anxiety and gave her medication and the nocturia stopped. I also just read about in Europe they have discovered that treating the nocturia problem has also improved the sleep disorder.

[Dreamcatcher]

Have you tried stopping your humidifier? Taking in water wont help your problem. Try a night or two without your humi. and see if this helps. Again seek advise from your sleep specialist and see if they can help

DC

[zonk]

Getting up once or twice at night is not an issue if you go back to sleep and feeling better which you do. If its cpap related than you need to work it out whether its leak, mask discomfort or may be sleep hygiene

[Sleepster]

People respond differently to CPAP therapy. Wait a few weeks and my guess is your nocturia problem will slowly subside. CPAP therapy is quite a shock to the system. Things that bother us when we first start no longer bother us after we've been on it for a few weeks.

[mjbearit]

Thanks for responding. The point that I am trying to get across is that I am on CPAP and that I went to the bathroom much less often before I was diagnoised with Sleep Apnea. The problem is that mynocturia has gotten worst on CPAP. Yes, it could be anxiety. I was just reading a post on the internet that this woman went to a Urologist for a few years and nothing helped. Then another doctor diagnosed her as having anxiety and gave her medication and the nocturia stopped. I also just read about in Europe they have discovered that treating the nocturia problem has also improved the sleep disorder.

Since I have been compliant with CPAP therapy I hardly ever get up in the middle fo the night to go pee. I had a horrible night last week I think it was, and I don't really know why, but my mask kept popping off and shooting air in my eye, I got wrapped in the hose, all sorts of weird things happened that night. It was horrible! That night I got up to pee 3 times. So, did I have a bad night because I got up to pee 3 times or did I get up to pee 3 times because I had a bad night? Good question. At no point when I went to relieve myself did I feel "refreshed" afterwards. It was more a feeling like "Well, I'm awake and can't lay here may as well pee!" I have since had no issues at all (and by the way my AHI that night was a good couple of points above my norm) and life has returned to normal. This could be a similar situation for you. Having to pee because you are already up rather than getting up because you have to pee. I'm just throwin it out there...