Peeing at night

[Danoo65]

I'm new to CPAP (10 days). I use a nasal pillow mask with a chin strap and tape over my mouth. My pressure is 6-10. 57 years old male. My AHI 17. 

I pee about 5-7 times a night and have for about 5 years. Very frustrating... I've seen multiple urologists over the years and have done many tests and all have been good. I've been tested for diabetes and nothing. I'm quite active and run 20-25 KMs a week. I just got back from my cardiologist and everything with my heart is good. Last year had my prostrate checked and it was a bit enlarged and I'm taking meds by now.

Just wanted to give you some back ground...

The cardiologist was quite surprised that after 10 days on CPAP my peeing issue wasn't better. However she didn't offer any advice on how to make it better.

I'm wondering if anyone has had a similar experience with peeing at night. Did it get better? if so how long did it take? Any advice?

Thanks so much. I had really hoped that CPAP was the answer.

[Big Guy]

When I started CPAP Therapy back in Sept. of 2018, the sleep doc asked me how many "trips" I made @ night. I replied 7-9. He looked at me and shook his head. 

My therapy didn't lessen the # of trips. I quit my therapy after three years of use. It was doing nothing for me. But, my trips have gone down a bit, as they are now 4-6 or so. 

It's been a long while since I've seen a urologist. I've even taken meds (Flo-Max) and no difference. I'm 68 and things do change as you grow older.

[StratCat48]

Prior to getting on CPAP I was getting up at night 5 to 6 times to go pee. Also a slightly enlarged prostate and my urologist wanted me on a med that should reduce the nightly trips (I didn't go on it as I didn't like what I read about the the side effects). After getting on CPAP I'm down to mostly 1 trip and on rare occasions 2. My AHI is generally below 1.0 and the pressure settings on my CPAP (Dream Station 2) are 8-20.
How did it come about that your pressure settings are 6-10, as they seem quite low and your AHI numbers should be much lower than 17 if the CPAP is treating you as it should.

[sauerkraut]

Danoo65;
     I was getting up 1 or 2 times a night before using My apap ..  After I regularly sleep through the night without problems ..
     If You download OSCAR and post 1 or 2 nights charts some of the more experinced people on the site .. 
Will help You get the best out of Your therapy ..  That may help with the bathroom trips ..
     Best of Luck ..     Steve

[Danoo65]

Prior to getting on CPAP I was getting up at night 5 to 6 times to go pee. Also a slightly enlarged prostate and my urologist wanted me on a med that should reduce the nightly trips (I didn't go on it as I didn't like what I read about the the side effects). After getting on CPAP I'm down to mostly 1 trip and on rare occasions 2. My AHI is generally below 1.0 and the pressure settings on my CPAP (Dream Station 2) are 8-20.
How did it come about that your pressure settings are 6-10, as they seem quite low and your AHI numbers should be much lower than 17 if the CPAP is treating you as it should.

Thanks so much StratCat48. 

I'm sorry for the confusion... 17 was my number during my sleep test. The past 10 nights have been the AHI has been under 1. The 6-10 was determined my the sleep specialist I met with while getting the machine.

My bad

---

Danoo65;
     I was getting up 1 or 2 times a night before using My apap ..  After I regularly sleep through the night without problems ..
     If You download OSCAR and post 1 or 2 nights charts some of the more experinced people on the site .. 
Will help You get the best out of Your therapy ..  That may help with the bathroom trips ..
     Best of Luck ..     Steve

Thanks Steve. I have downloaded Oscar. I will post tonight's data in the morning

---

Danoo65;
     I was getting up 1 or 2 times a night before using My apap ..  After I regularly sleep through the night without problems ..
     If You download OSCAR and post 1 or 2 nights charts some of the more experinced people on the site .. 
Will help You get the best out of Your therapy ..  That may help with the bathroom trips ..
     Best of Luck ..     Steve

Thanks Steve. I have downloaded Oscar. I will post tonight's data in the morning

[SaldusMiegas]

Hi Danoo65,

When I first got diagnosed I was getting up several times per night to pee.  I think it came on gradually over the years, and I figured it was just part of getting older.  

It was several months into therapy when someone new on the forum asked people what changes they had experienced from CPAP therapy.  I think it was someone else's post about it that caused me to realize that hey, me too.  And one of the moderators said yup nocturia is actually a side effect of sleep apnea. I learned something about getting up to pee at night.  I thought having to pee was waking me up.  Turns out that having to pee when we wake up is normal, and it doesn't much matter what woke us up.   Waking up several times each night from sleep apneas means we're going to be getting up to go pee because we woke up. Completely opposite of how I thought it worked. It was a total bluebird for me.

So there is good reason to expect that the number of trips to the bathroom overnight will go down significantly once you aren't waking up so often during the night.  Give it some time and try not to fret about it.  Hopefully one day it will simply occur to you that, hey I don't get up as much every night as I used to.  

In my case it was several weeks or even a few months.  Definitely not ten days.  Even though I felt much better from the first night on the machine, I was not sleeping comfortably through the night.  Lots of waking up due to my FFM coming loose and air gushing out.  Didn't always have to get out of bed, most of the time I adjusted the mask and fell back to sleep, but I wasn't sleeping in peaceful blocks of hours yet.  So I think maybe there was a correlation to achieving a more restful night with fewer wake-ups and the subtle relief from nocturia.

Keep your chin up.  If you got better sleep, felt pretty good during the day, and still peed a lot at night, it would still be a win. Let the nocturia go away on its own if it will. Thinking about it as you go to sleep each night probably won't be helpful.  But do expect that it will get better. Even if you have several causes, at least this one should go away and improve things a little bit. 

Saldus Miegas

[Danoo65]

Hi Danoo65,

When I first got diagnosed I was getting up several times per night to pee.  I think it came on gradually over the years, and I figured it was just part of getting older.  

It was several months into therapy when someone new on the forum asked people what changes they had experienced from CPAP therapy.  I think it was someone else's post about it that caused me to realize that hey, me too.  And one of the moderators said yup nocturia is actually a side effect of sleep apnea. I learned something about getting up to pee at night.  I thought having to pee was waking me up.  Turns out that having to pee when we wake up is normal, and it doesn't much matter what woke us up.   Waking up several times each night from sleep apneas means we're going to be getting up to go pee because we woke up. Completely opposite of how I thought it worked. It was a total bluebird for me.

So there is good reason to expect that the number of trips to the bathroom overnight will go down significantly once you aren't waking up so often during the night.  Give it some time and try not to fret about it.  Hopefully one day it will simply occur to you that, hey I don't get up as much every night as I used to.  

In my case it was several weeks or even a few months.  Definitely not ten days.  Even though I felt much better from the first night on the machine, I was not sleeping comfortably through the night.  Lots of waking up due to my FFM coming loose and air gushing out.  Didn't always have to get out of bed, most of the time I adjusted the mask and fell back to sleep, but I wasn't sleeping in peaceful blocks of hours yet.  So I think maybe there was a correlation to achieving a more restful night with fewer wake-ups and the subtle relief from nocturia.

Keep your chin up.  If you got better sleep, felt pretty good during the day, and still peed a lot at night, it would still be a win. Let the nocturia go away on its own if it will. Thinking about it as you go to sleep each night probably won't be helpful.  But do expect that it will get better. Even if you have several causes, at least this one should go away and improve things a little bit. 

Saldus Miegas

Thanks so much Saldus, 

What a great post. I really appreciate your encouragement. Exactly what I needed.

[mesenteria]

Danoo65, as we age our production of several hormones diminishes.  One of them is ADH, or 'anti-diuretic hormone'.  This hormone induces our kidneys to concentrate our urine and thereby to produce less of it.  It is especially active at night...at least that's the plan, and it works well when we are younger.  

One other thing: you mention your cardiologist.  May I inquire as to what the nature of your relationship is with him/her?  Do you have a cardiac problem that could be related to sleep apnea?  I do.  When I was diagnosed with severe apnea, it wasn't until the very last diagnostic, an overnight polysomnography, that the nature of my atrial fibrillation became clear. The AF seemed to have come first, but it turned out that it was the first symptom of my apnea.  The apnea actually came about four years earlier.

My message, and purpose about inquiring about your cardiac condition, is that atrial fibrillation, if it exists in you, controlled well or only partly, causes the body to flood you with adrenaline and to stop unnecessary hormones for the short term.  People experiencing AF report that they often have to pee two or three times in the first hour after onset.  Your frequency may be, could be, a sign that you have nocturnal AF, or what some term 'vagal AF', meaning that the tone of the Vagus nerve during sleep lets the AF come on.  It's surprising how many AF sufferers are fine during the day, but it their AF has symptoms they can detect, like chest thumping and bumping, or shortness of breath, they often awaken during the night, or awaken at the end of sleep, to find their hearts in arrhythmia.

None of this may apply and/or be true in your case, but I thought it would perhaps help to steer you into more inquiry or discovery about your night-time visits to the john.

[Danoo65]

Danoo65, as we age our production of several hormones diminishes.  One of them is ADH, or 'anti-diuretic hormone'.  This hormone induces our kidneys to concentrate our urine and thereby to produce less of it.  It is especially active at night...at least that's the plan, and it works well when we are younger.  

One other thing: you mention your cardiologist.  May I inquire as to what the nature of your relationship is with him/her?  Do you have a cardiac problem that could be related to sleep apnea?  I do.  When I was diagnosed with severe apnea, it wasn't until the very last diagnostic, an overnight polysomnography, that the nature of my atrial fibrillation became clear. The AF seemed to have come first, but it turned out that it was the first symptom of my apnea.  The apnea actually came about four years earlier.

My message, and purpose about inquiring about your cardiac condition, is that atrial fibrillation, if it exists in you, controlled well or only partly, causes the body to flood you with adrenaline and to stop unnecessary hormones for the short term.  People experiencing AF report that they often have to pee two or three times in the first hour after onset.  Your frequency may be, could be, a sign that you have nocturnal AF, or what some term 'vagal AF', meaning that the tone of the Vagus nerve during sleep lets the AF come on.  It's surprising how many AF sufferers are fine during the day, but it their AF has symptoms they can detect, like chest thumping and bumping, or shortness of breath, they often awaken during the night, or awaken at the end of sleep, to find their hearts in arrhythmia.

None of this may apply and/or be true in your case, but I thought it would perhaps help to steer you into more inquiry or discovery about your night-time visits to the john.

Thanks so much for taking the time to respond.

My father did quite young and my brother had a triple bypass in his 40's so it was recommended that I see a cardiologist. I don't have any heart problems but the cardiologist has been quite vocal about me getting on a CPAP machine. 

I will discuss atrial fibrillation with her when I have my next appointment. 

I really appreciate you feedback