My CPAP therapy is interrupted by the frequent need to urinate--often 3 to 5 times per night. A world-famous urologist said that the problem is not urological (i.e. not the prostate or bladder), and a sleep doctor said that it is not apnea-related. I quit drinking coffee for a two-week span and stopped taking diuretics for another two-week span, but neither strategy worked. I am looking for ideas about how to deal with this nocturea problem.

wbjohnson wrote:

My CPAP therapy is interrupted by the frequent need to urinate--often 3 to 5 times per night. A world-famous urologist said that the problem is not urological (i.e. not the prostate or bladder), and a sleep doctor said that it is not apnea-related. I quit drinking coffee for a two-week span and stopped taking diuretics for another two-week span, but neither strategy worked. I am looking for ideas about how to deal with this nocturea problem.

How long are you on CPAP ?
Have you had the Nocturia problem since starting CPAP ? or has it developed gradually ?

Daniel.


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The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

It is hard to pinpoint exactly when the nocturea developed.  I have been using the CPAP successfully for the past 6 months, and had used it unsuccessfully on and off for about 3 years before that. There were so many problems during the unsuccessful years that peeing at night just didn't come into focus. I think I have been waking up to urinate from the beginning of the successful therapy. The problem might have been present for quite awhile and just didn't become an issue until I discovered that it was interfering with an otherwise successful sleep therapy. There hasn't been any gradual change in the frequency.

Hmmm, when I started using CPAP, one of the first things I noticed was that I no longer was waking up in the middle of the night to urinate.  And I heard somewhere (not sure where, but think it was from a respiratory therapist) that sleep apnea CAN actually cause nocturia.  I know you said your sleep Dr. says yours is NOT from apnea, but just thought I'd share my experience with you.


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ResMed S8 Escape System with ResMed HumidAire 3i with EPR
ResMed Ultra Mirage full face mask
Pressure: 15

I have nocturia X 5 due to a radical prostatectomy.

I've found that the times I urinate each night are fixed - so I mask up after the 3rd time at about 1 AM - this way I can sleep walk to the bathroom and back to bed, having to wake up and play with fitting the mask only once or twice.

I also side sleep - I bought a ? shaped pillow on the net and it helps keep me on my side.

Good luck!

Thank you for the comment and suggestion. It is something to think about.

wbjohnson,

When was the last time you were titrated, in lab?   Though your Sleep Dr says this is not SA related... he/she may be saying this due to you being treated for the SA.  If you have not had an in lab titration withint the past year..you may be still experiencing mild apnea  and need a pressure change.  Another thought for you...how is your blood sugar?  Have you been checked for Diabetes?

All just thoughts for you.


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I am A ZOMBIE! 20 years+ undx'd. BiPAP Auto M 14/9. Nasal Swift&F&P Flex Fit 431 Full Face. RLS/PLMD, Primary CNS Hypersomnia, Sleep Paralysis, Parasomnia, Degenerative Disc Disease, Clinical MS, Fibromyalgia, COPD plus other past dx's..what's next?

There is no question in my mind that sleep apnea events cause nocturia. I know that there is a line of thought that says that you don't actually have to go more, it's just that you are waking up from apneas and so you think you have to go. That sure wasn't the case for me. Prior to starting CPAP I had gotten into a pattern of getting up 2-3 times a night and having to go VERY badly, and the urine was very concentrated and foul-smelling. At times I had to go so bad that I had to be careful how I got out of bed because I couldn't put any pressure on my bladder without losing control.

Until very recently I had no idea that this was caused by sleep apnea. I knew something has changed, because for most of my life I never got up to go at night. I just thought it was part of getting older.

I also noticed that during the times when I fell asleep during the day (I had very severe fatigue from very severe apnea), I would wake up even after an hour or two in the same circumstance.

The first night on CPAP, I didn't get up. Three weeks later, I still don't get up at all during the night, and I don't have to go that bad in the morning when I wake up.

So, I would second the suggestion to make sure your therapy is really working, especially since a urologist has cleared you.

I have been thinking along the lines you suggested, and I did ask my sleep doctor about taking a current sleep test as a means of evaluating the urination issue, but he said not right now.

I also have though about the sugar issue. As it turns out, my A1c = 5.9 (high-normal). I still suspect there might be a sugar problem, because an A1c of 5.9 corresponds to a mean blood sugar of ~ 130, but, in fact, fasting blood sugar in the morning is only between 88-93 (normal) and I never get to 130 during waking hours, even after meals. The numbers suggest that there might be a glucose buildup during the night. Unfortunately, there doesn't seem to be any medical research on this, and I am going to have a hell of a time trying to convince a doctor that there might be a sugar issue that needs to be investigated.