Any suggestions for continued nocturia?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
leebee
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Any suggestions for continued nocturia?

Post by leebee » Sat Jan 20, 2018 7:46 pm

Hi all,

I've been following here for a couple of months and have learned much - thanks for such an active community. I was diagnosed with severe sleep apnea at the end of October 2017. I did a sleep study to monitor my snoring issues and it came back that I was having about 87 OA events per hour....a pretty scary thing to learn when I had no idea! But, it was great to finally have a solid reason why I felt so crappy all the time, for why I just could NOT shift excess weight despite eating well and exercising, and for why I would get up 4-5 times a night to go to the toilet. Even having these symptoms investigated previously, not a single doctor ever asked me if I snore and then put two and two together...go figure....

Anyway, I started cpap immediately and I'm very pleased to say that I have 100% compliance and have actually started to feel very positive about using my machine (Airsense 10 Autoset for Her) - I have used it on average 7-9 hours every night since I got it at the start of November. I'm even now successfully losing weight and it's coming off relatively easily. A miracle! Although the worst symptoms of my apnea are gone (daily headaches, body aches, exhaustion etc), I certainly don't yet feel full of energy. I know it could be several months for my body to adjust, so I'm ok with that - I'm confident that continued compliance will reap the benefits in time.

My biggest challenge however is that three months on, I am still waking anywhere from 3-5 times a night to go to the toilet. I don't drink anything after 7pm, I go to the toilet before I go to bed and generally I'm pretty tired from the day's work by that time. I meditate and relax my body, but usually within 1-1.5 hours I wake for the first time needing to go. Then again another 1-2 hours later, then again around 2 or 3am, then again around 5.30-6am. I can almost bet on the times, which is interesting because they are the same times as I would wake prior to using cpap. The only thing that makes a difference to this is if I take codeine or something similar that makes me sleepy. Even then, I would still wake at least 2-3 times to go. Natural sleep products do nothing to change this pattern.

I have a few thoughts as follows:

1. Is this potentially a hangover from pre-cpap and my body just being really used to waking at these times, so the learned behaviour is continuing? If so, how might I break this cycle?
2. I note that it seems to be increased when dieting - if I go to bed a little hungry, I seem to wake more often. I know that reducing calories releases fluid from cells, but I thought that was only in the first few days of calorie restriction, not ongoing? I could be wrong.
3. Most importantly, is there something in my data that shows a reason for waking? Is the pressure ramp waking me up? I've taken a screen shot but can't seem to see where I can upload it for viewing...any help on that? LOL

Overall my stats are almost perfect - average of about 1.5 events per hour and no mask leakage. I would be so grateful if anyone has any suggestions or feedback for this situation with nocturia, as it's kind of the last mountain to conquer for me!

Many thanks,

Leah

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Last edited by leebee on Sat Jan 20, 2018 7:56 pm, edited 1 time in total.

USMCVet
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Re: Continued nocturia despite 100% cpap compliance

Post by USMCVet » Sat Jan 20, 2018 7:49 pm

How much are you drinking through out the day in general? What do you normally drink? Are you on any types of diuretics?

Congrats on great compliance and on the road to feeling better!

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leebee
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Re: Any suggestions for continued nocturia?

Post by leebee » Sat Jan 20, 2018 7:59 pm

Hi, thanks for your quick response!

I drink quite a lot of water in the morning when I exercise and then early afternoon as well. I do drink green tea in the morning but am careful not to have that after about 3pm. I don't drink any sugary drinks as a rule but occasionally I'll have a can of diet coke with lunch. That's about it!

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Julie
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Re: Any suggestions for continued nocturia?

Post by Julie » Sat Jan 20, 2018 7:59 pm

And you didn't mention your age but are you nearing 'prostate' time that would make all-nighters a problem?

Had your glucose tolerance checked recently?

leebee
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Re: Any suggestions for continued nocturia?

Post by leebee » Sat Jan 20, 2018 8:02 pm

I'm a 47 year old female, so not sure the prostate thing applies
I do have quite high visceral fat and suspect there is a little bit of a glucose issue, although I did have several tests in the past that all came back as normal range. That could of course be different now so it could be worth a follow up.

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leebee
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Re: Any suggestions for continued nocturia?

Post by leebee » Sat Jan 20, 2018 8:13 pm

Here's a screen shot of last night's sleepyhead data - I woke 5 times.

https://www.queenofsnowglobes.com/wp-co ... .02-pm.png

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Julie
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Re: Any suggestions for continued nocturia?

Post by Julie » Sat Jan 20, 2018 8:18 pm

Hi, sorry about the mix-up (should have paid attn to your name). I would definitely raise the low pressure by at least 2 or 3 cms and I think you'll do a lot better - 4 is the machine's default low and I'm surprised you can breathe at it!

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Goofproof
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Re: Continued nocturia despite 100% cpap compliance

Post by Goofproof » Sat Jan 20, 2018 8:19 pm

leebee wrote:Hi all,

My biggest challenge however is that three months on, I am still waking anywhere from 3-5 times a night to go to the toilet.

I have a few thoughts as follows:

1. Is this potentially a hangover from pre-cpap and my body just being really used to waking at these times, so the learned behaviour is continuing? If so, how might I break this cycle?
2. I note that it seems to be increased when dieting - if I go to bed a little hungry, I seem to wake more often. I know that reducing calories releases fluid from cells, but I thought that was only in the first few days of calorie restriction, not ongoing? I could be wrong.
3. Most importantly, is there something in my data that shows a reason for waking? Is the pressure ramp waking me up? I've taken a screen shot but can't seem to see where I can upload it for viewing...any help on that? LOL

Overall my stats are almost perfect - average of about 1.5 events per hour and no mask leakage. I would be so grateful if anyone has any suggestions or feedback for this situation with nocturia, as it's kind of the last mountain to conquer for me!

Many thanks,

Leah


You need to fill our your profile and your equipment in TEXT not Iconny, and your machine settings.

Also you need to get the Sleepyhead software, it's much more useful that the others. As far as, nocturne, it usually corrects after you get your treatment correct. That's what Sleephead is for. You can post the info from it (AHI-- Pressure--Leak Info--ECT) people can help you make adjustments. Until things you really not ready to go. There is Compliant and then there's Working Compliant. Jim

You are correct high glucose levels can cause nocturne. Might have the Dr do a A1C Fasting test!
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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RiverDave
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Re: Any suggestions for continued nocturia?

Post by RiverDave » Sat Jan 20, 2018 8:36 pm

Follow up on the blood glucose!

leebee
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Re: Any suggestions for continued nocturia?

Post by leebee » Sat Jan 20, 2018 8:43 pm

Thanks all for those suggestions. I will definitely go back to the doc for that blood glucose test.

Re other points (sorry, I'm not a regular forum user so I don't know how to reference other people's comments.... ):

Julie - thanks for the tip re pressure - I was thinking the opposite, that perhaps the higher pressure was waking me as it ramped up. It doesn't feel like it's too much, but I will take your advice and increase the minimum. It wasn't at default as I had it set up by a specialist, but it was set at minimum 5 and maximum 12.

Goofproof - thank you for your tip about filling out my equipment and other stuff, I've just done that I do use sleepyhead, there's a link to a screen shot from it just above, here it is again. This is last night's reading - https://www.queenofsnowglobes.com/wp-co ... .02-pm.png

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Goofproof
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Re: Any suggestions for continued nocturia?

Post by Goofproof » Sat Jan 20, 2018 8:52 pm

leebee wrote:Thanks all for those suggestions. I will definitely go back to the doc for that blood glucose test.

Re other points (sorry, I'm not a regular forum user so I don't know how to reference other people's comments.... ):

Julie - thanks for the tip re pressure - I was thinking the opposite, that perhaps the higher pressure was waking me as it ramped up. It doesn't feel like it's too much, but I will take your advice and increase the minimum. It wasn't at default as I had it set up by a specialist, but it was set at minimum 5 and maximum 12.

Goofproof - thank you for your tip about filling out my equipment and other stuff, I've just done that I do use sleepyhead, there's a link to a screen shot from it just above, here it is again. This is last night's reading - https://www.queenofsnowglobes.com/wp-co ... .02-pm.png
Maybe kidney test if due too.
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

leebee
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Re: Any suggestions for continued nocturia?

Post by leebee » Sat Jan 20, 2018 8:58 pm

Julie wrote:Hi, sorry about the mix-up (should have paid attn to your name). I would definitely raise the low pressure by at least 2 or 3 cms and I think you'll do a lot better - 4 is the machine's default low and I'm surprised you can breathe at it!
As you can see, I figured out the "quote" thing haha. I've adjusted my machine to 6/12 with a starting pressure of 5.4 (realised that was set at 4 previously), so it will be really interesting to see if that makes a difference. Thanks Julie

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ajack
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Re: Any suggestions for continued nocturia?

Post by ajack » Sat Jan 20, 2018 11:02 pm

I agree 6 will help with the OA. leave the EPR on 2, turn it to 1 if the CA bother you. I wouldn't worry.
Review in a few days. you might need 7, but probably not. If that was an average median pressure, for you.

There is a list of things that will choke a horse, that can cause the issue you have. It's a matter of a good doctor going through the tests and ruling things out. Then see what you have left. Hopefully it's just getting older and nothing stands out.

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Julie
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Re: Any suggestions for continued nocturia?

Post by Julie » Sun Jan 21, 2018 3:53 am

Many leave the high pressure setting at 20, or not far from it - it's the low setting that 'counts' in terms of addressing apneas, and if it's too low it can take too long to reach the levels events occur at - e.g. anything over 10 or 15 in time to stop them.

leebee
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Re: Any suggestions for continued nocturia?

Post by leebee » Sun Jan 21, 2018 4:23 am

Julie wrote:Many leave the high pressure setting at 20, or not far from it - it's the low setting that 'counts' in terms of addressing apneas, and if it's too low it can take too long to reach the levels events occur at - e.g. anything over 10 or 15 in time to stop them.
I was assuming that because my AHI is generally low (anywhere from 0.5 to 1.5) that the machine was stopping my apneas effectively. But this makes a lot of sense - thanks for the explanation Julie

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Mask: Eson™ 2 Nasal CPAP Mask with Headgear
Additional Comments: Settings: pressure 6.6/15, humidity 2, temp 27c