OSA Frequent Urination Stopped then Returned

[fritopie]

I have been ofn CPAP for about 2 months. At the beginning of my treatment I was so excited I didn't have to get up to pee several times a night. In fact, almost never did I have to get up any more. My average before treatment was about 3 times per night. About 1-2 weeks ago, I began to get up during the night again. One night was FIVE, yes FIVE times. I use the Swift FX for Her pillow mask, and just checked my S9 machine and it had the mask set to NASAL, and not PILLOWS. This hasn't been the case during all of the treatment, but probably has for the last week or two. I was changing back and forth for a while to decide which type mask I preferred.
The question being, would the setting on the S9 for the wrong mask type make a difference in urination? Surely not? Ideas?

[LoQ]

About 1-2 weeks ago, I began to get up during the night again.

This hasn't been the case during all of the treatment, but probably has for the last week or two. I was changing back and forth for a while to decide which type mask I preferred.

See any correlation there?



In any event, I believe the S9 parameter for mask is a feature you set so that the leak data will reflect the proper upper limit for amount of "allowed" leaking. I don't think it affects your therapy, though I could be wrong about that.

[DoriC]

My husband experiences that occasionally when his BP is a little elevated. He does have an enlarged prostate so he gets up 1x and if BP is elevated, 2x. In general his symptoms have improved greatly since cpap.

[BlackSpinner]

You need to check your data for your AHI during the last 2 weeks and your leak rate. Maybe you are mouth breathing and it is no longer catching all your apneas.

[fritopie]

I don't have any problems with blood pressure, and only once in a great while do I wake up mouth breathing. I just wondered if the mask setting was the issue since the pressure is different for each type of mask. I don't know when the mask setting was put on nasal for sure. It just seems really too coincidental that it's been roughly the same amount of time I "think" it might have been on nasal, and the length of time I have had to get up so many times again. I'm still trying to wrap my head around why CPAP makes you quit needing to go

[BlackSpinner]

I'm still trying to wrap my head around why CPAP makes you quit needing to go

Fear attack adrenaline rush pushes the water through to flush the hormones. Remember the "He peed his pants in fear/shock"?

What is your current AHI? That will tell you if your therapy is working.

[Pugsy]

I just wondered if the mask setting was the issue since the pressure is different for each type of mask. I don't know when the mask setting was put on nasal for sure. It just seems really too coincidental that it's been roughly the same amount of time I "think" it might have been on nasal, and the length of time I have had to get up so many times again. I'm still trying to wrap my head around why CPAP makes you quit needing to go

The mask setting might have a minor impact on the leak rate that is reported because ResMed subtracts a predetermined amount of intentional leak/vent before reporting the leak. The vent rate between the nasal mask and the nasal pillows mask is not huge. The nasal pillow mask has a slightly less vent rate.

Why did cpap cause a cessation of the need to urinate often? Because it was preventing the events that caused the production of the hormone which tells the kidneys to work harder. When the kidneys work more, urine is byproduct. Cessation of nocturia was my first real sign that my therapy was working.

Have you looked closely at your data to see if anything pops out that needs improvement since this increase in nocturia? It may be therapy related (also might not) but I can't see mask choice on the machine causing it. Now mask change from one to another might if the therapy is not as optimal.

My link to the ASAA this is broken but I copied it from an old post of mine. Explains why we have nocturia with OSA.

"Nocturia, or nocturnal urination, is sometimes a symptom of sleep apnea. In fact, nocturia among younger individuals--who are less likely to have other medical causes of nocturia--is a strong indicator of sleep apnea. While the precise relationship has not been thoroughly studied, it appears that the most likely reason patients with untreated sleep apnea have more frequent urination at night is related to the increased pressure in the right side of the heart. This increased pressure is usually the result of low oxygen levels in the bloodstream caused by the apnea events: when oxygen levels fall, the heart works harder to get oxygen to the brain.

An increased pressure in the heart is a sign that there is too much liquid in the body: when the heart receives the stimulus of the increased pressure, higher levels of a hormone called atrial natriuretic peptide (ANP) are secreted. ANP is a diuretic that is associated with the increased need to urinate.

When sleep apnea is effectively treated, nighttime urination is also reduced. Studies have shown that ANP levels in patients with untreated sleep apnea are increased and levels reduced in patients using CPAP effectively. Remember, not all causes of frequent urination are related to untreated sleep apnea; prostrate problems, for example, may cause increased need for urination. Discuss any concerns you may have with your doctor. "

[Goofproof]

Odd's are you are mouth breathing and getting poor treatment, correct that and the trips should be fewer. Jim

[SleeplessInBrussels]

Wow Pugsy that is the FIRST time I ever heard this explanation of Nocturia in relation to OSA. I have been getting up to pee at nights (also up to 5 times as fritopie says - but usually 3-4 times) since 2009 (it started when my dad was dying in hospital). My GP was convinced it was 'frequent urination' due to stress (I'm sure there's a more medical name in English) and sent me to 2 urologists who between them tested my prostate, blood etc and put me on THREE different treatments since 2009. Last one was Vesicare. None of them worked and one had bizarre side effects. None of these doctors once mentioned OSA. It's only when my partner came home from work one day and mentioend a colleague who had same problem and ended up going to sleep lab, getting CPAP etc that I mentioned it to my GP who then referred me to the sleep clnic. I stayed 2 nights in the sleep lab. the second night they gave me the CPAP and I slept through without going to the bathroom once.

Now I've had the CPAP at home for 2 nights. First night I was extra anxious and woke up many times or rather just didn't sleep a lot. Last night was better in that I got up only twice - and of course had to go pee.

The doctor at the sleep clinic did say the peeing was related to the OSA but not in any detail the way you explain above - so thank you for that. I will bring it up with her at my next appointment in November - the health ministry obliges the clinic to monitor from time to time because the treatment is paid for by our national health system. Anyway, I'm sooooooo looking forward to sleeping through the night without seeing that #%@*& toilet every night!! Right now I'm not accepting anything in my head other than the nocturia IS related to my apnea and the CPAP WILL work!

Cheers.

[Pugsy]

My GP was convinced it was 'frequent urination' due to stress (I'm sure there's a more medical name in English) and sent me to 2 urologists who between them tested my prostate, blood etc and put me on THREE different treatments since 2009. Last one was Vesicare. None of them worked and one had bizarre side effects. None of these doctors once mentioned OSA.

I think that some doctors just don't think outside the box or just simply don't know. My own GP and I were talking about my OSA therapy a while back and I mentioned that the biggest change for me at first was the cessation of the nocturia. He looked at me kinda funny and said "it shouldn't make any difference"... then I went on to explain to him what happens and he actually thanked me for bringing it to his attention. He had no idea. I think we often expect that just because a doctor has those fancy initials after his name that they "know all". They don't and the good doctors will admit it. My doctor said he will add the nocturia question to his OSA screening questions when he is talking to people about fatigue, sleep problems and such.

Men who complain of nocturia often get told the blame rests with the prostate (and it sure can be a factor) but it isn't the only factor. Women get told we have issues with our nerves, stress and small bladders. I always wondered why I could go hours and hours during the day without needing to empty my bladder and at night would wake up with bladder near bursting about every hour or so and even after withholding fluids for hours prior to bedtime.

For me the cessation of sleep disruption from the frequent trips to the bathroom was in itself a huge blessing even if I never had the miracle overnight feeling that I was 25 again (which I only have had the "miracle" once in over 2 years of therapy).

[fritopie]

I appreciate all the great info you are all giving me! What is bizarre is that last night, I didn't get up to go. I had changed back to the "pillow" setting. May be coincidence. Nothing else I did was different. Same meds, same liquid intake, etc. My AHI is always < 2 . I am currently trying to get the software and instructions of interpretations (free), to see if I can see what going on. I know there is a link from Uncle Bob on her, but want to make sure I don't get some smackdown because I'm not a clinician or physcian.... But I have brains just like they do

[xenablue]

The exact same thing happened with me - for the past 9 months I haven't gotten up for a bathroom visit, but before for decades it was at least once per night.

The last few weeks I've woken up a few times - maybe 2 or 3 nights per week. I started logging what I was doing for the few hours before bed and found I was drinking a lot more fluids after dinner. I put this down to spending more time outside, in the heat, watering my garden in the early evenings.

The nights I watered and drank were the nights I woke up to go to the bathroom almost exclusively.

As a diabetic and now a hosehead, I've found logging in detail tells me a lot about what causes odd changes in my body - tedious but very telling.

Cheers,
xena

[Roger2]

The question being, would the setting on the S9 for the wrong mask type make a difference in urination? Surely not? Ideas?

Have you been checked by a urologist for an enlarged prostate? Actually your GP should be able to tell that with a routine digital rectal exam.

I had an enlarged prostrate about a year ago and went to an urologist. He found besides an enlarged prostrate, I also had an infection so he put me on antibiotics for two weeks and prescribed Flomax. The infection went away and my prostrate size returned to normal after two months of using Flomax. He said that an infection is frequently the cause of the enlargement to begin with; I have not had a reoccurrence since that one time.

[JohnBFisher]

Wow Pugsy that is the FIRST time I ever heard this explanation of Nocturia in relation to OSA. ...

Google is your friend. Search for "nocturia sleep apnea" and you find:

http://www.sleepfoundation.org/article/ ... -and-sleep
http://www.talkaboutsleep.com/sleep-dis ... nation.htm

Among MANY other links.

Shoot, just looking up "nocturia cuases" yields:

http://www.nlm.nih.gov/medlineplus/ency ... 003141.htm
http://my.clevelandclinic.org/disorders ... turia.aspx

To just name a couple very credible sites.

Always remember that most doctors do NOT keep up with all the literature. In all fairness, how can they? The number of advances and new information is HUGE. So, you need to become your own advocate and researcher. Always be polite when you present this type of information. I was wondering if ... and point to a CREDIBLE website as the source that made you bring the question.

Hope that helps.

[JohnBFisher]

... As a diabetic and now a hosehead, I've found logging in detail tells me a lot about what causes odd changes in my body - tedious but very telling. ...

Some how, I missed this episode of Mr. Rogers:

Boys and girls, can you say "Logbook"? I thought you could!

Xena, that's a great suggestion! Your are definitely right. It can help sort out a lot of mysteries. As the old saying goes:

The palest ink is better than the best memory.