nocturia

[puppo]

Of late I've been waking up after 2-3 hours with a full bladder.This happens sometimes even if I have been on my side or stomach.It can occur with an AHI=0 during this time period.The desats are in the 89-91 range.My APAP setting has been 10-15cm so am considering an incremental increase to see if it will benefit me. Leaks are under control.Any suggestions?

[SleepyToo2]

The only person who can answer this is one or more of your docs. There are a number of reasons for nocturia - sleep apnea is only one. The doc should do some tests to determine whether you have diabetes, and, if you are a guy, whether you have a prostate problem. It is not something that can be diagnosed on a public forum. The only way you can know if your APAP settings need to be increased is by looking at the data or having your doc/DME printing it out for you and the doc writing a prescription. Just having leaks under control is not the only answer to this complex problem.

[kteague]

Not sure of the cause of your nocturia, but even when my OSA is controlled, when I'm retaining fluid in my legs, the fluid flushes out once I'm laying flat and sleeping, and that can give cause for a potty run a few hours after going to bed. When my sugar is high I'm prone to a midnight run also. As has been mentioned, it can be a process of elimination.

[avi123]

Nocturia is a sign of not optimally treated Sleep Disorder. See here about it:

https://www.youtube.com/watch?v=x8DZAHqNj9M

[puppo]

I am an M.D. and I feel confident that hypoxia is the cause of the nocturia as shown by pulseox studies.It seems weird that AHI is often low or normal during these events.My question is how to best increase my pressures to minimize the hypoxias.I'm also concerned about causing centrals.My current setting is11-15cm.

[avi123]

puppo, if you're an MD why don't you write yourself an Rx for an S9 Autoset like I have. It has the latest technology to prevent pressure rise when it is not needed such as during Central Apnea events. By running this Autoset in APAP mode it would find your optimal pressure and then you could set the machine on it which would be most likely less than 15 cm.
This could solve your concerns about raising pressures. See my pressure graph how it is much lower than the 13 cm (on CPAP) that was prescribed for me recently by a sleep study, as optimal.

Have you listened to Dr Barry Krakow (pronounced Kraiko) who is one of the best Seep Doc in the U.S., in my above link?

You can see in the pressure graph below that I stopped the machine twice, and went to pee. This Nocturia is in spite my pretty good treatment. I think. Could be b/c of Oxygen desaturion as you say. I don't wear PluseOx every night.

[puppo]

I just watched the youtube video Nocturia: Sleep is a terrible thing to waste . It shows how fluid returns from the legs at night and causes increased blood flow to the kidneys and more urine output. I have had some venous reflux in my legs and slight swelling of my ankles on occasion.This would explain my low to absent AHI. Hypoxia may not be the cause after all.Treatment involves decreased fluids,leg elevation and support socks.I'll give it a try.
re: s9 purchase I will keep that in mind if the above does not work but I think the S8 has the same algorithm as the S9.The S8 does not show if the apnea is central,however. I have Dr. Krakow's book.

[Elle]

I have to get up to the bathroom at night if my sugars are high. I have AHI of under 1 most of the time.

[kteague]

It can occur with an AHI=0 during this time period.The desats are in the 89-91 range.

Just wondering, if your AHI=0 during the time period, why are you even having desats? Maybe I'm missing something, or is this normal for you?