Frequent Night time urination.....UPDATE!!!

Been a while since I posted here....Pugsy and crew got me squared away years ago, my Ahi’s run in the .3-.5 range....lost 60lbs, all is well. My father has been having issues waking up 6+time a night to urinate...by the end of the night it amounts to about 2 quarts. We took him to the urologist who tried several medications...none worked. I know apnea can cause similar symptoms...he is 80, tall, very thin, and has a long neck.....certainly fits an apnea profile. Does the frequent urination if about a cup 6+ times a night sound like it could be apnea related?

Thanks in advance

keroseneburner wrote: ↑

Thu Feb 20, 2020 2:55 pm

Been a while since I posted here....Pugsy and crew got me squared away years ago, my Ahi’s run in the .3-.5 range....lost 60lbs, all is well. My father has been having issues waking up 6+time a night to urinate...by the end of the night it amounts to about 2 quarts. We took him to the urologist who tried several medications...none worked. I know apnea can cause similar symptoms...he is 80, tall, very thin, and has a long neck.....certainly fits an apnea profile. Does the frequent urination if about a cup 6+ times a night sound like it could be apnea related?

Thanks in advance

Since apnea goes hand and kidney together, yes.

There's better explanations out there, but when you can't breathe, your heart rate goes up, your BP goes up, your heart tells the kidneys to produce more urine to reduce blood volume to lower the BP, and you have to pee a lot at night, instead of the kidneys concentrating urine as they are supposed to during sleep.

As palerider says, apnea is certainly one idea to pursue. There is a good discussion of other possible causes here:

https://medlineplus.gov/ency/article/003141.htm

I'm surprised that the urologist isn't doing more to get to the bottom of this. Trying a couple of meds and calling it a day isn't acceptable.

keroseneburner wrote: ↑

Thu Feb 20, 2020 2:55 pm

My father has been having issues waking up 6+time a night to urinate

That describes Gramps before CPAP. With CPAP, he usually sleeps all night.

Another article in this month’s Journal SLEEP reported that OSA is associated with overactive bladder in men with or without urinary incontinence. The worse the severity of OSA, the worse the level of urinary problems. Not too surprisingly, nocturia (getting up at night to go to the bathroom frequently at night) is a known complication of obstructive sleep apnea.

Most people with these issues end up seeing a urologist initially and are placed on various medications that work to various degrees. However, a recent study suggests why you should see a sleep doctor instead—people who wake up in the middle of the night to go to the bathroom do so not because their bladders were full, but rather because they stopped breathing and then realized that they had a full bladder. OSA has also been shown to increase atrial natriuretic peptide (ANP), which is produced by the heart when it gets too much blood due to the sudden rush of blood after a lack of blood flow during an apnea episode. ANP causes you to make more urine to get rid of the excess fluid.

https://doctorstevenpark.com/do-you-hav ... continence

Miss Emerita wrote: ↑

Thu Feb 20, 2020 3:40 pm

As palerider says, apnea is certainly one idea to pursue. There is a good discussion of other possible causes here:

https://medlineplus.gov/ency/article/003141.htm

I'm surprised that the urologist isn't doing more to get to the bottom of this. Trying a couple of meds and calling it a day isn't acceptable.

this was my thought, as well. particularly as he's an 80 year old male.

Most definitely could be apnea related.
I was getting up to pee about every 2 hours (sometimes one hour) with a painfully full bladder before cpap...now it's extremely rare for me to get up and pee at all. Not to mention I don't have to make my first stop in the morning at the toilet because my bladder hurts.

Worth checking out especially when all the other culprits have been ruled out.

FWIW.... I have a long skinny neck too...probably the only thing skinny on me. But I was a skinny ass little thing when I was first diagnosed 10 years ago.

One of the nicest things about cpap: no moonlight (or no light) piddle runs.

Another theory on why sleep apnea causes frequent night time urination is that you are less likely to be in a deep sleep. As you come up into the lighter stages of sleep you are more likely to perceive the need to urinate. Everyone cycles in and out of lighter stages of sleep, but with sleep apnea we are more often in those lighter stages and for longer times.

Also, has he been checked for diabetes?

When prescribed HCTZ (hydrochlorathiazide), I was instructed to only take it in the morning,
because evening dosing tends to keep one up all night.
Check his meds for any "water pills", and confirm he is taking them when instructed.

He does not diabetes and is on no meddication...other than the various urology meds he tried. None helped at all. Now they are wanting to do a fairly unpleasant bladder testing series....which is why I thought about apnea.

They are going on fishing expeditions in hopes they will catch something. Throwing crap on the wall hoping something will stick.
Might as well add a sleep study to the fishing expedition list...it's really non invasive and not nearly as unpleasant as those bladder tests.

BUT.....do ask him if he did do the sleep test and it came out positive for sleep apnea would he even use the machine?
My mom is 87 and her doctor wanted her to have the sleep study and she told me she refused to even use the machine if it was proven she had apnea. No sense in doing the study when we know ahead of time there is a brick wall there about using a mask and machine.

Alternately...you know there is a way to screen for potential apnea by using your machine. I did that for my sister and her husband.
It's not perfect and has some limitations but it might offer an answer.
It's free and non invasive...

Do you have a spare machine available and I don't remember exactly which machine you are using and can't see your profile as I write this note. I can give you more information on how to go about doing the screening if you want it.

I suffer from this as well and usually wake up 4-5 times a night to pee. I am 35 years old and they couldn't find any reason for it and felt it was simply a developed habit that the body has gotten used to over the last 10 years.

Update, dad got the “take home” sleep study. It shows an ahi of 14.1. Which is considered mild. Could this still cause the night time urination issues?

Yes....most definitely it could cause the nocturia.

But at his age, I'd just as soon go with a prostate issue and want to see the urologist again (or find a new one).