CPAPtalk.com

Newbie here and first post that I thought I would respond to.........
I'm a 72 year old male and in Nov 2019 I went to a urologist to see about an issue of getting up about 5-6 times in the night to relieve myself. My own primary care doc had already diagnosed me with a slightly enlarged prostate which the urologist confirmed and as well did some other tests. The urologist prescribed Finasteride which I started on for a while, but subsequently I had some less than desirable side effects and upon reading how it worked and issues other users had developed, I stopped using it. In late Dec 2019 I started taking Saw Palmetto and Pygeum as an 'herbal' alternative and it helped a small bit in reducing nightly trips. Also in Dec I had bought a night time wearable pulse oximeter ring as I had suspicions of apnea related sleep problems. The oximeter revealed many episodes of low O2 levels through the course of the night. I brought several of the printed records of the oximeter reports to my primary care doc doc and he setup a sleep study which I undertook the first in Jan 2020 with a resulting diagnoses of 'severe obstructive sleep apnea' (REM AHI 57. and a follow up with titration in Feb 2020. In mid March 2020 a respiratory therapist delivered a Dreamstation CPAP to my home and fitted me up with a full mask (mouth breather). I mentioned to her about the 5-6 trips to the bathroom at night and asked the best way to disconnect from the hose. She replied that I probably would be making less nightly trips as the apneas would wake me and the disruption in sleep prompted the urge to urinate. She was correct and since starting the on the CPAP I've been down to mostly just one trip to the bathroom and occasionally two. While the Dreamstation is fitted with a humidifier (I've tweaked the settings a bit), sometimes my mouth gets extremely dry (despite Biotene rinse before heading to bed) and some night time trips are to get a drink of water at which time I relieve myself while I'm there.
My blood pressure and resting heart rate has also decreased significantly since beginning on the CPAP which is a good thing.

So we made pressure adjustments and it seems dad’s machine is bouncing off the rev limiter at 20. His AHI is down from the 40’s to 7-10 range and nighttime urination is half or less what it was before....what do people do that need more than 20” H2o?

A regular bilevel (not talking the specialized kind) will go to 25 cm.

How much do you think his higher pressure needs might be tied to sleeping on his back?

You might consider adding one of those cervical collars in an effort to keep the airway more open and not constricted if you think he might be doing a lot of chin drop down to his chest when he sleeps. Cervical collars have been known to reduce pressure needs for a lot of people.

Excellent idea....he is 80 and almost exclusively sleeps on his back. His S10 maxes out at 20 cm h20

I know someone who has this issue, has had it his entire life (up 2-6 times a night to pee). Being on CPAP didn't make any difference. The typical bladder tests were done, nothing of concern showed up. No prostrate issues. No followup was suggested.