Nocturia as a marker for OSA

I can't recall seeing this topic covered recently but came across it today - it is by Dr Barry Krakow & makes for an interesting read.
Nocturia is excessive urination in the night. The study looks at using Nocturia as a marker for OSA vs the current use of snoring.

Dr Krakow is an eminent Sleep Clinic practitioner. (about Dr Krakow: http://sleeptreatment.com/about/doctor- ... rspectives )

Definition for Nocturia ...
http://www.ehow.com/about_5085083_nocturia.html

The article summary ...
"Conclusions: Nocturia appears comparable to snoring as a screening tool for OSA in patients presenting to a sleep medical center. Research in urology and primary care clinics is needed to definitively clarify the use of nocturia as a screening instrument for obstructive sleep apnea."

The full article ...
http://www.springerlink.com/content/87j33u8vl1628733/

DSM

Sure was for me! I peed 8-10 times a night at my worst; stopped on night 1 of CPAP therapy, never to return.

Muse-Inc wrote:Sure was for me! I peed 8-10 times a night at my worst; stopped on night 1 of CPAP therapy, never to return.

Same here - and I went for over 20 years going at least once or twice - a real pain when you are in an unheated cabin in the winter and the out house is far far away through the snow. And once when the bathroom was downstairs I fell and broke my foot.

Sleep apnea can also cause bed wetting.

One of the most important consequences for me of an end to nocturia was the way it proved that something important was happening physiologically. If you say to someone, use CPAP and in six months you'll feel much better, he needs a lot of faith to keep with the program. If you say, use CPAP and (1) tonight you won't get up to go to the bathroom, (2) tomorrow you won't nod off after lunch, and (3) in six months you'll feel much better, the accuracy of predictions (1) and (2) reinforce his confidence that (3) is on its way.

bearded_two wrote:Sleep apnea can also cause bed wetting.

An interesting co-relation - that was a problem I went through as a kid.

This link has some info re this ...
http://www.talkaboutsleep.com/sleep-dis ... etting.htm

DSM

dsm wrote: http://www.springerlink.com/content/87j33u8vl1628733/ DSM

I wish that I were more impressed by this study.

In their introduction the authors describe nocturia as "a symptom with a precise pathophysiological link to sleep apnea". That seems a bit over the top as a starting point.

In addition, the study population is "A consecutive sample of 1,007 adult patients seeking treatment at two sleep centers." While their study therefore documents that persons who present themselves for evaluation of sleep problems are just about as likely to exhibit nocturia as they are to exhibit snoring, no conclusion can be drawn about the prevalence of sleep disorders among the population who experiences nocturia.

Event their conclusion that "Nocturia appears comparable to snoring as a screening tool for OSA in patients presenting to a sleep medical center" seems overstated. A comparable frequency does not necessarily make nocturia a "screening tool".

It has long been a personal question for me whether I awaken because I need to void, or whether I "habitually" get up to void when I awaken for other reasons. In either case there is certainly a "correlation" between voiding and awakening, but in which direction "causation" works is much less clear. Particularly for those of us whose age and gender provide us with problematic prostates. In the past I would typically awaken and void and average of 5 times per night; more recently the average is 2 - 3 times per night. I have been effectively treated for OSA throughout this period. The improvement can be linked to behavioral modification training during waking hours, which has fortunately carried over into the night.

Certainly, for those whose nocturia is directly and solely caused by OSA-induced awakening, xPAP therapy offers this additional benefit. But it would be, I think, a mistake to engage in generalized unbridled enthusiasm in this arena.

Regards, Velbor

Velbor, I think you made some great points that apply to men as to important if not overriding other causes of nightime peeing. For women, however, this might indeed be diagnostic because it's unusual for women to have to pee at night unless they have drunk a lot of liquid late in the day (we learn early not to do that) or they are diabetics with outta control blood sugar.

Velbor wrote:

dsm wrote: http://www.springerlink.com/content/87j33u8vl1628733/ DSM

I wish that I were more impressed by this study.

In their introduction the authors describe nocturia as "a symptom with a precise pathophysiological link to sleep apnea". That seems a bit over the top as a starting point.

In addition, the study population is "A consecutive sample of 1,007 adult patients seeking treatment at two sleep centers." While their study therefore documents that persons who present themselves for evaluation of sleep problems are just about as likely to exhibit nocturia as they are to exhibit snoring, no conclusion can be drawn about the prevalence of sleep disorders among the population who experiences nocturia.

Event their conclusion that "Nocturia appears comparable to snoring as a screening tool for OSA in patients presenting to a sleep medical center" seems overstated. A comparable frequency does not necessarily make nocturia a "screening tool".

It has long been a personal question for me whether I awaken because I need to void, or whether I "habitually" get up to void when I awaken for other reasons. In either case there is certainly a "correlation" between voiding and awakening, but in which direction "causation" works is much less clear. Particularly for those of us whose age and gender provide us with problematic prostates. In the past I would typically awaken and void and average of 5 times per night; more recently the average is 2 - 3 times per night. I have been effectively treated for OSA throughout this period. The improvement can be linked to behavioral modification training during waking hours, which has fortunately carried over into the night.

Certainly, for those whose nocturia is directly and solely caused by OSA-induced awakening, xPAP therapy offers this additional benefit. But it would be, I think, a mistake to engage in generalized unbridled enthusiasm in this arena.

Regards, Velbor

Good points - nicely analysed,

Can you point to a another such study ? - I can go look for another but must admit I was intrigued by the possibilities & thought it worth linking to

DSM

Velbor, you must have read some Darrell Huff in the past. Your questions are right on target.

http://www.amazon.com/How-Lie-Statistic ... 039309426X

I have no business relationship with the above. I'm just a 20+ year fan of the book.