Tuesday, July 9, 2024

Sleep Apnea And Urinary Frequency

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Is Your Sleep Interrupted By The Need To Urinate And A Lot Of Urine Usually Comes Out Even If You Avoid Liquids For Hours Before Bedtime

36 The Relationship Between Overactive Bladder and Obstructive Sleep Apnea in a Canadian Communit

Sleep apnea could be the reason.

Studies linking untreated sleep apnea to having to get up in the middle of the night more than once to urinate have been around for several years.

But it isnt just a link. There is an explanation.

There are many reasons why the urge to urinate wakes someone up more than once overnight, forcing them out of bed.

Sometimes the urine output is low, which may indicate nighttime overactive bladder, a prolapsed bladder or an enlarged prostate.

But what if you keep peeing and peeing large amounts, even though you abstain from fluids for several hours before going to bed?

This is susepct for untreated obstructive sleep apnea.

Is Nocturnia A Sleep Disorder

According to a study conducted by the Sleep & Human Health Institute in Albuquerque, New Mexico, 85% of the sleep apnea sufferers surveyed also experienced nocturnia.

What normally happens when you fall asleep is that the body releases an anti-diuretic hormone that prevents the kidneys from filling up with fluid. This allows you to sleep through the night without feeling the need to urinate. However, recent studies have shown that sleep apnea affects the way this hormone is released, thereby causing the kidneys to fill up with fluid and require emptying throughout the night.

Also, patients might mistakenly blame the effects of sleep apnea on having a urinary infection or overactive bladder. If a patient wakes up the middle of the night because of sleep apnea without knowing they have the sleep disorder, they might account for the experience by saying they were woken up by the urge to go to the bathroom.

Can You Prevent Having To Pee At Night

There are several things that you can do to help prevent having to pee at night due to OAB. These include:

  • Reduce fluids in the evening. While its important to stay hydrated during the day, limit your intake of fluids, especially ones that contain alcohol and caffeine, in the 2 to 4 hours before you go to bed.
  • Double void before bed. Some people with OAB have trouble fully emptying their bladder. Double voiding, or emptying your bladder twice, can help. Before going to bed, empty your bladder once, wait several minutes, and then try again.
  • Avoid triggers. Some foods and drinks can irritate the bladder and may increase your need to urinate. Some that you may want to avoid, especially later in the day, are:
  • alcohol
  • acidic foods, like citrus fruits and tomatoes
  • spicy foods

Since coping with nocturia due to OAB can be stressful, its also a good idea to make sure your bedroom is an environment that promotes sleep. A few things to consider include:

  • setting up a sleep schedule and a relaxing bedtime routine that you can stick to
  • making sure that your bedroom is dark, quiet, and a comfortable temperature
  • limiting or avoiding the use of TVs, cell phones, and computers or tablets in your bedroom
  • making sure the path to the bathroom is clear, in case you need to get up to urinate

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When To See A Doctor

Sleep is important for both your physical and mental health. Poor sleep can impact your alertness and memory, increase your stress levels, and raise your risk of health conditions like heart disease, diabetes, and obesity.

Make an appointment with a doctor if you find that your OAB symptoms cause you to frequently get up to use the bathroom at night. They can recommend methods to help reduce your urinary frequency.

Its also a good idea to talk with a doctor if the strategies youre currently using to prevent nocturia become less effective or stop working. Its possible that your OAB treatment plan may need to be adjusted.

Overactive Bladder Linked To Obstructive Sleep Apnea

Sleep Apnea and Frequent Night Urination

Obstructive sleep apnea has been linked with a large range of other health issues, including cancer, heart disease, and stroke. In addition to these serious ailments, though, research scientists are now also finding that OSA goes hand-in-hand with a number of urological conditions as well, including erectile dysfunction, urgency, and nocturia. In the past few years, two distinct studies, one focused on men and the other focused on women, have also found that sleep apnea is linked with overactive bladder .

Recommended Reading: Urinary Tract Infection Causing Hallucinations

Is Sleep Apnea Behind Your Nocturia

Disclaimer: Results are not guaranteed*** and may vary from person to person***.

Do you usually find it hard to fall into a deep, restful sleep at night? And when you finally do get to sleep, are you awakened by the sudden and uncomfortable urge to pee? Frequent urination at night, also known as nocturia, is a symptom of what could potentially be a much bigger underlying medical issue. It could indicate high blood pressure, diabetes, obesity, or even various types of sleep apneamost notably, obstructive sleep apnea syndrome .

Im going to tell you about a few treatment options to help you regain control of your situation. But first let me explain a little bit about sleep apnea.

What Is Obstructive Sleep Apnea Syndrome

OSAS is a condition that blocks your airways while you sleep, restricting or even pausing your breathing for an indeterminate amount of time. If your husband or wife snores extremely loudly in their sleep, it could be a sign of sleep apnea.

According to the American Sleep Apnea Association, roughly 22 million Americans suffer from some form of sleep apnea. Around 80% of moderate and severe OSAS cases go undiagnosed. Im not trying to scare you, but I do want to bring this to your attention in case you may be experiencing similar symptoms.

OSAS significantly lowers the length and quality of your sleep, which can negatively affect you in ways other than frequent urination at night. Shallow sleep can lead to daytime tiredness, reduced cognitive functions, and even early onset dementia. So, its definitely something you should get checked out. The earlier its diagnosed the better.

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The Connection Between Nocturia And Sleep Apnea

Both nocturia and sleep apnea can have a dramatic effect on how well someone is sleeping. If you already have nocturia, then you may be wondering the potential cause. Discussing your nocturia with your doctor is an excellent place to start. Still, it can help to better understand the connection between nocturia and sleep apnea as well.

As more research is being conducted, it is clear that nocturia seems common in sleep apnea patients and is often even used as a screening tool for sleep apnea. One study discovered that around 84% of sleep apnea patients also experienced nocturia. This is significant because, in the same study, almost the same number of sleep apnea patients were able to acknowledge snoring.

The thought is that because the soft tissues in the throat collapse during a sleep apnea cessation, a physiological domino effect may be triggered. Since oxygen decreases during a sleep apnea cessation, the patients carbon dioxide and blood acidity increase, their heart rate increases, and blood vessels in their lungs constrict. This entire system reaction is noticed by the body, and to reopen the airway, they must wake up at least a little.

If someone is having multiple sleep apnea-related breathing cessations throughout the night, their body may be registering multiple occurrences of fluid overload that lead to urination. So, even if the patient is unaware of their sleep apnea, it may be what is triggering their nocturia.

Nighttime Urination And Sleep Apnea

Urinary Frequency, Causes, Signs and Symptoms, Diagnosis and Treatment.

Nocturia is so prevalent in sleep apnea patients it has become a screening tool as significant as snoring. A research study showed that over 84% of patients with sleep apnea reported frequent nighttime urination while 82% acknowledged snoring.

How many bathroom trips do you make during the night? Its considered normal for one to be awakened once or twice during the night to urinate, but many patients with untreated sleep apnea report as many as 6 or more nightly trips. Often, people assume this disruption of sleep and having a small bladder causes treks to the bathroom.

Sleep researchers know that nocturia is a sign of sleep apnea, says Mary Umlauf, Ph.D., associate professor of nursing at UAB and lead investigator of the research study. However, because the underlying mechanisms linking sleep apnea and nocturia had not been studied before, people with nocturia were more likely to report the problem to their gynecologist or urologist, not a sleep clinician. Doctors most often attribute nocturia to aging in women or to prostate problems in men.

The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Contact your physician or health care provider when you have health related questions. Never disregard or delay medical advice because of information you have obtained on this site.

Read Also: Best Way To Get Rid Of Urinary Tract Infection

When Treatments Dont Work

If youve been experiencing overactive bladder despite a multitude of treatments , you may want to ask your doctor about the possibility of sleep apnea even if youre not obese.

The kidneys are supposed to be pretty much turned off during sleep so that we can get uninterrupted sleep for optimal restoration.

Dr. Rifkin is the CEO of Ognomy, a virtual sleep apnea practice that connects physicians with patients remotely, providing testing, diagnosis and treatment from ones home.

Dr. Rifkin is board certified in both neurology and sleep medicine. He also treats insomnia, RLS and narcolepsy.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.

Reducing Nocturia And Getting Better Sleep

Because it can have significant health consequences and connections to other illnesses, it is important to talk to your doctor about bothersome nocturia. A doctor can help identify the most likely cause and appropriate therapy for any specific individual.

When an underlying condition is causing nocturia, treating that condition may reduce the nighttime trips to the bathroom. Many patients with nocturia are treated with medications or have adjustments to their existing medications .

A number of lifestyle changes can help reduce problematic nocturia. These changes are designed to reduce nocturnal urine production and include:

  • Reducing evening fluid intake, especially before bed.
  • Elevating the legs an hour or more before bed in order to reduce the resorption and conversion of peripheral edema to urine during sleep.

Focusing on sleep hygiene, which includes your bedroom environment and sleep habits, can reduce awakenings during which you notice a need to go to the bathroom. Examples of healthy sleep tips include:

Working with a doctor and making lifestyle changes can reduce the number of bathroom trips you take each night, but they often may not eliminate them completely. For that reason, its important to take steps to make those trips as safe as possible, especially for older people.

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Also Check: How To Stop A Urinary Tract Infection Before It Starts

Frequent Nightime Urination And Sleep Apnea

Waking to urinate throughout the night is known as nocturnia. Many people who suffer from nocturnia believe this condition is caused by a urological disorder or feel it is simply a part of aging. Recent studies show the problem could be caused by something elsesleep apnea. Heres what you need to know about nocturnia and sleep apnea.

Thoughts On Sleep Apnea And Nighttime Urination

Frequent Urination and Sleep Apnea
  • Sara

    Diagnosis: UARS

    No to nighttime wakings to take a trip to the bathroom. Yes to overactive bladder during the day. Consistently worse just before my period however, when discussed with my MD, she reported never hearing a correlation to OAB and hormonal changes. Interestingly, when on a trial of Provigil, OAB symptoms significantly improved .

    You provided the explanation for the nighttime issues. How does sleep disordered breathing play into the daytime issues? Is it the same mechanism? Would you expect a patient with SDB to have problems both daytime and nighttime?

  • Sara,

    There are studies showing that SDB can cause both daytime and nighttime symptoms. Interestingly, the time just before your period is also when your sleep efficiency drops temporarily. Progesterone has been found to increase upper airway muscle tone. Since progesterone levels drop the most before your periods, its expected that your sleep efficiency drops as well. This can cause various internal organs to become hypersensitive , due to an imbalance of your involuntary nervous system.

  • Sara

    Very interestingso, decreased sleep efficiency leading up to a monthly cycle may contribute to irritable mood.

  • Jason, Rosthern, SK, CAN

    So I just started my CPAP machine and its awfully hard to get used to. that said, I dont usually go pee at night, but since I have used this machine, I have had to go every night since. Is there a correlation?

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    Sleep Apnea And Erectile Dysfunction

    Although, it might be surprising the stress of sleep apnea can contribute to a lot of issues with your internal plumbing, including erectile dysfunction and a decreased sex drive.

    “Yes, sleep apnea is linked with erectile dysfunction and a lowered sex drive. Although we still don’t know the exact cause, we do know that having sleep apnea usually leads to a decrease in testosterone, which is important for having a healthy erection. Also, it is suggested that the sleep deprivation from sleep apnea causes fatigue, which also plays a role in the lowered sex drive in people,” explained Dr. Haissam Dahan, DMD, MSc, Ph.D., lecturer at Harvard and McGill University.

    When the feeling is right, it can be ruined by the stress and fatigue brought on by sleep deprivation can quickly put the fire out. Plus, as well as decreased testosterone, sleep apnea can also lead to decreased oxygen, which is needed for a healthy erection.

    What Are The Causes Of Nocturia

    There are many possible causes of nocturia, depending on the type. The types of nocturia include:

    • Polyuria.
    • Nocturnal urinary frequency.


    People with polyuria urinate > 3,000mL in 24 hours. This is usually caused by there being too much water filtered by the kidneys. It can also happen if something is in the urine, pulling the extra water out, such as sugar .

    The causes of polyuria can include:

    Nocturnal polyuria

    Those with nocturnal polyuria experience a high urine volume only at night. Their urine volume during the day is normal or reduced. This is usually due to fluid retention during the day that often accumulated in the feet or legs. Once you lie down to sleep, gravity no longer holds the fluid in your legs. It can re-enter your veins and be filtered by your kidneys, producing urine.

    The causes of nocturnal polyuria can include:

    • Congestive heart failure.
    • Edema of lower extremities .
    • Sleeping disorders, such as obstructive sleep apnea .
    • Certain drugs, including diuretics , cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D.
    • Drinking too much fluid before bedtime, especially coffee, caffeinated beverages or alcohol.
    • Having a diet thats high in sodium.

    Nocturnal urinary frequency

    The causes of an inability to fully empty your bladder can include:

    The causes of an inability of the bladder to fully fill can include:

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    How Bedwetting Occurs From Sleep Apnea

    Because sleep apnea blocks the airflow to your brain it puts a tremendous amount of stress on your body. Its always fluctuating, trying to wake you up and also trying to keep you asleep. Due to this, you may not actually wake up to urinate throughout the night, and urinate yourself. Again, sleep apnea can appear months or even years in advance before you experience any bedwetting. However, that doesnt mean that sleep apnea and bedwetting arent interlinked.

    Not only does sleep apnea block necessary sleep, it also changes you chemically. Meaning that your body isnt properly functioning at its optimal levels. Sleep apnea is usually a lifelong condition, so just trying to ignore this wont solve the problem.

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    Why Can’t I Sleep? (Nocturia)

    So, why is a dentist offering information about urination? Its a fair question.

    A significant trigger of nocturia is OSA, obstructive sleep apnea. We specialize in treating this issue from root to symptom.

    Rejuvenation Dentistrys biologic approach to sleep apnea can improve not only your quality of sleep but also your quality of life. Our dentistry practice looks beyond the mouth to whole-body health.

    Schedule a consultation today to find out if your nocturnal polyuria can be transformed by dental work.

    Read Also: Medical Treatment Of Urinary Incontinence

    How Common Is Nocturia

    Nocturia is quite common among both men and women. Studies and surveys have found that 69% of men and 76% of women over age 40 report getting up to go to the bathroom at least once per night. About one-third of adults over age 30 make two or more nightly bathroom trips.

    Nocturia can affect younger people, but it becomes more common with age, especially in older men. It is estimated that nearly 50% of men in their seventies have to wake up at least twice per night to urinate. Overall, nocturia may affect up to 80% of elderly people.

    Rates of nocturia have been found to be higher in people who are black and Hispanic than in white people even when controlling for gender and age. The reason for this disparity is not well understood.

    Nocturia frequently occurs during pregnancy but usually goes away within three months after giving birth.

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