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Sleep and Urine
popular press just starting to connect the dots on sleep apnea and nighttime urination/ nocturia . . .
SUNDAY, Nov. 29 (HealthDay News) -- People who wake up during the night to urinate shouldn't automatically blame a urological problem. Sleep apnea, a breathing-related sleep disorder, could be the cause.
A new study suggests that nighttime urination, or nocturia, is comparable to loud snoring as a marker for obstructive sleep apnea, a disorder in which soft tissue in the throat blocks the flow of air into the lungs, disrupting sleep.
Previous studies established a link between nocturia and sleep apnea, a potentially serious condition that affects about 25 percent of U.S. men and 10 percent of U.S. women, the researchers said. But they believe this is among the first to show that screening for nocturia could help doctors identify patients with apnea.
The study also suggests that a common treatment for sleep apnea -- positive airway pressure (PAP) therapy -- can reduce symptoms of nocturia, thereby improving sleep and preventing debilitating falls among elderly people who get out of bed at night to use the bathroom.
PAP involves wearing a pressurized air mask while sleeping.
Typically, doctors screen for apnea by assessing patients' weight (the condition is associated with overweight/obesity) and asking if they snore heavily, notice breathing problems at night or feel tired during the day (because of interrupted sleep). But because many patients, especially those who sleep alone, are unaware that they snore, apnea often goes undiagnosed.
"When you ask people about symptoms like snoring and gasping, they tend to say, 'No, I don't have them'," said study author Edward Romero, research coordinator at the Sleep & Human Health Institute in Albuquerque, N.M. "But it's very easy for them to realize that they wake up at night to go to the bathroom."
One of Romero's co-authors, institute director Dr. Barry Krakow, said doctors and patients are quick to blame nocturia on diabetes, prostate enlargement and other medical conditions with which it is associated. "I see patients all the time who think they're waking up to urinate because they have prostate trouble or a small bladder," Krakow said. "About 80 percent of the time we discover that apnea is the cause of their problem."
Besides nocturia and snoring, symptoms of sleep apnea include daytime drowsiness, memory problems and depression. Untreated sleep apnea can lead to high blood pressure, blood clots and heart disease.
For the study, published online recently in Sleep and Breathing, the researchers reviewed data on 1,007 adults treated at two sleep clinics in New Mexico between 2005 and 2007. Of the participants, 797 were diagnosed with sleep apnea, 777 reported snoring and 839 reported nocturia. Neither snoring nor nocturia was proof of apnea, but the two symptoms were similar in their power to predict it: snoring was reported by 82.6 percent of apnea sufferers, and 84.8 percent of apnea sufferers reported nocturia.
The authors propose further research be conducted to confirm the effectiveness of nocturia as an apnea screening tool.
Mary Umlauf, a professor at the University of Alabama Capstone College of Nursing in Tuscaloosa and a noted nocturia researcher, said the study could play an important role in dispelling "old wives' tales" about nocturia.
"Many health-care providers and ordinary people think of nocturia as a urological or gynecological problem," she said. "They don't understand that sleep apnea can cause the body to produce too much urine at night.
"People who wake up to urinate shouldn't assume that it's my prostate, or 'I'm just old'," she said.
excerpted from: http://health.usnews.com/articles/health/healthday/2009/11/29/sleep...
SUNDAY, Nov. 29 (HealthDay News) -- People who wake up during the night to urinate shouldn't automatically blame a urological problem. Sleep apnea, a breathing-related sleep disorder, could be the cause.
A new study suggests that nighttime urination, or nocturia, is comparable to loud snoring as a marker for obstructive sleep apnea, a disorder in which soft tissue in the throat blocks the flow of air into the lungs, disrupting sleep.
Previous studies established a link between nocturia and sleep apnea, a potentially serious condition that affects about 25 percent of U.S. men and 10 percent of U.S. women, the researchers said. But they believe this is among the first to show that screening for nocturia could help doctors identify patients with apnea.
The study also suggests that a common treatment for sleep apnea -- positive airway pressure (PAP) therapy -- can reduce symptoms of nocturia, thereby improving sleep and preventing debilitating falls among elderly people who get out of bed at night to use the bathroom.
PAP involves wearing a pressurized air mask while sleeping.
Typically, doctors screen for apnea by assessing patients' weight (the condition is associated with overweight/obesity) and asking if they snore heavily, notice breathing problems at night or feel tired during the day (because of interrupted sleep). But because many patients, especially those who sleep alone, are unaware that they snore, apnea often goes undiagnosed.
"When you ask people about symptoms like snoring and gasping, they tend to say, 'No, I don't have them'," said study author Edward Romero, research coordinator at the Sleep & Human Health Institute in Albuquerque, N.M. "But it's very easy for them to realize that they wake up at night to go to the bathroom."
One of Romero's co-authors, institute director Dr. Barry Krakow, said doctors and patients are quick to blame nocturia on diabetes, prostate enlargement and other medical conditions with which it is associated. "I see patients all the time who think they're waking up to urinate because they have prostate trouble or a small bladder," Krakow said. "About 80 percent of the time we discover that apnea is the cause of their problem."
Besides nocturia and snoring, symptoms of sleep apnea include daytime drowsiness, memory problems and depression. Untreated sleep apnea can lead to high blood pressure, blood clots and heart disease.
For the study, published online recently in Sleep and Breathing, the researchers reviewed data on 1,007 adults treated at two sleep clinics in New Mexico between 2005 and 2007. Of the participants, 797 were diagnosed with sleep apnea, 777 reported snoring and 839 reported nocturia. Neither snoring nor nocturia was proof of apnea, but the two symptoms were similar in their power to predict it: snoring was reported by 82.6 percent of apnea sufferers, and 84.8 percent of apnea sufferers reported nocturia.
The authors propose further research be conducted to confirm the effectiveness of nocturia as an apnea screening tool.
Mary Umlauf, a professor at the University of Alabama Capstone College of Nursing in Tuscaloosa and a noted nocturia researcher, said the study could play an important role in dispelling "old wives' tales" about nocturia.
"Many health-care providers and ordinary people think of nocturia as a urological or gynecological problem," she said. "They don't understand that sleep apnea can cause the body to produce too much urine at night.
"People who wake up to urinate shouldn't assume that it's my prostate, or 'I'm just old'," she said.
excerpted from: http://health.usnews.com/articles/health/healthday/2009/11/29/sleep...
Views: 108
Replies to This Discussion
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Permalink Reply by D. W. Conn on
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Since the 1980s we have talked with our patients about nocturia and the possible correlation with sleep apnea. This article reads as if this is something new. We have been aware that when the Spo2 drops the patient’s brain will signal chemicals that will flush the kidneys to the bladder. This will cause the patient to wake up and ambulate to the bathroom. The awakening allows for deeper breathing and increasing oxygen levels in the blood feeding the necessary tissues.
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Permalink Reply by Mike on
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i find that many of the things we have been talking about for a long time on SG are treated as "news flashes" in the popular press. I've made efforts to get these stories out, but have met with very little interest/ understanding. for years, the only story the media wanted to run was that there WAS a condition called sleep apnea -- now they're starting -- slowly -- to peel back the onion and get to the juicy stuff we talk about here on SG.
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Permalink Reply by RockRpsgt on
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It is good that the information is getting out now. Prior to getting into sleep I had heard very little about apnea or or any other sleep problem. Keep em coming Mike!
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Thanks for the reminder. When you work in the field what you think is common knowledge actually escapes the common public.
We as healthcare workers have to remember that we are dealing with individuals whose lives to not revolve around our occupation.
Keep up the great work Mike!
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Permalink Reply by Tim on
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Sleep apnea also seems to cause bed wetting. I know a few people, along with myself, who stopped bed wetting when we started CPAP.
I had been going to various urologists for years for bed wetting -- and endured a number of unpleasant tests. My bed wetting stopped the night that I started using CPAP.
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Permalink Reply by Steph Serrano on
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Is there any scientific proof for a correlation between sleep apnea and nocturia? So far, I haven't read or heard much about this. I haven't had any problems with nocturia but I am wondering if it has something to do with the intensity of sleep apnea.
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Permalink Reply by Mary Z on
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http://www.sleepapnea.org/resources/pubs/noct.html
This is just one site that mentions the connection. If you google "sleep apnea and nocturia" you can come up with some studies.
Mary Zimlich
Steph Serrano said:Is there any scientific proof for a correlation between sleep apnea and nocturia? So far, I haven't read or heard much about this. I haven't had any problems with nocturia but I am wondering if it has something to do with the intensity of sleep apnea.
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Permalink Reply by Toni Cacioppo on
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Nocturia and OSA are related to low blood oxygen level, but the nocturia is also related to the decrease in negative pressure in the thoracic cavity. When the airway becomes blocked by the tongue, the respiratory muscles continue to work - you are trying to breathe, but the airway is blocked. The movement of the muscles decreases (causes more) negative pressure, which dilates the right atria of the heart. The body thinks that the atria is being stretched due to increased blood volume, so hormones are produced to signal the kidneys to kick in to reduce blood volume by reducing the amount of water in the blood. This leads to chronic, low level dehydration, which is related to obesity, diabetes control, headache, fatigue. . .the cycle continues. . .
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Permalink Reply by sleepycarol on
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Interesting Toni. Your explanation I can follow and understand.
For me I have gotten up at night, even as a child I made routine visits to the bathroom. I knew that my siblings didn't, but never gave it much thought actually. It was a pain as a child when we used to camp in the state parks. I would have to wake up one of my parents to walk with me to the restroom facilities at least once a night. I was too big to go behind a tree, yet they didn't want me to walk in the dark by myself. No, we didn't have a porta-potty at the time.
As I got older, I was finding regular bathroom breaks happening more often. It was not unusual to be up 2 or more times in a night. This causes my sleep to be disrupted as well. Even with a sleep aide or other medications, I have never slept all night. I have tried the medication for over active bladder, it doesn't help
I had some tests done about 10 years ago and they found that my bladder does not empty completely. Doctor said it could be corrected with surgery and since I needed surgery anyway I said go for it. Unfortunately, the surgery didn't correct the problem as my bladder had folded up on itself and resulted in permanent nerve damage. I am more diligent about trying to empty it completely and drink plenty of fluids to help keep down infections.
When I started treatment, I found that I still have to get up to go to the bathroom, but not as frequently. I have wondered if this disrupts my sleep just enough to keep me from feeling more refreshed after sleeping. About a year after starting therapy, I tried the Nasal Aire II and did find that I slept one night without getting up that I could remember. It was a cause for a celebration, but unfortunately it has only been that one night.
I
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Permalink Reply by susan mccord on
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Okay, I just got home from 2 weeks in AZ so maybe I've been out in the sun too much. But does anyone else think the title of this discussion is funny??!!!
This was the first Discussion I ran across this a.m., and it just struck me as hilarious!!
Important topic, for sure--just sun-poisoned, I guess!!!!!!! LOL
I hope I have something more substantial to bring to the table soon!!!!!!!!
Susan McCord :-D
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Permalink Reply by Jenny Foerst on
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Hmmm, I've been complaining of Nocturia for 20 years, and, even recently, my neurologist and other docs. never did anything but shrug it off, nonplussed. I had to do 24-hour urine collections twice and was amazed at how much more I collected at night than during the day! No one ever offered to explain this to me, even though I also complained of light, crappy sleep.
Well, I gained 70 pounds from a migraine preventive medication, so I've been blaming the weight for much of the OSA. But I was skinny back when the nocturia became a problem, so maybe weight loss won't cure me. As soon as I went on CPAP, the copious nighttime urination ceased. When I tell even the sleep specialist, she seems baffled. And I live around major research university hospitals!
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