Do you wake up in the middle of the night to urinate? Is your spouse or partner also telling you that you snore? Do you wish you could for once just sleep through the night without waking up at 2 am with that “need to go” feeling? There is a solution – CPAP! Dream Sleep is here to help by offering FREE Level 3 Sleep Studies and CPAP machines with the latest technology and most comfortable masks and interfaces. If you feel you might be suffering from sleep apnea and find yourself waking throughout the night to urinate, ask your Doctor to refer you to us today for a sleep study! Also be sure to read below for an intriguing study from the International Neurourology Journal by Wang and colleagues:
Nocturia, as defined by the International Continence Society, is “the complaint that the individual has to wake up at night one or more times to void (urinate/pee)”. In otherwise healthy and well-hydrated individuals, during sleep, your body produces more concentrated urine than during the day, allowing you to sleep 6-8 hours uninterrupted. In nocturia, this process is disrupted. A study conducted by Schatz and colleagues found the prevalence of nocturia increased with age, from 3.4% in men below the age of 30, up to 32.4% in men over the age of 60. The assumption has historically been that men suffering from nocturia have benign hyperplasia of the prostate and women have an overactive bladder or a reduced bladder capacity. According to the National Sleep Foundation, patients with severe cases of nocturia often wake to urinate over 5-6 times per night, which has a profoundly negative effect on sleep cycles.
OSA (obstructive sleep apnea), is defined as repetitive occlusion of breathing in the upper airway and is surprisingly common, affecting over 20% of the world’s population. A study conducted by Krieger and colleagues showed that the rate of nocturia was significantly greater in patients diagnosed with OSA compared with otherwise healthy patients not suffering from OSA. CPAP (continuous positive airway pressure) is the gold standard treatment for patients with OSA and has been found to not only improve the respiratory status in these patients but also decrease the frequency of nocturia and the associated urine volume as well.
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Wang and colleagues conducted a meta-analysis (a statistical procedure for combining and comparing data from a multitude of studies) and found many studies in the literature point to the fact that OSA is a potential cause of nocturia, which seems to be a more serious issue with OSA patients in general. In fact, studies show that the frequency with which nocturia occurs more than once nightly increases by 52-77% in OSA patients (dependent on the severity of the OSA itself). Other causes of nocturia include, but are not limited to, urological infection, bladder or prostate tumors, bladder prolapse, disorders affecting sphincter control, heart failure, liver failure, poorly-controlled diabetes mellitus, diabetes insipidus, pregnancy, and use of diuretic medications. Keep in mind that suffering from nocturia does not necessarily indicate you suffer from any or all of the above, and you should visit your Doctor if you are concerned.
Patients with more severe cases of OSA (high RDI, or respiratory disturbance index – which can be found in your FREE Level 3 Sleep study at Dream Sleep Respiratory), were noted to have higher night-time urine volume and elevated ANP (atrial natriuretic peptide) excretion. ANP acts on your kidneys to encourage water excretion, or urination. CPAP provides positive pressure into your lungs as you sleep, relieving obstruction in the airways and thus avoiding expansion of the atria of your heart. This in turn reduces excretion of ANP, which then reduces the urge for the kidneys to excrete water, and prevents you from waking to pee. In simpler terms, CPAP prevents your body from excreting the hormone that makes you pee, so you get a better and longer sleep IF YOU WEAR CPAP and avoid those 2 am trips to the bathroom!
This study also compared the AHI (apnea-hypopnea index) of patients on versus off CPAP. The AHI uses the number of apneas (breathing cessation episodes) and hypopneas (shallow breathing episodes) to calculate the severity of your sleep apnea. This would also show on your sleep study results. The AHI of patients who were compliant with their CPAP therapy was significantly reduced compared to those diagnosed with OSA and not using CPAP.
CPAP can have a positive impact on your health and life in so many ways. Imagine going to bed every night with 8 hours of uninterrupted sleep not only for you, but for your bed partner as well! This therapy is well-covered by many benefits plans and Dream Sleep Respiratory will work with you and your benefits plan to find the right machine and solution for you. Contact us today with any questions!