Nighttime urination, or nocturia, is a condition where you wake up multiple times during the night to urinate. There is a growing body of evidence suggesting a link between nocturia and obstructive sleep apnea (OSA).
Impact of Sleep Apnea on Nighttime Urination
Nighttime urination and sleep apnea can be interconnected, with sleep apnea potentially exacerbating nocturia through fluid shifts, hormonal changes, and sympathetic nervous system activation.
Increased Pressure and Stress Responses
Interstitial Fluid Shifts: During sleep, especially in the supine position (lying on the back), fluid from the legs and other parts of the body can shift to the bloodstream. This fluid shift increases blood volume and can lead to increased urine production. In individuals with sleep apnea, the repeated episodes of airway obstruction and subsequent arousals can exacerbate this fluid shift, leading to increased nighttime urination.
Sympathetic Nervous System Activation: Sleep apnea leads to intermittent hypoxia (low oxygen levels) and frequent arousals from sleep, which activate the sympathetic nervous system (the body’s “fight or flight” response). This activation can increase blood pressure and stimulate the kidneys to produce more urine, contributing to nocturia.
Hormonal and Metabolic Changes
Antidiuretic Hormone (ADH) Disruption: Sleep apnea can disrupt the normal secretion of antidiuretic hormone (ADH), which regulates urine production. Reduced ADH levels can result in decreased ability to concentrate urine, leading to increased urine output at night.
Aldosterone and Fluid Regulation: Chronic sleep apnea can affect the regulation of aldosterone, a hormone involved in fluid balance and blood pressure regulation. Disruption in aldosterone levels can influence urine production and contribute to nocturia.
Sensation of Urgency To Urinate Caused By Sleep Apnea
The combination of increased blood volume and elevated sympathetic nervous system activity can enhance the sensation of urgency. The body may signal the need to urinate more frequently as part of its response to the altered fluid balance and stress.
Research on Nighttime Urination and Sleep Apnea
This study explores the concept that treating sleep apnea improves the symptoms of an over active bladder. While the findings indicate that patients with moderate to severe sleep apnea were more likely than the general population to have an over active bladder, by treating sleep apnea with PAP therapy, the majority of patients saw an improvement in symptoms, indicating that separate treatment for over active bladder is unnecessary in those patients.
The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment.
Comments