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Cpap Without Study for Nocturia
#1
Hi,

New here so please take this into account.

Some studies suggest a link between sleep apnea and nocturia (excessive night time urination). And I do understand
that the recommended protocol is to have a sleep study done before getting a Cpap. That said, even if I'm diagnosed
with Sleep Apnea, and get a Cpap, there is still no guarantee that my nocturia will resolve.

So, I was thinking why not just cut to the chase and get a Cpap (no sleep study) and see if my night time
bathroom trips stop. If they do, then I've resolved the problem and keep wearing the Cpap. If my nocturia
remains the same, then I stop wearing the Cpap.

What is wrong with my thinking, if any?

Thanks for any help on this.

Jim
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#2
Welcome

You are just guessing at a diagnosis. It may be caused by sleep apnea and/or something else. You may also need time to get used to using a CPAP and to get the therapy dialed in, if you need one. It's better to get an official diagnosis based on your medical history and a sleep study. Have you taken the Epworth Sleepiness Questionnaire, an early step toward a sleep apnea diagnosis?  http://www.apneaboard.com/sleep-apnea-in...iness-test
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#3
I have never met anyone who enjoys an in-lab sleep test.  However, they do have their place in the process.
Some people do resolve nocturia with CPAP because apnea increases blood pressure; and creates a greater pressure across the nephron.  Also, the increase in BP will suppress the renin-angiotension mechanism and it's end product, ADH (Anti Diuretic Hormone).

The risk of just going for a machine is mostly financial.  You could be stuck with a machine you don't need.

Get some bloodwork first -- look at Creatinine, BUN, K+ and your eGFR.

eGFR is estimate by most labs using the Modification of Diet in Renal Disease (MDRD) formula:

see: https://en.wikipedia.org/wiki/Renal_func...29_formula
It's just an estimator; and is best >90. If less than 60 see a nephrologist.
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#4
(05-08-2017, 09:12 PM)jmjm28 Wrote: Hi,

New here so please take this into account.

Some studies suggest a link between sleep apnea and nocturia (excessive night time urination). And I do understand
that the recommended protocol is to have a sleep study done before getting a Cpap. That said, even if I'm diagnosed
with Sleep Apnea, and get a Cpap, there is still no guarantee that my nocturia will resolve.

So, I was thinking why not just cut to the chase and get a Cpap (no sleep study) and see if my night time
bathroom trips stop. If they do, then I've resolved the problem and keep wearing the Cpap. If my nocturia
remains the same, then I stop wearing the Cpap.

What is wrong with my thinking, if any?

Thanks for any help on this.

Jim
 i went 3x as often at the sleep lab while they were trying to titrate me

imho i wake up because i have to go
i dont have to go because i wake up 

i learned to live with it
dont get upset
just go 
and back to sleep in a minute or so
except maybe early in the morning 
in that case i get up and go back to sleep after breakfast
to make up for the sleep i didnt get because i got up early
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#5
Hi jmjm28,
WELCOME! to the forum.!
Hang in there for more answers to your questions and good luck to you.
trish6hundred
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#6
Thanks for the replies so far. While I'm new to the subject of sleep apnea, I am quite knowledgeable with regard to urology and nocturia. Nocturia has multiple causes and sleep apnea can be primary in some cases. That doesn't mean everyone with sleep apnea has nocturia, or that resolving sleep apnea will resolve nocturia. Also, with nocturia, there is no quick way to find out its cause. You have to use trial and error and that is what I'm doing here.

So all I'm asking is what if I just skipped the sleep study step and went ahead and purchased a CPAP. If the CPAP resolves my nocturia, then I'm a happy camper. If the CPAP doesn't resolve my nocturia, that won't mean I have (or don't have) sleep apnea, but it would tell me that the cause of my nocturia is other than sleep apnea. 

So in this context, what are the limitations of skipping the sleep study? Is it required to set up the CPAP or can one set it up properly using a manual and with
some experimentation? Anything else I may be missing here?

Jim
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#7
A sleep study does more than just diagnose a case of sleep apnea. It will determine the severity and also the sleep issues that are prevalent. This will enable a diagnosis that determines what sort of machine you need, what it's optimum settings are and whether any supplementary aids (such as oxygen) are neccessary. The question to be asked is do you have sleeping issues such as snoring, waking up in the middle of the night out of breath, fatigued during the day, etc. As Big Dave said, taking the Epworth Scale questionnaire is a first step. The next step is seeing your doctor who might suggest a sleep study. He might also suggest a PSA test for prostate problems or something similar.

Yes, xPAP fixed my nocturia (thanks for the explanation JustMongo - I always wondered why) but may not in your case if you don't have OSA. To be blunt, go and talk to your doctor.
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#8
I'm a contrarian, and fully support the idea of getting an auto CPAP and seeing if you can get the results you seek. There is virtually no risk on the down-side, and many potential up-side benefits. Sleep studies can easily exceed the cost of acquiring an auto CPAP, and even a home sleep test can come very close. Machines are abundant and cheap on the internet and can provide a lot of data to confirm or refute that sleep apnea may be a contributing cause to nocturia. I recognize nocturia may have many causes, but sleep apnea is a leading one. Combined with awareness of snoring, low SpO2 and fatigue, and I think you have a pretty conclusive argument. CPAP is largely a trial and error process to optimization, and using CPAP as a trial to see if it can improve nocturia isn't going to hurt anyone.
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#9
I also think that if you have sleepiness in the daytime, trying an auto machine with data to look at is reasonable. I think the top two causes of nocturia are sleep apnea and high blood sugar. I presume you have ruled out diabetes.
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#10
Thanks Sleeprider for your well articulated contrarian point of view! Yes, as you suggest, all I'm doing is conducting a trial. I'm
a tinkerer by nature and comfortable with a trial and error approach which oftentimes resolves things that a direct diagnosis cannot.

Do you have any suggestions for a "cheap" and/or moderately priced unit I can get on the internet that should serve my purpose?

As to my other symptoms, they would be daytime fatigue, occasional snoring and at least one occasion where I woke up from a dream gasping for air.
Haven't taken my SP02 recently.

Jim
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