I too have not been able to go a single night without at least one pee break (usually several) for many years, and APAP hasn't cured me of this. I have been doing better lately with some sleep hygiene ideas and, frankly, some drugs (prescription ones only). I wish I could get four straight hours without drugs, but have yet to achieve that. With them I have gone as much as 6.5 hours. I'm consulting with a urologist but waiting for tests with a very long wait for an ultrasound.
I know that prescription drugs hurt my sleep quality, but at least my AHI is low and I actually get a reasonable amount of sleep overall. Impaired quality sleep is better than no sleep, I think...
Anyway if I ever go over 7 hours before that first pee break I'm getting up for good that day.
The above is my opinion. It is just possible that I may, occasionally, be mistaken.
I am neither a Doctor, nor any other kind of medical professional.
Everything put together sooner or later falls apart.
It's called nocturia. When your OSA is untreated you struggle to breathe you create negative intrathoracic pressure. Your body thinks you have fluid on the heart and tries to counter it by making you pee more to get the perceived excess water out.
"Although nocturnal voiding is frequently attributed to urologic disorders, nocturia and enuresis are also important symptoms of sleep-disordered breathing. However, polyuria can be elicited by obstructive sleep apnea as well as bedrest, microgravity and other experimental conditions where the blood volume is shifted centrally to the upper body. The nocturnal polyuria of sleep apnea is an evoked response to conditions of negative intrathoracic pressure due to inspiratory effort posed against a closed airway. The mechanism for this natriuretic response is the release of atrial natriuretic peptide due to cardiac distension caused by the negative pressure environment. This cardiac hormone increases sodium and water excretion and also inhibits other hormone systems that regulate fluid volume, vasopressin and the rennin-angiotensin-aldosterone complex. Treatment of sleep apnea and airway compromise has been shown to reverse nocturnal polyuria and thereby reduce or eliminate nocturia and enuresis. Thus, careful evaluation of nocturia and enuresis for evidence of nocturnal polyuria can increase the diagnostic certainty of referring primary care providers and sleep specialists. In addition, the resolution of these bothersome symptoms after treatment can contribute to patient satisfaction as well as reinforce treatment compliance."
Oooh, another standards geek!
I think for me I just thought that was the reason I was waking up but actually it was the spells of not breathing. Also about once a week I would wake up choking on acid which I contribute to gasping for air. I was getting up 3-4 times a night and now none at all. So much more peaceful. Michael