Steven Y Park, MD

Steven Y Park, MD
Male, 54
New York, NY

Specialties: Sleep-breathing disorders

Interests: Running, Baking, origami

Private Practice
212-315-9058

New York, NY

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Sleep Apnea and Nighttime Urination

Dec 11, 2009 - 27 comments
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We’ve know for many years that frequent bathroom trips at night are usually not due to bladder or prostate problems, but mostly due to breathing pauses that make you wake up and and think that you have to go. Numerous studies have shown that most men and women who have to go to the bathroom often at night or have overactive bladders during the day actually have sleep apnea.

A new study confirms these findings again, but points out that the presence of frequent trips to the bathroom is as sensitive in predicting obstructive sleep apnea as snoring!

Sleep apnea also makes the body produce more urine, and because you wake up every few hours, you’ll want to go, but you won’t have a completely full bladder. Sudden shifts in blood flow into the heart after an obstructive event increases production of atrial natriuretic peptide, which makes you produce more urine. One study found that diluted levels of urine during these episodes is also predictive of having obstructive sleep apnea.

I often see complete or near total resolution of these sort of problems after definitive sleep apnea treatment.

Do you suffer from frequent nighttime urination, or have an "irritable" or overactive bladder during the day? Please enter your responses in the box below.

References:

http://www.springerlink.com/content/87j33u8vl1628733/?p=29800620cad04ab995333b5c8c65747a&pi=6
http://www.ncbi.nlm.nih.gov/pubmed/8604961
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635592/
http://www.ajog.org/article/S0002-9378(08)00168-3/abstract

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Does drinking water before you go to bed cause you to wake up and urinate during the night?

I don't have an overactive bladder during the day, actually I probably find myself not going enough during the day becasue I get involved in work.  But my wife does think I have sleep apnea.  I snore and she's told me that I seem to stop breathing at times.  And I do sometimes find myself having to urinate at night but it doesn't occur every night.

So I may have sleep apnea but not a severe case.  I know I do feel tired almost everyday during work but I attribute that to my 5 hours of sleep on average per night.  But I feel that way sometimes even if I get longer sleep.  Should i be worried?  Or do you think I;m just not getting enough hours of sleep?  Thanks!

It sounds like you may have obstructive sleep apnea. Studies have shown that even mild cases can cause problems with your heart, car accidents, etc. If you do stop breathing, you most likely have it. Not sleeping long enough is good reason to be tired, but during the 5 hours that you're sleeping, you're probably not getting deep sleep. The best thing to do is to see a sleep medicine doctor.

Dr Park,
As always, thanks for sharing information for us to ponder. Nocturia is not fun and definitely cuts into the quality of my sleep.

be well,
Laura
MS forum

I always thought it was normal to have to get up in the middle of the night ......

I don't think I've ever slept straight thru the night before, normally up once or twice a night. Definetly information to ponder.

Any male, particularly over the age of 40, should go to the doctor for prostate check, and PSA blood level check, if suddenly he is having to get up to pee more than once or twice during the night. My husband had this suddenly happened, but it was not given sufficient attention. He was getting up to pee numerous times, so he became exhausted in the day. The maximum count of this nocturia, was 14 times a night at its worst.
It was discovered (too late) that he had Prostate cancer. It might have been curable if he had done the prostate tests sooner....

Ginger899,

A screen for sleep apnea should be considered in addition to any standard urologic workup for for frequent urination. The standards for prostate cancer screening is currently a topic of intense debate. I have my own theories about how sleep-breathing problems can trigger BPH and prostate cancer, but that's for another discussion.

On a personal note, my father has advanced prostate cancer with a PSA in the 600s, but is more active and healthier in general than all this doctors.

Well, who knew! Here I was thinking I was drinking too much before bedtime, and I do have sleep apnoea. I often wake in the wee hours (pun intended!) and it drives me nuts! I do tend to urinate often in the day time too. I just put it down to me being me! Hmmm, very interesting!

I am 79, I take 0.75 Mg. of Alprozolam at night for sleep since last 18 years.
I get up usually 2 or 3 times for urination during nitht time. Few days back on consecutie two days I had to go to bathroom for 10 to 12 times in the night.
I got lower abdomen sono-graphy the report is as under.
Kidneys are normal in size.( approximately 8.5 cm.) with smooth regular contour. Renal cortical echogenecity is within normal limits. And cortical differentiation is adequate. No pelvicaliceial dilatation is seen.
Ureters are un-dilated.
Urinary bladder is normal in size. And contour with mild trebeculated walls echofree lumen.
There is no significan past void residue.
Prostate measures 4.0x2.7x3.0cm with normal echo structure.
URINE- ANALYSIS IS NORMAL.
I was asked to take valium or increase the dose of Alprozolam. And was not prescribed any specific drug for the bladder.
I am doing kegel exercises off and on. Pleas suggest appropriate pelvic floor exercises if indicated. Is self prostate massage beneficial or damaging? Can there be any explanation why on two nights, I had more than usual urination? Pleas guide me and oblige. Thanks.
I do not think I have sleep apnea. How do I findout about sleep apnea?.

Dalubaba,

You have a sleep problem which is likely to be caused by an underlying sleep-breathing problem. You won't know if you have sleep apnea unless you undergo an overnight test. If you prefer not to sleep on your back, then it's even more likely. You should see a sleep doctor to know for sure. You don't have to snore or be overweight to have it. In the small chance that you don't have sleep apnea, then at least you know.

Dear Dr Park. I was wondering if you could give me your opinion on whether or not i have sleep apena and whether i should go and have it tested for? During the day i definitely urinate more often than all my friends, this is most noticable when we engage in drinking alcohol, especially at the start. I've always put that down to me just being me though, and i do try to drink water regularly so that probably contributes. I can't remember the last time I've woken up in the night, to pee or otherwise, i always seem to sleep right through, but sometimes in the morning i wake up on sunrise needing to pee, i go do that then go back to sleep after. I do suffer from chronic fatigue and anxiety even though i get a lot of sleep each night, but i am also a mouth breather and am going to buy some nostril dialators and saline spray and try to switch over to nose breathing. Do you think i possibly have sleep apena? and if so should i try and sort out the mouth breathing during sleep and see if the chronic fatigue goes away before i look into the sleep apena? Im going to see an ENT doctor next week to get him to diagnose my nose congestion efforts in an attempt to switch to mouth breathing during sleep so is he able to evaluate possible sleep apena and upper airway resistance syndrome aswell? thanks.

Igre010,

You're on the right path. It's good that you're taking care of your nasal congestion first. Then see how you feel.

Conceptually, one thing that's important to point out is that nasal congestion does not cause sleep-breathing problems. Rather, sleep-breathing problems, due to the anatomy, causes nasal congestion. Usually, the narrowing is not just in your nose. Regardless, the first thing to do is to optimize your nasal breathing, and then reassess your sleep-breathing status. If you're found to have sleep apnea, then being able to breathe through your nose should help you with your treatment. Good luck.

I dream all night and can wake up go to the bathroom, return to bed and pick up the same dream. I never feel rested. How can I alleviate the dreaming or is this possible?

I am in my early thirties (female), and have been have sleeping problem for some time. I normally hit the bed around 11 or 12pm. Though, everyday around 3 - 4pm I would wake up once for urine. This has been happening for almost one month now. Once I wake up i take me a while to doze off back. During the day, I do think i that I frequently urine. Every time I consume liquid, within minutes I have to go urine. Just because of this have been not taking too much liquid.

I do take liquid at times, maybe 1 hour before sleep.

I do not take any other form of medication and do take coffees at time during the day.

Hi Steven, i had this problem quite a few times ... i dreamt of urinating in my dream and in reality , i am too ... am i sick?

I'm 44 yr over weight F and find myself getting up 2 sometimes 3 times a night to go to the bathroom, the trips are usually every two hours. I often dream of being in the bathroom and emptying my bladder to just wake up and find myself in need of a diaper. My husband says I snore, could this be due to sleep apnea?

Justwonderingwhy,

Yes.

Dr. Park

I am a young male 29 yo. I have gone to 3 urologists for frequent urination throughout the day which started all of a sudden one day 4 mnths ago. I also started to notice I get up every so often at least 1, 2 or 3 times a night to urinate. The urologists that have seen me have said I have a form of prostatitis, but I have had no pain at all. Also I have no problems with flow since I go a normal amount. The final urologist who specializes in neurobladders also said that I do not have a neuro problem but its most likely related foods or what I drink. Could this be sleep apnea related? I know I am a big time mouth breather and snorer.

Dear Dr. Park, I am a 56 year old female, and for the past 3 years, I can't sleep any longer than 2 to 3 hours and wake up to urinate! I'm also a MMT patient, as well as my pain issues. Today, I had to have my husband stop & I had to empty my bladder at a closed rest stop! Humilated, embarressed, I just wanted to cry. Saw a urologist in 1990, he said he could find nothing, gave me ditropan. I don't have a bladder infection, I am prone to yeast infections, since age 53.
Any help would be greatly appreciated. Don't have $$ just to have tests run, no insurance & no job. I have a pain in my left backside by my kidney's?
trying2live4me4myguy

Frequent nighttime urination IS mainly caused by bacteria , maybe you can try to use the Diuretic and Anti-inflammatory Pill , it can kill all kinds of bacteria, viruses, pathogens, thus clearing heat, detoxicating, discharge of pus, sterilizing, absolutely diminishing inflammation. After 3 days treatment, obvious effect will be visible. or you can take some antibiotics .

I am a 37 yr m. Have a open wound, left metatorso amputee. I get up 5 to 6 times a night to urinate. And still i have an accident. I snore loudly and i cant sleep on my back... i am also taking pain and blood pressure meds..can you point me in the right direction??

I have a 9 yr old son who both snores and wets the bed.....what could be a cause?

i am 30 female , and was recently diagnosed with sleep apnea...i stopped breathing in my sleep and it made me use the bathroom 2-3 times a night, it soon tuned into me peeing on myself trying to make it to the restroom or wetting myself in the bed and i too could never sleep on my back either, without feeling like i was choking every few minutes.... i had no idea my bladder problem was due to my sleep apnea, i thought it had to do more with my weight, but when i was doing my sleep study i was using a cpap machine and the urge to go to the restroom at night was gone, some of my other symtoms of sleep apnea were, dry mouth and throat, i was tired all the time, even began taking naps in the middle of the day, and started to nap while watching t.v., which are things that have never been in my character, my question is, i get why now from reading the other post on this page why i had to urinate, but why did it get to the point that i couldnt hold it?

I am a 44 yr old male.Good health overall.About 3 mnths ago i went to urinate and felt i had to push.Within the next week i started having frequent urinations and strange feelings in my penis.I also started feeling spacey(brain fog).The doctor says it prostatitis but the brain fog is so depressing.Leading up to getting prostatatis I had been getting up about 3 times to urinate in the night anyway.Can this all be caused by bad sleep?

I am a 64 year old male. Generally in good health but was diagnosed with benign prostate hyperlasia a few years ago. Interestingly the prostate is not very much enlarged. However, I have to urinate very frequently at night -- 4 or 5 times in 6 hours. I am also very dorwsy during the day, often falling asleep at my computer or during meetings (much to my extreme embarassment). I'm scheduled for a sleep study later this year but I was concerned that the frequent bathroom breaks would make the whole thing pointless, aside from the inconvenience and embarssment of having to call the technician to disconnet me every time I have to pee. So I was very interested to learn that frequent urination and sleep apnea are sometimes connected. Despite the inconvenience I look forward to the results of the study. I've tried various medications to help with the drowsiness (caffeine, of course, and most recently modafinil) with no success. (The modafinil was especially disappointing since I had read about what a dramatic beneficial impact it had on most users in boosting wakefulness and increased focus; for me it had only negative side effects and no effect whatever on my daytime drowsiness or lack of focus.)

I am a 74 year old male. Active workout one hour plus daily and generally in good health.
Have had problems with over tiredness and excess urination both night and daytime with extreme urgency.
Have completed a sleep study and was diagnosed with mild sleep apnea and got a c-pap machine.
This did not help with either tiredness or urination so the sleep Dr prescribed Modafinal in conjunction with the C-Pap. So far no identifiable progress.
My eurologist recommended a TURP which was done a week ago Monday. So far all symptoms are worse, but to be expected at this stage.
Found your article quite interesting and wonder how my situation might might relate to your experience?

I'm a 48 yr old woman who gets up 3 to 5 times a nigh!! I think I'm actually sure I snore. And I'm super tired by mid morning and want to crawl h see my desk because my sleep gets disrupted so many times throughout the night! What can I do or what do you think?

I am a 69 year old female. I have sleep apnea and am being treated for it and I am also on medication for my leaking bladder. However I am still up 2 and 3 times a night to go to the bathroom. I also have night sweats just as often. What would your advice to me be. I am also tired a lot. Tired of getting up at night carousels19973



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Sleep Apnea and Nighttime Urination

Sleep Apnea

overactive bladder

prostate hypertrophy

nighttime urination