Been on CPAP for 7 mo's - still have polyuria

[Spongehead]

Hi Everyone!

I've been reading this forum for about a month now and I just want to say you guys are a life saver. :,) I can't figure this out so I wanted to ask the forum:

I've been using CPAP since November. Twice a night I wake up having to go to the bathroom - but not because I feel full like I drank too much water or like when you've been on a road trip and can't find a gas station. Sometimes my heart is beating faster and I need to take my mask off so I can breathe easier.

My ResMed 10 says my AHI is less than 1, so why am I still having these episodes? I am still suffering a lot of brain fog and my driving has become concerning.

Overnight study showed AHI of 6-7. CPAP was set to 10 by DME/Dr. I enabled autopap from 10 - 12; EPAP off. RAMP 15min, pressure = 6.

More background:

Began CPAP (pressure 4 ->14 AUTOPAP) in Feb 2017, had UPP|Septoplasty|Tonsillectomy in June 2017. Follow up overnight study in November showed no change in AHI. Went back to CPAP. Resmed Autoset 10, mask is Amara View.

Thank you in advance,

SpongeHead

[jnk...]

Twice a night I wake up having to go to the bathroom

If there is no feeling of urgency, it may just be that you woke up for some other reason and your body uses that opportunity to have you empty your bladder. Although other bladder issues and conditions such as diabetes and some medications can be factors, it seems most often to be the case for those of with sleep issues that . . .

Some people who have poor sleep and awaken frequently will go to the bathroom whenever they awaken. Typically in these cases, it is not the need to void that awakens them. -- https://my.clevelandclinic.org/health/d ... 0-nocturia

Just sayin'.

Sometimes my heart is beating faster and I need to take my mask off so I can breathe easier.

A racing heart can have many causes, and waking up in a sort of panic can be residual from experiences during your untreated days. But any time someone has to take off a mask to breathe easier, it may, just maybe, be because pressure isn't high enough at that instant. My body overreacted to sleep disturbances for months after I began treatment, since my OSA was particularly severe for a number of years before treatment, although that may not be the same for someone like you with milder OSA, depending.

I am still suffering a lot of brain fog and my driving has become concerning.

That statement, in those exact words, should, in my opinion, be shared with your sleep doc AND your regular doc. We can give you ideas here, but if you believe your safety may be at stake, don't settle with saying those words to us in an Internet forum.

I enabled autopap from 10 - 12; EPAP off. RAMP 15min, pressure = 6.

Using EPR may make you more comfortable and thus less likely to wake up at night. And many here stop using RAMP once they are comfortable with full pressure.

had UPP|Septoplasty|Tonsillectomy in June 2017.

UPPP can sometimes make it difficult for an APAP to discern some snore-like changes in the airway, so you are being smart to keep your minimum APAP pressure up relatively high. But I would not limit the maximum pressure on an APAP unless pressure was running away at too high a pressure, which rarely is an issue with recent APAPs. I keep my maximum all the way up at 20, even though my pressure never gets anywhere near that high. No reason to limit.

Resmed Autoset 10

Great machine, that.

You might get more suggestions and observations if you post screenshots of data from SleepyHead here.

[SewTired]

As mentioned, you may have another cause in ADDITION to sleep apnea. FWIW, I sometimes wake with that fast beating heartbeat and not being able to breathe. That, for me, turned out to be sleeping with my chin against or near my chest. Lots of things can cause you to need to go during the night including increased blood glucose (diabetes), non-symptomatic bladder infection, mild kidney failure, loss of bladder muscle control. I'm also woken up at night by restless legs which, along with the diabetes, are the most likely causes for me getting up once per night. Do run this issue by both your sleep doctor and your primary so that they can look at further causes. You should be past the fogginess by now.

[jnk...]

. . . non-symptomatic bladder infection . . .

Good point.

Or an irritated bladder.

Sometimes people drink less fluid to try to keep from having to go as often, and the higher concentration of the urine ends up irritating the bladder further, making things worse. Counter-intuitively, drinking more water throughout the day to keep the urine clear can, over time, lessen irritation and correct some bladder issues.

[prodigyplace]

. . . non-symptomatic bladder infection . . .

Good point.

Or an irritated bladder.

Sometimes people drink less fluid to try to keep from having to go as often, and the higher concentration of the urine ends up irritating the bladder further, making things worse. Counter-intuitively, drinking more water throughout the day to keep the urine clear can, over time, lessen irritation and correct some bladder issues.

If male, prostate issues are also a possibility.

[Rubyslipperss]

I have had to get up at night for as long as I can remember. Doctor told me I have a small bladder and it is “tipped “ so it doesn’t empty right. Perhaps you may have something similar.

[yourbrokenoven]

I started having urinary frequency when I started using my machine. I started having to get up at least twice during the night to pee. Symptoms only went away in the last year. I'm back to going to the bathroom just before bed and then again when I wake up in the morning.

I mentioned urinary frequency at every doctor visit and it was indicated this was normal, though I don't remember exactly what was said.

[chunkyfrog]

I started having urinary frequency when I started using my machine. I started having to get up at least twice during the night to pee. Symptoms only went away in the last year. I'm back to going to the bathroom just before bed and then again when I wake up in the morning.

I mentioned urinary frequency at every doctor visit and it was indicated this was normal, though I don't remember exactly what was said.

Exactly the OPPOSITE of most people's experience, ybo.
You would be the exception to how things REALLY work.

[yourbrokenoven]

Yeah, I've been pointing out to my doctor creatures that I have felt less rested than before being diagnosed, and that I'm always drowsy, especially in the evening, etc. I even switched doctors because I thought I wasn't being listened to.

[GreenBean]

Have you been back to the ENT who did your surgery? Has he/she ordered a post-op CT? The surgery may not have given optimal results or possibly had some complications. Have you used pulse oximeter to check your oxygen levels?

[Spongehead]

Thank you for your counsel, everyone. I apologize for not showing up lately.

I returned to my sleep doc this past monday and she looked over my resmed data. She didn't see anything that caused concern. But did notice I had been changing my settings. And offered me Clonazepam; I turned her down. I did schedule a pulse oximeter test.

I recently had a physical done in March; here's some lab results:

--Diabetic---
Glucose: 86 mg/DL
Hemoglobin A1C: 4.9%
Insulin: 6.6 uIU/mL

--Prostate---
PSA: 0.5

--Kidney--
Creatinine 0.96 mg/dL
Urea Nitrogen (BUN) 16 mg/dL
eGFR 101 mL/mn/1.73m2

Carbon Dioxide: 22 mmol/L

None of these were reported as out of range.

[Spongehead]

Have you been back to the ENT who did your surgery? Has he/she ordered a post-op CT? The surgery may not have given optimal results or possibly had some complications. Have you used pulse oximeter to check your oxygen levels?

I did return in late October. He performed a visual exam and was pleased with what he could see. But I do like the idea of a CT to look a little deeper. I will add this to my list of potential appointments.

I've scheduled an overnight pulse-ox. I hope it gives some clues.

[Spongehead]

I have had to get up at night for as long as I can remember. Doctor told me I have a small bladder and it is “tipped “ so it doesn’t empty right. Perhaps you may have something similar.

You know, it has been different lately when going during the day. My mother has some bladder issues. I'll look into this. Thank you.

SpongeHead

[Spongehead]

I started having urinary frequency when I started using my machine. I started having to get up at least twice during the night to pee. Symptoms only went away in the last year. I'm back to going to the bathroom just before bed and then again when I wake up in the morning.

I mentioned urinary frequency at every doctor visit and it was indicated this was normal, though I don't remember exactly what was said.

Perhaps mine will wear off as well. Its encouraging that maybe this is just a transient thing of getting used to the machine.

Thank you,

SpongeHead

[Spongehead]

I'm not sure what I should post for SleepyHead data, so here's the overview:

...you know now that I'm thinking about it, that minSPO2 reading in Feb does not look good. Minimum = 11?!

Edit: That reading may be a fluke. Gonna look closer.

All ideas welcome. Thank you again,

SpongeHead

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