Waking Up to Pee once a night

[SleepyGuy001]

I'm a 44-year-old male who started CPAP therapy in February 2024. I'm experiencing a consistent issue where I wake up once a night, about 6 hours into my sleep, to urinate. After this, I struggle to fall back asleep. I'm trying to determine if this is age-related or if I need to adjust my Airsense 11 settings.

To manage this, I've already implemented the following:

- Restricting all liquid intake after 8 PM

- Avoiding alcohol completely

- Limiting caffeine to one cup of coffee in the morning (6-7 AM)

- Maintaining a consistent bedtime of 11 PM

My goal is to achieve 7-8 hours of uninterrupted sleep. Has anyone experienced similar issues or have insights on how to improve sleep continuity with CPAP therapy? Below is lastnight's OSCAR data.

Any tips or advice would be greatly appreciated!

[Pugsy]

When you wake up is your bladder painfully full so you need to go pee or is it more of a wake up where you say to yourself I might as well go pee?

There's nothing really exciting pointing to sub optimal therapy that I can see on this report.

It's normal to wake a few times each night even without OSA being in the mix.
Like did you know it was normal to wake after the completion of each REM stage sleep cycle?
Normally we don't wake up totally and we just rollover and go back to sleep but sometimes we just can't go right back to sleep and when that happens we remember being fully awake.

Do you have to go pee frequently during the day?

[zonker]

I've been on cpap for 9 years and I still get up once per night to pee. as pugsy says, it's either that you just HAVE to go or that you're awake and figure may as well.

the latter is what happens with me. but I'm retired and not worried about having to wake up the next day. I usually get back to sleep fairly quickly.

but that's just me.

[lazarus]

Once per night is generally not even considered an issue by sleep pros, as I understand it:

"Nocturia is diagnosed when you are regularly waking to pee more than once per night. . . . The symptoms of nocturia are waking up more than once per night to pee on a regular basis." (Italics added by me.)
--https://sleepeducation.org/sleep-disorders/nocturia/

---

not worried about having to wake up the next day.

It is my preference that you do, though.

Just sayin'.

[zonker]

not worried about having to wake up the next day.

It is my preference that you do, though.

Just sayin'.

if I don't wake up the day AFTER that, on the other hand....

[Conrad]

I'm abnormal, there I said it.

Every night, right before bed, I drink a big glass of ice water. If I don't, I'm VERY dry during the night. Yes, I do use the CPAP humidifier and XyliMelts as well. 99% of the time I don't have to get up overnight to urinate.

To further add to my strangeness, if I have a few adult beverages in the afternoon/evening, my apnea numbers go WAY down, most of the time the numbers are fractional and below one.

I'm not talking about being drunk either. Just a few beers or cocktails while my wife and I play cards or the like.

[ChicagoGranny]

if I have a few adult beverages in the afternoon/evening, my apnea numbers go WAY down,

Smoke a joint in the morning before looking at your numbers. The numbers will always look good.

[Conrad]

if I have a few adult beverages in the afternoon/evening, my apnea numbers go WAY down,

Smoke a joint in the morning before looking at your numbers. The numbers will always look good.

Wake 'n bake? I won't say that I've never done this..

Don't need an entire joint though. With the super high quality of weed available at the dispensaries here in Illinois, one, maybe two hits are all that I need to get a good buzz on. It's also a good sleep aide if needed.

[lazarus]

good sleep aide

Or not:

"Some people think that using marijuana will help them sleep, but research has actually shown that marijuana use is associated with impaired sleep quality,” said Dr. Andrea Matsumura, a sleep medicine physician and spokesperson for the AASM.--https://aasm.org/marijuana-use-leads-to ... the%20AASM.

And:

"A scoping review published in the Journal of Clinical Sleep Medicine reported that while 21% of studies have shown improvements in sleep with cannabis products, 48% reported worsening sleep, 14% reported mixed results, and 17% showed no impact at all. Open-label trials of cannabis have shown no improvement in sleep quality over three months. Large epidemiological studies of patients reporting regular use of cannabis for medical reasons have shown that cannabis products are associated with increased middle-of-the-night awakenings, and regular cannabis users report substantially increased or decreased total sleep duration as compared to non-users."--https://aasm.org/viewpoints-cannabis-an ... d-to-know/

[Pugsy]

Or not:

A scoping review published in the Journal of Clinical Sleep Medicine reported that while 21% of studies have shown improvements in sleep with cannabis products,

Well.....it might not be perfect but if you are one of the 21% they talk about then that's pretty important and not to be discounted as total crap.

I am one of that 21%. No, not perfect but a helluva lot better than nothing when the docs won't give you pain meds for the night time pain waking you up all night long.

[ChicagoGranny]

a helluva lot better than nothing when the docs won't give you pain meds for the night time pain waking you up all night long

+1

[lazarus]

I believe that statement may be about 21% of the studies looked at, not necessarily 21% of the people. But either way, point taken. People gotta do what people gotta do. No doubt.

Nevertheless, the things people may do that counterintuitively they may be unaware can further hurt their sleep quality are, in my opinion, always worth pointing out the scientific consensus on in the sleep/PAP forums.

[robysue1]

Or not:

A scoping review published in the Journal of Clinical Sleep Medicine reported that while 21% of studies have shown improvements in sleep with cannabis products,

Well.....it might not be perfect but if you are one of the 21% they talk about then that's pretty important and not to be discounted as total crap.

I am one of that 21%. No, not perfect but a helluva lot better than nothing when the docs won't give you pain meds for the night time pain waking you up all night long.

Without knowing anything about how the studies were set up, it's hard to interpret statistical stuff that seems to contradict itself.

Could well be that in the studies where cannabis had a negative affect on sleep had very few people dealing with chronic pain issues. And it could be that in the studies that showed improvement? Maybe there were a greater number than average of people dealing with chronic pain issues.

In other words, in your case the cannabis may be helping your sleep indirectly by addressing the pain issue directly. After all, we all know that when you're in pain, it's difficult to get a decent night's sleep. And cannabis has been shown to be effective at relieving some people's intractable pain.

[lazarus]

All research is incomplete. All medicine involves compromise. Choices differ. Understandably so. Especially when it comes to sleep and questions of quantity versus quality. But knowledge beyond the anecdotal is power.

Or not.

It certainly seems to help some with chronic pain, with PTSD, or with RLS:

https://www.sleepfoundation.org/sleep-a ... -and-sleep

On the other hand, peeing is generally good and recommended by experts for most everyone!

(Feeble attempt to retouch on thread topic. )

[Pugsy]

My goal is to achieve 7-8 hours of uninterrupted sleep. Has anyone experienced similar issues or have insights on how to improve sleep continuity with CPAP therapy

You want to close your eyes and go to sleep and sleep soundly for 7-8 hours with no awakenings at all during those hours???
Is that correct?

That's really an unrealistic expectation because even people who don't have OSA and don't use cpap will have an occasional normal awakening. Like it is entirely normal to awaken after the completion of a REM stage sleep cycle and since we might have 4 or 5 REM cycles during the night then it is entirely possible to have 4 or 5 awakenings that are entirely normal.
It's not so much the awakening that is the problem as what happens after that awakening that might create a problem.
How long are you awake before you go back to sleep or is that what the problem is....you can't get back to sleep in a timely manner