Frank in Florida
thank you for the insight that Sleep Disordered Breathing (SDB) elevates the level of a peptide that prevents slowing of urine flow from the kidneys such as is supposed to occur during sleep and as a result it is possible to eliminate some forms of nocturia by using a CPAP machine to eliminate the peptide’s elevation , the urine flow and so the SDB.
Was it by experimenting at home with a CPAP machine you were able to determine which pressures did the trick – in which case may others of us perhaps have a fighting chance of doing the same? (I say ‘fighting chance’ as I see from your ‘bio’ you are a retired physician and so would inevitably I imagine have brought to bear on any such pressure determination ‘at home’ your training and experience.)
Or is such pressure determination on one’s own impossible in principle and instead one of necessity relies on the most advanced of sleep clinics and its staff if one is to arrive at the pressures that effect a cure of the SDB / nocturia and hence elimination of the elevated levels of the peptide and so arrival at the holy grail of 9 hours unbroken sleep - 9 hours that presently take me 14 hours, woken as I am every 1.5 to 2.5 hours to pass (up to) 500ml and it then taking time to get back to sleep? (I note there was never sufficient noise to trigger a very sensitive Voice Activated Tape Recorder I set running each night over several weeks back in the 80s – whereas had there been OSA I understand there would have been ample noise to trigger it into recording - so I conclude my SDB is caused by Central rather than Obstructve Sleep Apnoea.) (I conclude that there is CSA from there being, on my waking the penultimate time each morning, perfectly peacefully (peacefully in the sense of low heart rate and no particular urge to breathe, and certainly no struggle to breathe) a thunderous ‘diving reflex’ (explosive elevation in heart rate) after I decide, three or four seconds after regaining consciousness amidst all this peace and quiet, that I might as well take a breath (such a diving reflex requiring that there have been a prolonged failure to breathe in the period preceding that first breath (or so I was advised by a Consultant at Oxford University’s John Radcliffe Hospital whom I bankrupted myself spending an hour questioning one Friday afternoon in the mid 90s, which I mention because of the following tale about
Sir John Radcliffe. He was Royal Physician to King William 3rd, a King of England Scotland and Ireland. Sir John liked his sleep. Summoned to the Palace in the wee hours to advise the King on the King’s spindly legs he gave his verdict as he departed: 'I would not have your Majesty's two legs for your three kingdoms.' the offended King thereafter mortifying the temptation to disturb his physician’s sleep.)
I would also be most grateful for any recommendation for make of CPAP machine.
Frank in Florida said...
Incidentally, there are many other causes of nocturia. I have sleep-disordered breathing, related to obstructive sleep apnea (OSA), and that is the major cause of my nocturia. I am on CPAP and only need 6 cm H20 pressure to fix my breathing, but need 8 cm to get rid of the nocturia. The mechanism is atrial natriuretic peptide which is elevated by OSA and reduced by using CPAP. In BPH you tend to have multiple small voids during the night, due to incomplete emptying of the bladder. In OSA you tend to have multiple large voids because the urine flow from the kidneys doesn't slow during sleep like it is supposed to. If you are suspicious you might have SDB or OSA, Google them and try to figure it out. In my case, I started with SDB, BPH, and mild interstitial cyctitis which was very confusing, but they are all now under adequate, not perfect, control. BPH was actually the easiest to take care of, at least for me.