Many doctors unaware the sleep disorder boosts urine production, experts say

“When you ask people about symptoms like snoring and gasping, they tend to say, ‘No, I don’t have them’,” said study author Edward Romero, research coordinator at the Sleep & Human Health Institute in Albuquerque, N.M. “But it’s very easy for them to realize that they wake up at night to go to the bathroom.”

SUNDAY, Nov. 29 (HealthDay News) — People who wake up during the night to urinate shouldn’t automatically blame a urological problem. Sleep apnea, a breathing-related sleep disorder, could be the cause.

A new study suggests that nighttime urination, or nocturia, is comparable to loud snoring as a marker for obstructive sleep apnea, a disorder in which soft tissue in the throat blocks the flow of air into the lungs, disrupting sleep.

Previous studies established a link between nocturia and sleep apnea, a potentially serious condition that affects about 25 percent of U.S. men and 10 percent of U.S. women, the researchers said. But they believe this is among the first to show that screening for nocturia could help doctors identify patients with apnea.

Because in the patient’s earlier split night study, in which this individual suffered from raging and life-threatening sleep apnea, the patient could only sleep for 87 minutes before we needed to switch over to PAP therapy, after having witnessed more than 100 apneas as well as repetitive oxygen desaturations below 60%.

The DME company claimed that Medicare would not cover the cost of the patient’s PAP device, because the individual needed 120 minutes of sleep to confirm the diagnosis of…did I mention it was raging life-threatening sleep apnea…

So, in the infinite wisdom of Medicare, an institution that imagines that sleep doctors don’t actually know what’s best for their patients, we were obliged to have the patient spend another night in the lab to confirm the diagnosis, because on the first night (split-night) we made the egregious mistake of being overly concerned with treating our patient for a serious medical condition and having enough time to complete a superior titration.

There ought to be a law!

I too was one of those individuals that just couldn’t imagine putting yet another contraption around my face or head, yet once I effectively placed the chinstrap and obtained a much better clinical response, I was very grateful that so many different styles of chinstraps were on the market.

The biggest barrier to the use of the chinstrap, I believe, is psychological comfort, because when you first use one, it really feels confining. But, I think this physical sensation actually translates into a psychological feeling of discomfort, which is the more difficult sensation to overcome.

Currently, I use the Respironics Premium Chinstrap, which I personally believe is the best on the market for two reasons. First, it uses a behind the head strap to leverage the chinstrap in a snug but not too tight manner. Second, because of this design, the chinstrap component that goes under the chin and up over the head actually exerts force in a vertical fashion to pull the chin up. Whereas, you can find many chinstraps that are designed in a more compact way, these straps exert force on the chin in two directions, up and backward. This backward force occurs because the chinstrap imaterial runs in a diagonal from the chin towards the top portion of the back of the head. You can actually feel that it’s tugging your jaw backwards, which theoretically could worsen your breathing.

In sum, never sell short the potential value of a chinstrap in your efforts to achieve a great response to PAP therapy. If you awaken in the morning with a dry mouth, chances are high you need one.