As a guy approaches the age of 50, along with the sudden desire to buy a sports car, he can expect to start hearing some complaints from his prostate.
It’s basically a rite of passage, which is probably why I have so many bleary-eyed men stumble into my office convinced that their prostate is to blame for their frequent night-time trips to the bathroom. Many are shocked when I explain their prostate is fine, but then ask them if they snore.
It may seem like a strange question to ask a guy who comes in for trouble with an overactive bladder, but it’s a question more doctors should be asking. Because frequent overnight urination is often caused by something far more sinister than a swollen prostate… and that’s sleep apnoea.
It’s a connection that far too few doctors make, but if you’re getting up more than twice a night to pee, sleep apnoea could be the cause.
I’ll connect the dots between sleep apnoea and frequent urination in a moment, but first let’s take a quick look at what sleep apnoea actually is.
Sleep apnoea comes with serious dangers
When you ask if they snore, for some reason most people laugh. But it’s far from a laughing matter because sleep apnoea and poor sleep are literally hazardous to your health.
Sleep apnoea is far more than ‘just snoring’. It’s a serious condition that can have life-threatening health consequences. In one 2008 study, published in the journal Sleep, researchers linked the condition to early death.
Sleep apnoea causes you to literally stop breathing for short periods of time over and over again throughout the night. Your body reacts to this emergency by sending out a surge of adrenaline into your bloodstream to jolt you awake so you don’t die.
And while those adrenaline surges save your life they cause other problems.
And it’s not just fatigue that’s a problem. Sleep apnoea has been tied to pretty much every major killer in the industrialised world including high blood pressure, heart failure, atrial fibrillation, stroke, depression, obesity and car accidents. The bottom line is, the worse you sleep the earlier you die.
Those adrenaline surges are also linked to that frequent night-time urination I mentioned earlier.
You see, each surge of adrenaline diverts blood from your heart to your brain and this sudden shift increases production of a hormone called atrial natriuretic peptide (ANP). It’s the ANP that makes your body produce more urine.
Racking up frequent flyer miles
The trouble is, many people who suffer from sleep apnoea have no idea they even have the condition, as a study published in the journal Archives of Internal Medicine illustrates perfectly.
The study was conducted in a sleep lab and a total of 80 patients were eventually observed by researchers. Whenever a subject woke up the researchers recorded what caused the patient to awaken… such as loud snoring or, most often, sleep apnoea. The patient was then asked what he believed had caused him to wake up.
According to the researchers, the vast majority of the volunteers who woke up because of sleep disorders such as apnoea attributed their waking to the pressure to urinate. Only five per cent of the participants correctly identified the real reason they woke up.
Not really a surprise since we’re always asleep when apnoea occurs so it’s easy to not even know it’s happening. And although heavy snoring can accompany sleep apnoea, it doesn’t always, so even those with a spouse may be unaware of the issue.
But since most folks are often able to recall how often they have to drag themselves out of bed for a bathroom run, racking up frequent flyer miles running back and forth to the bathroom night after night can be an important clue to an undiagnosed sleep disorder.
In fact, there’s even been some research done which revealed that asking a patient how many times he urinates a night could be as reliable a predictor of sleep apnoea as some of the other current testing methods used to diagnose the condition.
Suspect sleep apnoea? Try an app
If you suspect you may have sleep apnoea you should make an appointment to see your doctor. But in the meantime, if you want to get a better idea of what your typical
sleeping pattern looks like there are a number of smartphone applications that could help.
These apps record your sleep and wake cycles, highlighting the inefficient or disrupted sleep which could be a sign of a serious sleep disorder. Sharing this information with your doctor may even help him with his diagnosis.
Misdiagnosis can leave you drowsy and drugged
Sleep apnoea is shockingly common, and an estimated 180,000 people in the UK suffer from this dangerous condition. Twenty per cent of adult men and nine per cent of adult women will experience some form of sleep apnoea in their adult life. Yet 80 per cent of those cases go undiagnosed.
And it’s not just the apnoea alone that’s dangerous, misdiagnosis leads to people being prescribed heavy-duty medications that they don’t even need.
In fact, I just recently took one of my own patients off his prostate medication after I successfully treated his sleep apnoea. And he’s far from alone. Countless men end up on prostate shrinking or artery dilating medications they shouldn’t be taking… and saddled with the disturbing side effects that go with them including dizziness, fatigue, impotence, decreased sex drive and even breast growth.
While many women end up on unneeded bladder-drying medications that deliver some serious side effects of their own including dry mouth and severe dizziness that can lead to devastating falls.
Even worse, far too many rushed-doctors respond to a patient’s complaint of ‘trouble sleeping’ by prescribing a sleep drug that not only may mask the problem but could turn a bad situation into a deadly one. The drugs can leave you unable to awaken from the snoring and apnoea.
Putting a stop to sleep apnoea
If you find yourself waking up multiple times a night, if you snore or if you find you get very sleepy during the day, you should ask your doctor about sleep monitoring. Your doctor may recommend an overnight sleep test in a clinic or hospital. Trying to sleep hooked up to a bunch of wires, or in a strange bed isn’t the most comfortable way to spend a night, but it can help firm up a diagnosis.
If you’re diagnosed with sleep apnoea your doctor will most likely want to prescribe a device called a Continuous Positive Air Pressure machine, or CPAP for short. CPAP is a mask that you wear that continuously pushes air through your nose to keep your airway open so you don’t stop breathing. CPAP is very effective. However the mask can be cumbersome and takes some getting used to, and as a result many people stop using them.
A more permanent solution is to lose weight. People who are carrying around some extra pounds are more prone to sleep apnoea, but studies show that shedding the extra weight can help. In a 2000 study, researchers found that for every 10 per cent of weight lost, sleep apnoea decreases an impressive 26 per cent.
While you work on losing the weight, temporary fixes such as an anti-snoring mouth piece from your dentist or Breathe-Right-Nasal strips may help. And since sleep apnoea typically occurs when sleeping on your back, learning to be a side sleeper can help.
Dr. Glenn S. Rothfeld
Nutrition & Healing
Vol. 9, Issue 12, December 2015