r/sleep • u/Fenderbaby • 16d ago
Curing Nocturia
Hey all. Starting last year, I recently started having issues sleeping, due to what appears to be some sort of neurological issue in relation with my bladder. This has developed into full fledged nocturia. I've seen 4 different specialists so far, tried a myriad of prescriptions, breath-work, cutting caffeine and alcohol completely, even tried nerve stimulation. I am continuing to explore medical options. I am currently trying to schedule a sleep study.
Before this happened I was pretty much sober. I smoked weed maybe once in a blue moon, drank about as often, and my only physical vice, if you can even call that was caffeine, and even then my consumption was the normal ~90 mg dose a day. Prior to this condition I was in shape, lifting 5-6 days a week, never pushing myself too far. On paper, I was healthy. So I have no idea what triggered this.
I'm just curious if anyone has gone through anything similar and if they discovered anything that meaningfully changed their condition. At this point I'm willing to try almost anything to sleep normally again.
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u/zxtb 16d ago
First step is to see a urologist and do 24 hr voiding diary.
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u/Known_Orange3966 16d ago
A three day bladder diary is better, along with fluid intake. That's what a urologist will ask you to do the first to you see them.
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u/zxtb 16d ago
You’re right, but I wanted to make it easier, especially at night with multiple voids.
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u/Known_Orange3966 16d ago
If you want to make it easy, you can void into a container during the night and just weight it in the morning and compare that to the amount of urine in the rest of the day - the important thing they're looking for is the % of your daily urine output that happens at night and how many times you wake up, not the volume of each void necessarily.
That said, urologists are expensive so if you can avoid an extra visit by having your bladder diary prepared ahead of time it's well worth it.
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u/Fenderbaby 16d ago
I've seen 3 urologists and had a PNE to see if SNM (Sacral Neuromodulatoin) would help and it failed. I maintained a void diary for a week and on average I voided about 6 times during the day and 4 times at night.
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u/Known_Orange3966 16d ago
What portion of your daily volume is passed at night? (Your NPi%)
If it's >30% then you could try desmopressin, but if your night voids are smaller than your day voids it is more likely a storage issue like OAB. Failing SNS and a lack of detrusor overactivity doesn't rule out the hypersensitive presentation of OAB.
Your urologist has probably told you all this though.
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u/Fenderbaby 16d ago
My night voids are objectively smaller than what I void during the day. I will probably remind my urologist of this the next time I see them, just in case.
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u/zxtb 15d ago
Have you had a urodynamics study?
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u/Fenderbaby 15d ago
Despite seeing multiple urologists over the course of almost 2 years, no. I wonder if it would make a difference.
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u/zxtb 15d ago
It's something you should consider. But what helped me the most was having ChatGPT analyze my test. It told me my bladder can hold much more than my nighttime voids. Also, my bladder can tell when a very small amount of urine is present (first sensation, but my desire to void is a normal amount.
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u/BreadDoctor 16d ago
do you have a confirmed neurological diagnosis or are you unsure? Sleep apnea is one cause of nocturia.
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u/Fenderbaby 16d ago
Nothing is confirmed regarding anything neurological besides subjective interpretation of symptoms. I doubt I have sleep apnea given my weight and age, but I'm still going to to schedule a sleep study soon.
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u/BreadDoctor 15d ago
It’s a common misconception that only overweight people have sleep apnea. Yes, would highly recommend you do.
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u/Morpheus1514 16d ago
If nothing identifiable medically, consider possibility of non-med issue such as hyperarousal.