Dr. Roach: Those with sleep apnea might need to urinate more than others

Key Points:

• Obstructive sleep apnea (OSA) can cause frequent nighttime urination due to increased secretion of atrial natriuretic peptide (ANP), which promotes kidney excretion of salt and water when the heart is stressed by apnea events.
• The negative chest pressure from trying to breathe against a closed airway in OSA leads to atrial stretching and ANP release, causing increased urine production at night.
• Effective treatment of OSA, such as using a CPAP machine, can reduce or eliminate frequent nighttime urination by stabilizing breathing and reducing heart stress.
• Asymptomatic urinary tract infections (UTIs), especially in elderly patients, generally should not be treated with antibiotics because the risks, including allergic reactions and dangerous infections like C. difficile, outweigh potential benefits.
• Urine testing for infection is not recommended in people without symptoms unless under specific conditions like recent kidney transplant, pregnancy, or before urological procedures.