Nocturia and OSA: Mechanism

Nocturia is a common symptom associated with obstructive sleep apnea. [1]

WHY? Increases in atrial natriuretic peptide (ANP) is thought to be a possible cause for increased nocturnal urine production amongst OSA patients.

Negative intrathoracic pressure swings caused by obstructive events induces myocardium stretch and the release of ANP. Increased levels of ANP leads to increase sodium and water excretion (natriuresis) and urine production.

References

1. Maeda T, Fukunaga K, Nagata H, Haraguchi M, Kikuchi E, Miyajima A, Yamasawa W, Shirahama R, Narita M, Betsuyaku T, Asano K, Oya M. Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms. Can Urol Assoc J. 2016 Jul-Aug;10(7-8):E241-E245.
2. Doyle-McClam M, Shahid MH, Sethi JM, Koo P. Nocturia in Women With Obstructive Sleep Apnea. Am J Lifestyle Med. 2018 Jun 18;15(3):260-268.
3. Fitzgerald MP, Mulligan M, Parthasarathy S. Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment. Am J Obstet Gynecol. 2006 May;194(5):1399-403.