While sleep apnea and overactive bladder (OAB) are two conditions that may appear as different health conditions, recent research suggests a connection between them.

The need to wake up during the night to urinate links both sleep apnea and OAB by disrupting the natural sleep cycle.

This article explores the relationship between sleep apnea and overactive bladder, shedding light on their causes and offering insights into managing both conditions simultaneously.

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The connection between sleep apnea and overactive bladder lies in their shared association with disrupted sleep patterns resulting from the need to get up to urinate.

Sleep apnea is a sleep disorder characterized by recurrent pauses in breathing during sleep, accompanied by loud snoring and gasping for air. These breathing interruptions can last for seconds to minutes and occur multiple times while sleeping, leading to low levels of oxygen and poor-quality sleep.

A 2018 study highlights the relationship between sleep apnea and urologic dysfunctions, which researchers also commonly see in OAB.

On the other hand, OAB includes symptoms, such as nocturia, a urinary condition characterized by a sudden and uncontrollable urge to urinate, often leading to frequent awakenings to use the bathroom. The urgency and frequency of urination can disrupt sleep continuity, resulting in reduced sleep quality and duration.

Nocturia occurs in approximately 50% of people with obstructive sleep apnea (OSA). This is because sleep apnea affects a hormone in the body known as atrial natriuretic peptide (ANP), which causes the body to produce more urine while sleeping.

This shared pattern of sleep disruption can have a profound impact on an individual’s overall health and well-being.

What is sleep apnea?

Sleep apnea occurs in three main forms:

  • Obstructive sleep apnea (OSA): This is a common form of sleep apnea characterized by the temporary relaxation or collapse of the throat muscles during sleep, leading to partial or complete obstruction of the airway. As a result, a person’s breathing becomes shallow or stops altogether until their brain signals them to awaken and resume standard breathing.
  • Central sleep apnea (CSA): This is a less common form of sleep apnea, affecting less than 1% of adults. It involves a failure of the brain to transmit the proper signals to the muscles responsible for breathing. Unlike OSA, there is no physical obstruction of the airway in CSA. Instead, the brain momentarily fails to initiate breathing, causing pauses in respiration.
  • Complex sleep apnea: This is a type of sleep apnea that combines OSA and CSA. It occurs when a person is using a treatment for OSA called continuous positive airway pressure (CPAP) therapy. As a result of the treatment, they start experiencing CSA. Sleep apnea can lead to a range of health problems, including cardiovascular issues, daytime fatigue, cognitive impairment, and mood disturbances.

Learn more about the types of sleep apnea.

What is overactive bladder?

An overactive bladder (OAB) is a urinary condition characterized by a sudden and uncontrollable urge to urinate, often accompanied by symptoms, such as nocturia.

A person with OAB may also experience urinary incontinence, which is the involuntary loss of urine. The exact cause of OAB is not always clear, but it involves a combination of factors, including bladder muscle dysfunction and nerve signaling abnormalities.

Learn more about OAB.

While an overactive bladder does not directly cause sleep apnea, it can significantly contribute to sleep disruption, making sleep apnea symptoms worsen in individuals who already have the condition.

The frequent need to wake up to urinate can lead to a cycle of sleep deprivation and exacerbate the symptoms of sleep apnea. This interaction between OAB and sleep apnea highlights the importance of addressing both conditions for improved overall health and sleep quality.

Some of the causes of sleep apnea may include:

  • Obesity: Excess weight, particularly around the neck, can lead to airway obstruction, increasing the risk of OSA.
  • Age: Sleep apnea becomes more common as people get older.
  • Gender: Men are more likely to develop sleep apnea than women, although the risk for women increases after menopause.
  • Smoking and alcohol: Both smoking and excessive alcohol consumption can relax throat muscles, contributing to airway obstruction.
  • Medical conditions: There is a link between conditions, such as hypertension, diabetes, and congestive heart failure, and an increase in the risk of sleep apnea.

Some of the causes of an overactive bladder may include:

Given the connection between sleep apnea and OAB through disrupted sleep patterns, addressing both conditions can be crucial for improving a person’s overall quality of life.

Here are some strategies for managing both conditions simultaneously:

  • CPAP therapy: CPAP is the primary treatment for obstructive sleep apnea. It involves using a machine that delivers a continuous stream of air pressure that keeps the airway open during sleep. It may also be effective for individuals with OAB.
  • Lifestyle modifications: Adopting a healthy lifestyle can benefit both conditions. Maintaining a moderate weight, getting regular exercise, and avoiding alcohol and caffeine before bedtime can help manage both sleep apnea and OAB.
  • Behavioral therapies: Behavioral therapies, such as bladder training and pelvic floor exercises, can help individuals with OAB regain better control of their urinary function.
  • Medications: Depending on the severity of symptoms, a doctor can prescribe medications for both conditions. For OAB, medications, such as fesoterodine, can be effective. For sleep apnea, medication use may be in conjunction with CPAP therapy.
  • Surgery: In people with severe cases of sleep apnea or OAB, who do not respond to other treatments, a doctor may consider surgical interventions. Surgical options for sleep apnea include uvulopalatopharyngoplasty (UPPP) or mandibular advancement devices. Surgical procedures for OAB include electrical stimulation or bladder augmentation.
  • Consultation with doctors: Seeking guidance from healthcare professionals, such as a urologist or a sleep specialist, is essential for an accurate diagnosis and comprehensive treatment plan tailored to individual needs.

Sleep apnea and overactive bladder may seem unrelated at first glance, but their connection becomes apparent when considering the impact and causes of disrupted sleep patterns. Sleep apnea can lead to fragmented sleep, contributing to increased symptoms of an overactive bladder. Additionally, frequently waking up due to an overactive bladder can worsen sleep apnea symptoms. Recognizing this connection between both conditions can be crucial for individuals seeking to manage both conditions effectively.

Treatment approaches that address both sleep apnea and OAB can include CPAP therapy, lifestyle modifications, behavioral therapies, medications, and for some people, surgery. Seeking guidance from healthcare professionals is essential to develop a tailored treatment plan that can improve sleep quality and overall well-being. By addressing both conditions, individuals can enjoy better sleep and a higher quality of life.