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Nocturnal Polyuria in Type 2 Diabetes: A Symptom of Obstructive Sleep Apnea

School of Nursing and Center for Sleep and Respiratory Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia; 305 Nursing Education Building, 420 Guardian Drive, Philladelphis, PA 19104-6096 echasens{at}nursing.upenn.edu

Mary Q. Umlauf, RN, PhD

School of Nursing

Dennis J. Pillion, PhD

School of Medicine

Judy A. Wells, RN, MSN, GNP, C

University of Alabama at Birmingham

PURPOSE

Polyuria and nocturia in individuals with type 2 diabetes may be due to obstructive sleep apnea (OSA), a recently recognized etiology of excess nighttime urine production. This exploratory study examined the relationships among glucose control, OSA, and nocturnal urine production.

METHODS

A sample of community-dwelling older adults (20 nondiabetic subjects and 10 poorly controlled type 2 diabetes subjects) was recruited based on self-report of nocturia more than twice per night. Participants were monitored on a metabolic research unit for 24 hours to track intake/output, collect blood and urine samples, and conduct an overnight polysomnography sleep study.

RESULTS

None of the subjects had fasting serum glucose levels above the renal threshold. OSA was found in 65% of subjects. Those with moderate/severe OSA had significantly greater overnight urine production than subjects without OSA. Subjects with type 2 diabetes and moderate/severe OSA had the highest nocturnal urine production.

CONCLUSIONS

The high incidence of undetected OSA in subjects with type 2 diabetes with nocturia suggests that nocturia, OSA, and type 2 diabetes frequently coexist and may be interrelated.

The Diabetes Educator, Vol. 28, No. 3, 424-434 (2002)
DOI: 10.1177/014572170202800312


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