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Why am I getting frequent urination and drop in SpO2 numbers during sleep? Is this related to heart issues?

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Question regarding drop in SpO2 numbers during sleep or even when being awake and laying down flat. I use a pulse oximeter and have noticed that the SpO2 numbers flactuate (from what i've noticed so far between 95%-89% during sleep). When awake...and standing the SpO2 is usually around 96%....the laying down awake numbers could go as low as 91% from what i've noticed so far. I do not know how long i stay at each SpO2 level during sleep...but i do know i wake up breathless and with a high heart rate when i see SpO2 numbers on the lower end as mentioned above. Furthermore i have noticed more frequent uritation at night. Also as i try to sleep and during sleep my heart rate is around 90bpm. Aslo i find it more diificult to sleep now as i am affraid of these episodes. When i wake up breathless it can shoot up to over 130bpm for a while. I have to stand up and calm myself to recover from these episodes. For the past while i've also been hyperventilating more while awake and during sleep. I would appreciate some explanation as to why the SpO2 numbers drop in this fashion during sleep? I wonder if this is anxiety, hyperventilation, arrythmia, apnea or there could be another issue (problem with diaphragm, problem with oxygen transfer/binding, or another type of heart problem...i,ve been told that frequent urination and problems with SpO2 levels when laying flat could be indicative of heart issues? is this true? Thank you
Posted Sat, 3 Nov 2012 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 3 hours later
A straight answer, from above information would be difficult.
Anxiety is less likely here - anxiety settles down when you sleep. A problem like this adds to anxiety and a vicious cycle may set in
The syndrome of hyperventilation also occurs when awake

It could be from heart - 'orthopnoea' is breathless more when lying down / better on sitting up / wakes one from sleep / it is because fluid from dependent areas, that could not drain against gravity, are mobilised when lying down, overloads a weak heart - sign of heart failure.
It could be the lung - Obstructive Sleep Apnoea. Cor Pulmonale, marked obesity and some cases of upper respiratory obstruction (like huge adenoids) cause this.
Diaphragm too could contribute or cause - it moves up in position and its movements are less
There are a few others - like reflux that can contribute

It needs more assessment for further assistance / more than one speciality is involved.
Starting point generally is cardiology / apart from importance, it is easier to exclude in many cases as an ECG, ECHOcardiogram and X-ray chest with basic blood tests are necessary. There are more in the pipeline - in case of doubt or positive pointers - example 24 to 48 hours ambulatory monitoring (Holter) can show hidden arrhythmia
Pulmonologist comes to the picture simultaneously. A spirometry tests your lung function/ There are facilities to test gas transfer and so on. We'd also like to test you at sleep laboratories - to monitor and document many parameters
You have not mentioned your weight - Obese? / your habits - smoking? / other diseases - diabetes or hypertension? / family history, past illness if any /
For further assistance, you need further assessment and a physical examination by your internist with specialist examination and investigations.

Take care
Good luck
Above answer was peer-reviewed by
Follow-up: Why am I getting frequent urination and drop in SpO2 numbers during sleep? Is this related to heart issues? 56 minutes later
Dr. Anantharamakrishnan:

Thank you so much for your response!!!! I am not a doctor...but I am reading a lot on this health issue...the heart is very suspicious to me also. I was in the emergency yesterday here in Toronto, Canada. I was taken by ambulance. They took chest x-rays, did an ECG and blood work. All was normal. About 5 months ago I had two stress tests of which one was a stress echo. The first test showed ST segment it was repeated with a stress echo later..the second stress echo was normal. A month later another stress echo was done again normal and aan event monitor gave normal results....Doctor please let me know if after all this Congestive Heart Failure is still a possibility? Is it possissible what I am experiencing during sleep now Cheyne-Strokes Respiration?
Is somerthing being missed here? I would respect your opinion GREATLY!!
This problem started for me last March...after some type of chest virus felt like my lungs were not the same again.....could it be possible that the virus affected the heart and things are now showing up? Your explanation about fluid build up in the vertical position....would explain the SpO2 numbers coming down in the vertical possition?

Toronto, Canada

Ps. There is some obiity around my waste, cholesterol is around 6, and unfortunately my lifestyle did not include too much exercise after the age of 25. After that it included a very stressful marriage.
Answered by Dr. Anantharamakrishnan 1 hour later

The following is mostly answers to your queries - one by one... with some add on here and there...
It appears from these investigations that Congestive Heart Failure is very unlikely. There can be false positives in stress EKG. An option better than stress ECHO will be thallium stress EKG – more to exclude than to enroll – provides peace of mind for the patient and the physician. The total picture does not favor heart disease at all. Worrying about heart disease could be worse than heart disease...
Cheyne-Stokes is from respiratory depression and is also less likely – there is no obvious cause. Have you seen a lung specialist yet? – You should.
That a virus infection could have caused and initiated the events is a possibility – but not common.
Yes – upright posture reduces venous return and will reduce fluid in lungs –saturation improves...
‘Some obesity and cholesterol around 6’ have no direct and immediate relation to your state – they have only long term implications and can easily be controlled.
Discuss directly with your doctor in person – is it not better than books and browsing? Face to face will fare better than Facebook! You are spared the problem of uncensored or unprofessional information...
No need to worry what was before – now is the time – you can change your life style and start exercising
You are not the only one with stressful marriage, nor is it new! – Did not Socrates have? Be positive! One can get another spouse! Some get even the old one back!! – But you cannot get back even one second that has passed. Enjoy every moment. Try to be happy and try to make others happy.
A psychiatrist can help – seeing a psychiatrist does not mean one is suffering from psychiatric problem... it could as well be to rule out – as ruling in! He can guide / refer to a psychologist for counseling, in case of need
In summary – heart disease is unlikely / Lung is possibility / anxiety can supplement or even supplant

Hope I have been of some help...

Good luck
Above answer was peer-reviewed by
Follow-up: Why am I getting frequent urination and drop in SpO2 numbers during sleep? Is this related to heart issues? 7 hours later

Thank you for yor response!!!....I will follow your advice...I suppose the "massive" hyperventilation during the night and the recent apneas "got me going".
If there is nothing wrong with my heart....than refocusing on life needs to happen for sure.....with plenty of exercise. Yes...i read a lot and I think a lot...maybe too much at times...but its my nature:))...but anybody going through these experiences...would probably do the same.

Why hyperventilate so much during sleep if hyperventilation is a day thing? If you are not fimiliar with the work of the late Russian Professor/MD Dr. Konstantine is worth a look..he answers some "massive questions"...some western doctors don't like to explore for some reason..perhaps they are not aware...other people say that he was at least 200 years ahead of his time. I have copy of his lecture that he delivered at Moscow State University in 1969..infront of the Soviet elite at the time...behind closed doors.....I find it astounding that many people of "science" can "somehow ignore" the work of a man that spend 40 years of his life doing first class research. If you'd like a copy of his lecture....I would be more than happy to send you one....even just to get your opinion...just let me know where to send it.

I appreciate your philosophy regarding true!!! I do try to take time now to "smell the roses"...something that i ddidnt do too much before. Yes,,, Socrates had a bad marriage(I am of Greek background and i remember this from my teacher back in Greece). At one of his students came by his house to pick him up for philosophy class....his wife being against all this....started yelling at him and and threw a backet of water all over him....Socrates turned to the student and said something like..."You see son....first came the thunder...than came the rain" :))

Thank you so much for your help, XXXXXXX

P.S. I can tell from this short interaction that you are a great human being and a
brilliant doctor!!!!

Anyway...again thank you for your response again
Answered by Dr. Anantharamakrishnan 14 minutes later
Dear friend

Thank you for the great compliment!

It has been my approach and basis of my medical practice for the last four and half decades...
The best compliment we expect from our clients (Is not the word 'client' better than the word 'patient'?) is the news that they are well and back in full swing

God bless you... Do not forget to close this discussion if all your queries are addressed. I will be available on this forum ( WWW.WWWW.WW if you wish to contact me in future.

Good luck!!!
Above answer was peer-reviewed by
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