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One commonly overlooked cause of nocturia is osmotic diuresis, which occurs when there is excessive sugar in the blood that gets filtered by the kidneys. This leads to increased urine production, especially in diabetics. Other risk factors for nocturia include hypertension, obesity, and obstructive sleep apnea. Sleep apnea can lead to hypoxia, causing a decrease in the parasympathetic nervous system, which controls the bladder's smooth muscle, valves, and nerves. The underlying cause behind sleep apnea, obesity, diabetes, and hypertension is insulin resistance. Making lifestyle changes such as stopping nighttime snacking, practicing intermittent fasting, and reducing carbohydrate intake can help improve insulin resistance and alleviate nocturia.