Sleep doctor:"Apnea shouldn't make me feel this tired"???

[benz42428]

A few days ago I had my mom visit a doctor in my home country (in Asia) on my behalf to discuss a treatment plan there. I'm doing this because I plan to take a leave from my school in US and since I can't stay here during that time, I have to return home and get a treatment there. This doctor, according to what my mom heard from the hospital staff, is one of the best in my country, so I anticipated quite a lot from him. However, when he read the note describing my conditions (written by me) and the sleep test results, he kinda laughed it off and said that my level of apnea should not make me feel this tired, should not affect my ability to study PhD, and should not have a permanent effect on my brain function. In all, he implied that I don't really need to come back and get a treatment. The only problem is that I do feel tired and I can't really think clearly while I'm doing research. So now, it's either the doctor was being BS or maybe it's a psychological condition in which I become hysterical and feel tired because I think I have a severe apnea. So my question here is if my AHI is 27 without CPAP (and mostly hypopnea), is it true that it is a benign condition that doesn't really affect my daily functions? Also, I wonder if anyone ever heard of a psychological condition or maybe other physical issues that can manifest as sleep apnea? Thank you.

PS. Again I don't know why this is not showing up on my profile but my machine is Resmed S8 Elite II, with pressure of 10. I haven't been able to sleep through a night without yanking the mask off though.

[chunkyfrog]

Let me guess: the "treatment" you seek is a surgical "cure" for apnea.
Lots of luck, if that is the case.
A cure is the holy grail, only real for the faithful, and not yet disillusioned by reality.

[oak]

" I haven't been able to sleep through a night without yanking the mask off though."

How many hours per night are you sleeping with the mask on
Do you have problems with leaks
How many times during the night are you waking up
How long have you been treating with CPAP
Are you rested when you wake up

[benz42428]

" I haven't been able to sleep through a night without yanking the mask off though."

How many hours per night are you sleeping with the mask on
Do you have problems with leaks
How many times during the night are you waking up
How long have you been treating with CPAP
Are you rested when you wake up

-I sleep only 1-2 hours with the mask on, if I do fall asleep.
-I don't really have a problem with leak or maybe I haven't worn it that long to notice.
-I wake up only once a night.
-I got my CPAP 5 years ago, but as I can't really get acclimated to it or haven't tried hard enough, I never have a success in using it. Usually when I use the equipment, I end up not being able to sleep and I wake up really tired. This is probably a stupid reason why I never really tried CPAP for that long, as I could barely go to school whenever I did.
-I'm not really rested. I am not sure if it has something to do with the fact that I sleep for so long and wake up in the afternoon (like 1-2 PM)

To answer Chunkyfrog: I actually would consider any treatment option, surgery or not. The reason I seek a treatment in my home country is because I thought the doctor is more accessible and will see you much more often that in US (not to mention cheap even without the insurance). That applies to CPAP adjustment too. However, the doctor said that there's not really any reason for me to come back here and probably I could continue studying without even using the CPAP...

[tetragon]

As an undergrad with an AHI of 11.4, all hypopneas, and without any significant desaturation (my nadir was 96%), I can say that it affected my academic life. There are other conditions that can make you feel tired or unable to focus on projects, like anemia or depression, but they wouldn't affect your AHI. It's entirely possible that, like I did, you have multiple, concurrent conditions contributing to the tiredness, but to deal with that, you still need to be using your CPAP.

[Julie]

Hi- it sounds like you're doing more sleeping without a mask than with one, which is why you're sleeping so long (and not really getting treated at all). You need to look into a few things, but one at a time so you'll know which is which and what's causing the problems, and you need to persist with each one for at least a few days at a time, as one night under any circumstances cannot be counted on as typical.

Have you considered whether you're a 'mouth breather' when sleeping and if so, that you're losing all the 'good' air that way so that it never gets to keep your airway open? And therefore a full face mask - in the right size and properly fitted to you - should be tried, but at least a chinstrap or taping for a few nights would tell you something.

Are you being consistent about bedtimes, about not drinking alcohol beforehand, about not eating too much, too spicy or too full of caffeine for many hours before sleep (silent GERD is a real issue for many and if it's yours, it needs addressing because it'll keep waking you up). Are you sleeping in a quiet and somewhat cool place?

What are your pressures set to? Do you use the ramp and for how long?

How's your mattress? Your pillows? Your leak rate?

[kaiasgram]

So my question here is if my AHI is 27 without CPAP (and mostly hypopnea), is it true that it is a benign condition that doesn't really affect my daily functions?

Hi benz -- No, it is not true that it's a benign condition that doesn't really affect daily functioning.

Also, I wonder if anyone ever heard of a psychological condition or maybe other physical issues that can manifest as sleep apnea?

benz, other conditions can make you feel tired and have trouble concentrating, but those condidtions would not have sleep apnea as a symptom or manifestation.

You have a documented diagnosis, you know you're not yet getting effective treatment for it, and you are having trouble functioning. Honestly, given this doctor's attitude and dismissal of the seriousness of your apnea, if you do go home I would not look to this doctor to help you get the apnea effectively managed.

Keep us posted.

[chunkyfrog]

My AHI was only 13, pre-CPAP, but I was virtually circling the drain, mentally and physically.
My quest for a good fitting mask included no less than 20 masks in 2 years,
due to a slightly non-standard (but cute) face.
(Thanks to cpap.com for mask return insurance)
My advice: don't give up until you've tried them all.

[DavidCarolina]

Geez, how many of us here take everything a sleep doctor says completely seriously?

I mean, ive been told multiple things that ive practically learned to laugh off over the years. I dont say this to scare you,
but unless you HAVE sleep apnea you make all sorts of ignorant statements.

I have another med condition and people make all kinds of idiotic statements and "diagnoses"

Apnea DOES DOES DOES make you that tired. It does make you that sick. It does make some of us wake up gasping for air.
It does plummet our oximetry. I CAN do serious damage to our various nervous systems.

I was told by a top ENT surgeon that i was "most likely" having panic attacks in my sleep. This was off the top of his head.

But we all know the intricacies of sleep therapy. There can be another condition, a vitamin deficiency, a sleep pattern disorder (delta wave),
a leak problem, a snore problem, a titration problem, a problem with centrals, a stress adrenaline problem, a circadian problem.

This stuff is dang complicated. Easy pat answers from ANYBODY are.......................to be replaced with solid science and experience.

[wardmiller]

benz42428, your story reminds me of the person who was over weight so he went to the gym each day, but continued to overeat, and could not figure out why he didn't lose weight.

You've been diagnosed with moderate sleep apnea and have had a CPAP machine for 5 years, but, for all practical purposes, don't really use it enough to reap its benefits. Then, you wonder why you still feel tired during the day. If your doctor gave you some miracle drug that would cure your sleep apnea, but you did not take it, you'd have the same result.

Pardon my bluntness, but if you are smart enough to work for a PhD, you should realize your first priority is to use the CPAP machine as a form of therapy. Used properly, it should minimize the effects of sleep apnea and eventually make you feel better. So, JOB ONE is to use the machine, all night, every night.

If the mask gives you problems, you must try other masks. That is a problem many of us had in the beginning, and it only gets better by trial and error. If just wearing the mask gives you problems, then try wearing it, unconnected from the machine, for a while in the evening so you can get used to it. But keep focused on the objective, to use the mask all night, every night. Like the medicine on the shelf, it won't help you until you use it.

I'll leave it to others here to discuss if this is the right CPAP machine for you and what the settings should be. But you MUST start using it all night, every night.

The next problem to solve is your sleep HABIT. Just like the guy who would not change his eating habits and couldn't lose weight, you must establish healthy sleep habits. Sleeping to 2 p.m. should not happen. Seven or eight hours is sufficient and should be your goal. It goes hand-in-glove with sleep apnea. If you toss and turn and think you have not sleep enough, you should still get up after 7 or 8 hours, and build that habit. Eventually, you'll build a healthier habit, if you keep trying. It won't happen in a day, a week, or a month. It will take hard work on your part. But the rewards are worth it.

Nobody said it was easy, but you have wasted five years and have not improved your situation, so something has to change. It is up to you.

You did not specify what "treatment plan" you were considering. If it is surgery, according to many people on this forum, there is no miracle surgery for sleep apnea and some people who have had surgery have become worse off. So most people would recommend against surgery in this case.

I urge you to set the objectives of using the mask/machine all night, every night, and developing healthy sleep habits. Above all else, those must be your primary objectives, now and in the foreseeable future.

Good luck!

[benz42428]

benz42428, your story reminds me of the person who was over weight so he went to the gym each day, but continued to overeat, and could not figure out why he didn't lose weight.

You've been diagnosed with moderate sleep apnea and have had a CPAP machine for 5 years, but, for all practical purposes, don't really use it enough to reap its benefits. Then, you wonder why you still feel tired during the day. If your doctor gave you some miracle drug that would cure your sleep apnea, but you did not take it, you'd have the same result.

Pardon my bluntness, but if you are smart enough to work for a PhD, you should realize your first priority is to use the CPAP machine as a form of therapy. Used properly, it should minimize the effects of sleep apnea and eventually make you feel better. So, JOB ONE is to use the machine, all night, every night.

If the mask gives you problems, you must try other masks. That is a problem many of us had in the beginning, and it only gets better by trial and error. If just wearing the mask gives you problems, then try wearing it, unconnected from the machine, for a while in the evening so you can get used to it. But keep focused on the objective, to use the mask all night, every night. Like the medicine on the shelf, it won't help you until you use it.

I'll leave it to others here to discuss if this is the right CPAP machine for you and what the settings should be. But you MUST start using it all night, every night.

The next problem to solve is your sleep HABIT. Just like the guy who would not change his eating habits and couldn't lose weight, you must establish healthy sleep habits. Sleeping to 2 p.m. should not happen. Seven or eight hours is sufficient and should be your goal. It goes hand-in-glove with sleep apnea. If you toss and turn and think you have not sleep enough, you should still get up after 7 or 8 hours, and build that habit. Eventually, you'll build a healthier habit, if you keep trying. It won't happen in a day, a week, or a month. It will take hard work on your part. But the rewards are worth it.

Nobody said it was easy, but you have wasted five years and have not improved your situation, so something has to change. It is up to you.

You did not specify what "treatment plan" you were considering. If it is surgery, according to many people on this forum, there is no miracle surgery for sleep apnea and some people who have had surgery have become worse off. So most people would recommend against surgery in this case.

I urge you to set the objectives of using the mask/machine all night, every night, and developing healthy sleep habits. Above all else, those must be your primary objectives, now and in the foreseeable future.

Good luck!

I totally agree with everything you said here! I guess I didn't see it this way before partly because I had been so distracted by treatment options (surgery, oral device, etc.) And whenever I can't use CPAP, the doctor would convince me to try something else rather than keep at CPAP. All this time I've felt that I have taken a very long detour, but now that I start to realize I don't really have a choice but CPAP, I can focus all my energy on it. I really wish I came to this board or connected with other sleep apnea patients earlier rather than trusting the doctor's decision too much.

[martinsr00]

Many of life's problems lack solutions because, in mathematical lingo, "we've constrained the solution set".

For example, I have a friend at work who has severe apnea. He said, "I'd rather be dead than use one of those machines." Well, (1) he may eventually get his wish, and (2) damage from his sleep apnea continues unabated. He ruled out the one effective solution. That may mean no solution.

"Oh, I'm can only use my CPAP machine 2 hours a night". Well, then at most you get 2 hours of good sleep. On what basis would one expect to reap the benefits of 8 hours of good sleep per night?

Being only recently diagnosed, doctors kept trying to motivate me. I finally had to tell them that they were wasting their time because I was commited to go the distance to treat my apnea. Ulcerated nose? Get a mask that fit. Cushioned the nose. Trouble dealing with the rhythm and pressure from the machine? Learn how it works and learn the correct rhythm. Got dry mouth? Learn strategies mitigate . Have a bit of aerophagia? Try different strategies to make it work. Surgery? Never mind. Only as a last resort. Wearing a mask is just to easy and the results self-evident while the surgery is a crap-shoot.

Most of us would be far happier if we learned to make problem solving a habit of the mind.

For me, it was simple. After having felt like dirt for a couple of decades, and finally feeling 10 years younger, I thought that maybe, just maybe, a little bit of problem solving was worth all the effort.

One of the problems associating with "having it our own way", is to reap the consequences of "having it our own way".

[archangle]

Don't forget that you may have medical conditions other than sleep apnea.

Yes, an AHI of 27 can make you tired and cause other medical problems, including long term degenerative problems like brain damage, heart problems, etc. Even if it's just hypopnea, you may be partially waking up 27 times an hour when you have a hypopnea and never getting the right sleep stages.

I suggest you get an S9 AutoSet or a PRS1 Auto machine. If you can get a doctor's prescription, you can order it from our host, cpap.com. They're an excellent supplier. You might also find a used machine on Craigslist. If you get a new machine, be sure to get one that's fully data capable. Some of the cheaper machines don't record much data.

Your S8 machine records some data, but an S9 or PRS1 records more data and is much easier to access the data from.

Whatever you get, learn to use the software, adjust the machine yourself, and manage your own therapy. Even if a doctor is "in charge," it helps to monitor your own results.

[benz42428]

Many of life's problems lack solutions because, in mathematical lingo, "we've constrained the solution set".

For example, I have a friend at work who has severe apnea. He said, "I'd rather be dead than use one of those machines." Well, (1) he may eventually get his wish, and (2) damage from his sleep apnea continues unabated. He ruled out the one effective solution. That may mean no solution.

"Oh, I'm can only use my CPAP machine 2 hours a night". Well, then at most you get 2 hours of good sleep. On what basis would one expect to reap the benefits of 8 hours of good sleep per night?

Being only recently diagnosed, doctors kept trying to motivate me. I finally had to tell them that they were wasting their time because I was commited to go the distance to treat my apnea. Ulcerated nose? Get a mask that fit. Cushioned the nose. Trouble dealing with the rhythm and pressure from the machine? Learn how it works and learn the correct rhythm. Got dry mouth? Learn strategies mitigate . Have a bit of aerophagia? Try different strategies to make it work. Surgery? Never mind. Only as a last resort. Wearing a mask is just to easy and the results self-evident while the surgery is a crap-shoot.

Most of us would be far happier if we learned to make problem solving a habit of the mind.

For me, it was simple. After having felt like dirt for a couple of decades, and finally feeling 10 years younger, I thought that maybe, just maybe, a little bit of problem solving was worth all the effort.

One of the problems associating with "having it our own way", is to reap the consequences of "having it our own way".

You know what? When I read your comment, initially I thought it kinda made sense, but then I wonder how that actually fits in the context of my post here. I really hope that you are not comparing me to your friend who totally abandons the treatment. Yes, i did say that after 5 years I still couldnt settle on a treatment option that would work for me, but that in no way means that I've been idling all this time. I just don't feel the need to explain all details about what I have done, what emotional difficulties I've gone through, and the fact that i was an undergrad student without any substantial income and a good insurance. You said as if this "problem solving habit" that you've mastered is all it takes to get there. For example, my previous insurance wouldn't even allow me to try different masks and if I were to buy them all out of my own pocket I would probably not have enough money to buy textbooks and other necessary things (although that now i am a grad student I do have more income and money is not an issue anymore). Maybe it is just easy to get smug when you can do it and see that another person can't. Just please don't think that I leave my conditions untreated this long because I try to "have it all my own way."

[Julie]

Hi - I wonder if part of the problem here is that a lot of us are somewhat older than you and have been here long enough to let everything hang out - we're used to sharing things that anywhere else would be considered way too personal (or yucky or seemingly trivial) and so when a newbie comes along we want to help, and end up wanting all the details of your history looking for clues. And then sound know-it-all and righteous about our replies. Please don't take it personally - we're nerds, jerks, dorks half the time and half asleep the rest of it, but we mean well and your story is a challenge for us. We're not being nosy or prurient but eager, and just want to help. If there's anything at all, silly or small as it might sound, that you think could add to your story to expedite feeling better, tell us (and we won't tell anyone else ) but it might lead to a bell going off for someone that could help you. And I hope we don't act too 'smart' about answers.