Minimal AHI ... Still DEAD Tired! - 10 years in.

[bwexler]

Average AHI over 565 days does not really tell the whole story. I was looking at my AHI yesterday and for the last 2 weeks it has been bouncing all over the place. As low as 0.49 and as high as 6.99. If my average is 3.5 that doesn't take into account the nights I fought leaks all night, leaving me sleep deprived. As an engineer you will need to look at the fine details now rather than the statistics. What does your pressure, leaks and events look like minute by minute? What anomalies do you see in tidal volume? Get copies of your blood workups and study them. Normal implies just like everyone else. That doesn't mean good. For example vitamin D levels over 30 are considered normal by most labs. The doctors I have listened to suggest that 50-80 is much better. Some have enumerated the benefits added at various levels between 50 and 80. After 4 years of study and effort mine is now at 75, where I want it.
If you check with normal people you might discover many are sick and tired of being sick and tired.

[Guest]

What model machine and software are you using?

I am using Sleepy Head to read the data from the machine; and I am using a ResMed Autoset S9 Elite

[deadtiredcanadian]

What model machine and software are you using?

I am using Sleepy Head to read the data from the machine; and I am using a ResMed Autoset S9 Elite

[Guest1]

Try the simple fix first. If your pressure doesn't bounce up more than 8cm, then just try and sleep on a straight pressure of 8cm for 7+ nights and see how you feel. And make sure you have no ramp. If straight 8 bothers you then maybe you can ramp up from 6 to 8 in 15 minutes.

My AHI was always below 1 on an APAP but I didn't feel rested in the morning. Going to straight cpap on my auto machine did the trick for me.

[deadtiredcanadian]

Average AHI over 565 days does not really tell the whole story. I was looking at my AHI yesterday and for the last 2 weeks it has been bouncing all over the place. ... As an engineer you will need to look at the fine details now rather than the statistics. What does your pressure, leaks and events look like minute by minute? What anomalies do you see in tidal volume? Get copies of your blood workups and study them.

Yes indeed, I considered that. So, I've looked at the data for the past 2 years and it's consistently under 5. I look at the leaks and they have been quite good certainly since I changed mask over 18 months ago. The pressure as well is pretty constant between 4 and 7 with peaks as high as 10 but those are rare. This is why I am dumbfounded because the statistics suggest the therapy is working for me, but the persistance of my being constantly tired is saying otherwise.

[Guest]

Try the simple fix first. If your pressure doesn't bounce up more than 8cm, then just try and sleep on a straight pressure of 8cm for 7+ nights and see how you feel. And make sure you have no ramp. If straight 8 bothers you then maybe you can ramp up from 6 to 8 in 15 minutes.

My AHI was always below 1 on an APAP but I didn't feel rested in the morning. Going to straight cpap on my auto machine did the trick for me.

I've got nothing to lose. I've ramped up the settings and will try that tonight. Any other suggestions?

[Pugsy]

There's no such thing as a ResMed AutoSet S9 Elite.
It's either a ResMed S9 Elite or
a ResMed S9 AutoSet...and only the AutoSet has the apap mode where pressures can self adjust.

[deadtiredcanadian]

There's no such thing as a ResMed AutoSet S9 Elite.
It's either a ResMed S9 Elite or
a ResMed S9 AutoSet...and only the AutoSet has the apap mode where pressures can self adjust.

ResMed S9 AutoSet is what I have

[Krelvin]

This is why I am dumbfounded because the statistics suggest the therapy is working for me, but the persistance of my being constantly tired is saying otherwise.

OSA is only one of many issues you can be having that may be causing your sleep issues. If you have got your OSA therapy under control and you are still having issues, you need to start looking at other possible causes.

[GTOJim]

Assuming this is directed at me. Prior to being diagnosed with PLM I was waking up during the night, tried Ambien, didn't help. Problem wasn't getting to sleep, problem was I couldn't stay asleep, Ambien made no difference for me. A doctor suggested depression, I didn't agree but tried an anti depressant for a few months, don't remember the medication but it was for sever depression. I didn't feel any different, didn't feel any change in mood, still very tired plus my wife couldn't detect any change in my mood or energy level. Pramipexole seemed to cause me to sleep less so it was a wash as to how I felt. Pramipexole was helping the PLM but with less sack time I was just as tired. Doctor prescribed Mirtazipine 30mg which made a huge difference in how I felt, finally I was getting a decent nights sleep, sleeping all night without waking up. This was about 3 years ago, gradually over time I've been feeling more tired and started taking Nuvigil about a year ago.

I"ve read most sleep doctors tend to ignore PLM which is what my last doctor attempted to do until I pointed it out.

I know my PLM has slowly gotten a bit worse and had a sleep study about 6 weeks ago ordered by my new sleep doctor. I didn't realize he is the director of the sleep lab, and also the doctor who reviewed actual data of the study. It took a lot of nagging to get a copy of my sleep study, results of study, no limb movements detected, but there is a very tiny graph showing arousal's caused by limb movements, the graph is to tiny to interpret.


On a more personal note concerning the sleep study I just had:
The day I received a copy of my sleep study I also picked up a new prescription for a blood thinner, called in by my sleep doctor. My heart doctor reviewed my sleep study and stated the blood thinner has to be a mistake, do not take it. So I"ve got a few things to discuss with my sleep doc next month. There is other conflicting information from my study so I'm afraid this latest sleep study is going to be a total waste of time and money, unless the doctor comes clean so to speak. He lied when I asked if he was the doctor who reviewed the data of the study and answered no he was not. Turns out his name and signature are on the summery/results of my study.

what about more medications that you take especially the psychotic ones? Please list them
Nuvigil 125mg
pramipexole .35mg

[Woody]

By any chance do you take Zocor or it's generic Simvistatin ? The reason I ask is it
realy messed my sleep up. Somehow I just couldn't get enough sleep and I have a friend
that had the same experience. As soon as I stopped it my sleep was a lot better and I
no longer was sleeping 12 hours or more and still wanting another nap !

[GTOJim]

Yes I take Simvistatin but I didn't notice any change in my sleep when I started taking it.

By any chance do you take Zocor or it's generic Simvistatin ? The reason I ask is it
realy messed my sleep up. Somehow I just couldn't get enough sleep and I have a friend
that had the same experience. As soon as I stopped it my sleep was a lot better and I
no longer was sleeping 12 hours or more and still wanting another nap !

[kaiasgram]

GTOJim -- Please start your own thread so that deadtiredcanadian's can stay on track -- both of you will get better help that way.

The OP deadtiredcanadian has already said that he doesn't take any medications.

[library lady]

You mention that your wife reports twitching and occasional shuddering at night.. you might look into that with your doctor if you haven't already; it could be what's waking you up in addition to the OSA, thus preventing optimum sleep. Your machine probably isn't going to respond to twitches and shudders.

I have fibromyalgia, which was diagnosed not by my PC doc, but a rheumatologist, and it's main symptom is fatigue. That's something else to look into. I am still tired, but I'm definitely sleeping better and usually can sleep through the night now though I occasionally make one potty trip. I get to sleep more quickly, thus reducing the frustration of trying to get to sleep, and I have modified my evening routine to enhance my sleep quality.

[deadtiredcanadian]

GTOJim -- Please start your own thread so that deadtiredcanadian's can stay on track -- both of you will get better help that way.

The OP deadtiredcanadian has already said that he doesn't take any medications.

Thanks a lot...