Six months into CPAP therapy...

[bkn]

Six months into therapy and I'm waking up exhausted every morning. Machine says one or two minor mask leaks, otherwise I'm on the machine easily seven hours each night. Asthma/sleep doc wants to put me on an anti-depressant but I'm seeing primary care first to see what else may be wrong. Something just isn't right. My question to the community is, is this normal? My pre-therapy AHI was 22, on the machine I'm down to 1 or 2 per night. I switched to a different mask which has been better, but I have never had that a-ha moment where I wondered why I didn't get on CPAP before. I don't look forward to sleeping at night because I really can't stand this machine, and now six months into treatment, the fatigue is affecting my work and my life. Looking for some thoughts or suggestions from those who have been there before.

[Julie]

What are your pressure settings? They may just be too low - happens a lot.

[kteague]

For some reason your story sounds very much like a recent person who was not signed into an account. Is this your first time asking? Just don't want to give you redundant info if you're the same person but now registered. Please tell us specifically what things about the treatment you are having trouble with so our responses will be more targeted thus more likely to be helpful.

[bkn]

Pressure settings are 5 to 12, I'll ask about that next visit. kteague I don't remember asking here before, so I appreciate the info and advice. I am not able to use nasal pillows so I have the full mask. The first mask I used I fought with every night so they switched me to the Air Fit F20. Much better, although now I'm fighting it so perhaps it's time for a new one. I do the mask fit test every few days to make sure I have it adjusted correctly, seems too tight but when I loosen the straps the fit test blows air everywhere. When I wake up in the morning, I almost feel more tired than I did the night before. I've read that my apnea may have gone untreated for so long that I may just be working off a large sleep deficit, I suppose that's possible but something just feels off, so I'm going to my primary care doc on Monday to see if there is something else contributing. Like I said before, in six months of daily use (haven't missed a night yet) I have never woken refreshed, I have never had that light bulb moment where I can't believe I never went this way before. Very frustrating. I'm kind of hoping the doc finds some other underlying issue causing the fatigue.

[Pugsy]

Are you using the software to see the daily details up close or are you just looking at the numbers on the LCD screen or MyAir website?

If not using the software...maybe use it and post a typical night so that we can look to see if something is standing out screaming "fix me"?

Also..couple of quick questions.
Do you take any medications of any kind and if so what?
And you say you are averaging 7 hours of sleep...are those hours fragmented by multiple wake ups? If so about how many and any idea why?

Don't know about the software?
https://sleep.tnet.com/equipment

For examples of what I am talking about in terms of details see this thread..
viewtopic/t103468/Need-help-with-screen-shots.html

[bkn]

The only medications I'm taking are for asthma. I had been looking at the data on Sleepyhead for awhile, I haven't looked at it closely for a couple of months so I'll take a look again this weekend. The LCD screen and myAir website are a decent indicator but I like to dive into the details if i can. I need to look over the last month or so for any obvious wakeups, if sleep is fragmented I'm not aware of it.

I really appreciate all the advice, I'm traveling the next couple of days and will take another look at the data on Sunday and post. I'm also researching some items to talk about with my doctor.

Cheers,

[Julie]

I'd raise your min. pressure to 7 or 8 for a few nights and see how you feel... 5 is very low and only a few people find it effective.

[kteague]

Agree that some of the data gurus here might be able to spot if there's something going on with your treatment that could be improved, or at least confirm that nothing is obvious. What other health things have you already been tested for? Some things that come to mind are thyroid function, blood sugar, B12, iron studies, and Vitamin D. I'm guessing since you don't mention a lot of wakeups that limb movements are not likely to be an issue. If seemingly restless sleep is present, then that question would matter more. Also, have any meds been assessed for side effects that might correlate with your symptoms?

[Pugsy]

so if the AHI is down to 1-2 - more pressure will help how ?

isn't it more likely with that low AHI that there are other sleep issues causing him to be tired ?

the pressure is 5-12
dont you think the machine is giving him more than 5 if he needs it
do you think 12 is not enough ?

You will find that Julie often advises more pressure baseline minimum pressure without seeing the reports when the AHI is low (or even without seeing any report numbers at all) because "most people need more and 5 or 6 is ineffective".

It's something that I don't like to do myself...suggest pressure changes without a valid basis based on personal opinion of a minimum starting point.
That's why I asked about the detailed reports. For all we know the remaining AHI of 1 or 2 could be central in nature and more pressure won't kill them anyway. They could be a lot of things and since there is no detailed data available to explain it why not wait till we see it.
With an AHI of 1 to 2 whatever type of events...there's no urgent need to do anything until more information is known.

Now when no data is available for some reason or other...that's another story. Do the best we can with what we have.

[Hammer]

I just passed the one-year mark and have the same issue as you. Still exhausted all the time regardless of time on machine and AHI. I joined here with the hope of continuing therapy, but if things don't improve in the next 3-months I'll be selling a Dreamstation with low miles on it.

[Julie]

Actually, you will find that many of us suggest slight rises in pressure when the set pressure is so low that it's difficult for many to inhale at, and the change advised is still very low, highly unlikely to be a problem and only advised as a trial for a few days to see how you feel.

[Zeds]

Six months into therapy and I'm waking up exhausted every morning. Machine says one or two minor mask leaks, otherwise I'm on the machine easily seven hours each night. Asthma/sleep doc wants to put me on an anti-depressant but I'm seeing primary care first to see what else may be wrong. Something just isn't right. My question to the community is, is this normal? My pre-therapy AHI was 22, on the machine I'm down to 1 or 2 per night. I switched to a different mask which has been better, but I have never had that a-ha moment where I wondered why I didn't get on CPAP before. I don't look forward to sleeping at night because I really can't stand this machine, and now six months into treatment, the fatigue is affecting my work and my life. Looking for some thoughts or suggestions from those who have been there before.

Before I was sent for a sleep study, the docs had another idea about my extreme fatigue....low vitamin levels. Bingo: in fact, my Vit D was undetectable. Every MD who's looked at the test results is astonished that I'm even viable.

The D is fixed now, but I'm no more alert. However, I'm putting that out as a concept that's cheap to test and fix and can cause horrible fatigue: Vitamin levels.

[bkn]

Left for awhile, many other tests done without finding any clear reason for the fatigue. I started waking my spouse up at night like I did before the diagnosis. A new mask helped, although I still fight it with it all night long, every night. I'm about ready to throw this stupid machine off of any tall building, tree or cliff. More follow up med appointments coming up in November. Maybe some day I'll actually wake feeling somewhat refreshed. I don't remember what that feels like. Frustrating.

[RicaLynn]

Left for awhile, many other tests done without finding any clear reason for the fatigue. I started waking my spouse up at night like I did before the diagnosis. A new mask helped, although I still fight it with it all night long, every night. I'm about ready to throw this stupid machine off of any tall building, tree or cliff. More follow up med appointments coming up in November. Maybe some day I'll actually wake feeling somewhat refreshed. I don't remember what that feels like. Frustrating.

Have you looked at the details on SleepyHead like Pugsy suggested? If she/we can see what's happening during the night, we will have a better idea of how to help you.

[Julie]

And have you raised your min. pressure from the lowest of lows (5) to something more reasonable as was suggested before?