what's the cause of being tired even after CPAP? Help please

[williamco]

I am new to this and need your help please
I have been on CPAP for 2 months and I am still tired and can't function
I even raised the pressure on my machine several times and didn't help. I have no leak to speak of because I have data capable machine. the AHI comes between 2-5, yet even with best AHI of 2, I am still tired

any thoughts.???
I appreciate your input
William

[Pugsy]

Because numbers don't always tell the whole story. Because sometimes we just need to give it a lot of time.

Can you please update your user account profile with your equipment details?

What pressure do you use?
What is the leak situation?

[elader]

there are days, even weeks, that I feel like I did pre-cpap. Sometimes you get crappy sleep even though you only stop breathing 2-5 times per hour. Hopefully on the days that you do feel better, you take advantage of it and get out and be active. Healthy lifestyles lead to better sleep too.

[williamco]

I updated my profile. Thanks
My pressure is 13 cmH2O - My leak is almost nothing above the designed leak for the pressure graph, thanks to a great mask
leak comes at : 33-35 L/M

[williamco]

elader : does this mean that this is normal to be up and down. no cure whatsoever??! even with CPAP????and why ? what is caused by if AHI is less than normal limits?

[Pugsy]

Sometimes we have other issues that affect how we feel outside of the AHI numbers thing.

I have a recent discussion along those lines just today because I have some discomfort issues that prevent a good restorative sleep despite getting great numbers.

I have quit going to the bathroom several times a night. I have reduced my morning headaches about in half. I get sleepy at around 5 PM instead of 10 AM. Otherwise I don't see any big difference either. Been on the machine since May 23.

Sometimes it isn't so much the numbers but where those events are placed (like closed together) or if they are really long events.

I feel OK with AHI of 2-3. I feel much better when it is less than 1. Do you have the software to see if you are having little groups of events that might make you feel worse but not give you bad averages because mostly good hours? Are you getting your numbers off the LED screen only? Are these averages or are you resetting the numbers to zero each night? I found that once I got the software, what I saw on the LED screen wasn't even close.

[williamco]

Yes, I agree the Software is totally different than the machine's screen. I have the software and look at the report every day. the numbers that I stated earlier are from the software. my attacks seems scattered not grouped together- and they are not long events because I mainly had Respiratory resistance events which cause immidiate alertness
is the norm for AHI to be below 1 in order to feel good? ?

[Pugsy]

is the norm for AHI to be below 1 in order to feel good? ?

For me yes, apparently it seems to be what I need.

For other people it will be other numbers. There is no one magic number that means we get to put out a big neon sign saying we have seen the light. Komodo today or yesterday it was, says she/he (I forget) had numbers with AHI around 12 I think it was but got 10 hours of sleep and felt markedly better than with numbers half that.
Seems like amount of sleep factors in.

I get around 6-7 hours if I am lucky. On the nights I have got 8 + hours, I can tell I feel much better. It is a struggle to get good hours though because of awakenings that I have because of discomfort.

So you have to look at the overall picture. If number of hours slept is good. Quality of those hours is good. We can't blame it on leaks or rogue clusters (which I get). Good AHI numbers. We have ruled out other possible causes, then sometimes we just have a sleep debt to pay and this pay off is gradual and improvement is very gradual and this is where patience comes in.

If all we had to do was slap on the mask and turn on the machine to see a 180 degree turn around, this cpap thing would be a walk in the park. Unfortunately, it is not uncommon to have other issues at work, or simply need some time for the body to heal from the damage the OSA has done over the years.

[SleepyT]

williamco,
so...how long do you think you have had sleep apnea? pugsy is right....you may have a massive sleep debt to pay.

t.

[atab]

Headaches and tiredness depend on too many variables. Today I have a big headache. My AHI is 6.8 AI is 4.2. Somewhat higher than recent days but not drastically different. Then I checked my data. two apneas of 55 and 60. Many others in 30s and 40s. So, that really bogged me down. Some other days, when I didn't sleep well, AIs and AHIs read fine; but I am dead tired. If you don't sleep you don't get events. RT will look at number of events and say I am doing fine. My apneas are REM specific. So, if I don't get much REM sleep my AI count stays low. Different problems for different folks.

atab

[OwlCreekObserver]

Overall fatigue can be due to a whole lot more things than apnea. I suspect that treating the apnea may bring other issues to the surface that we were too tired to notice previously. Maintaining a proper diet, getting daily exercise, avoiding tobacco, moderating alcohol consumption, getting enough sleep (as in skipping The Late Show) and many other factors may help improve our overall "good" feeling.

My bride and I walk 2 to 3 miles every morning -- outdoors at this time of year. It does wonders for our attitudes for the rest of the day. If we miss more than a day or two for some reason, we both definitely feel it and grumpiness prevails -- her, not me of course.

Now that you're treating your apnea, you might want to step back and think about what might still be affecting how you feel. Tension at work? Family issues? Lack of exercise? Other health problems? If you can't think of anything else, then this might be a good time to go back to your doc and talk it over with him/her.

By the way, we used to take a lot of supplements every day. One day, after my wife's doctor said he'd like to see her back away from some of them, we both decided to go back to just taking a multiple vitamin and a baby aspirin each day. Within a week, we both noticed a HUGE improvement in how we felt. Who would have guessed?

OCO

[Muse-Inc]

How long are you sleeping each night? I slept 9+ hrs for the first several nights (well, the first 4 were from hell adjusting to my pressure so I ignore those). Then, I settled into 8 hrs of sleep (occasional 9-10 hrs nights) which is what I need to feel good. It took me at least a month to go from exhaustion to plain old tired, then months of slow improvements in all the area that apnea had mangled. My docs had warned me that some of their patients don't see much improvement for a year...thankfully I wasn't one of those poor folks! Even after 18 months, I continued to see improvements. Now, if I have a lot of events that wake me up, I'm tired the next day. I was sold one of those #amn usage-only machines so can't post numbers. Doc wants me to move up to an APAP but ins says no and without a job right now my personal funds don't stretch that far. There are plateaus and in my case backsliding that occur on this adventure.

[Hoze-Zay]

No matter what, (America) is on your side. Wink

[Pugsy]

I got 9 hours of sleep right on the nose last night. Yep, took my Ambien. My AHI was 1.3. This is about 2 to 3 hours more than what I have been getting. I had no clusters of events last night. Only the very rare event. I feel much, much better today. Not 100 % better but not nearly as tired as I was yesterday (AHI was 2.6) with 6 hours of sleep. Normally by this time I would be fighting the urge to nap (5 PM my time).

I think we simply have to look at the other factors and realize that just because we have "low" numbers, it doesn't always mean we are going to feel that miracle people hope for. The numbers are just a starting point, a guide.
My husband says the improvement is huge. I don't see it. I don't feel it. He says I have a sparkle in my eyes again, I laugh more, I give him crap more (he loves it). The largest single improvement I can see is the absence of the night time visits to the bathroom.

So if we have "good " numbers and don't feel markedly better then we have to evaluate other possible causes and slowly eliminate them. I need more sleep. I need deeper sleep. I need patience..... I am working on all 3...

I tell myself I didn't get this way overnight, it took years. I can't really expect to fix all the damage overnight either. Though I sure wish I could.

[always_tired]

I don't want to discourage or depress you, but I have been on CPAP for two years with little improvement. However, I have a neuromuscular disease in my history, even though it has long been in remission. I probably had sleep problems for two years before a diagnosis was made, so that's a lot of sleep deprivation to make up if it is even possible to do that. I just moved on to my third doctor who is a neurologist with sleep medicine specialty, and she just switched me to a BiPAP. I hope to see some improvement soon or at least an explanation of why I'm not improving. As some of the other posters have said, there can be other underlying problems. Have you had your thyroid tested? Have you been tested for anemia? My new doctor won't consider looking for other problems until I have been sleeping 7-8 hours/night with the BiPAP. I haven't slept that many hours a night in probably 6-7 years.

Good luck and don't give up. Don't hesitate to find a new doctor if you're not getting the support you need.