Brand New User: APAP makes me MORE Tired!!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Centralia
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Joined: Sat Dec 01, 2012 9:48 am

Re: Brand New User: APAP makes me MORE Tired!!

Post by Centralia » Wed Dec 12, 2012 12:16 pm

I liked the sound of the contoured pillow, Mozart, and went to the site. I tried to order one, along with a pillow case, but found they only sell to the US. However, their Ebay shop does sell overseas, on http://stores.ebay.com/Contour-Products ... 581&_pgn=2 So I very cheerfully ordered a pillow and pillowcase, only to notice that the postage on each was astronomical to my part of the world -- $35 for the pillowcase, and $46 for the pillow, a total of $147 odd for the cushion and pillowcase. Interestingly, I could order it here from Independent Living for $135 without the pillowcase, and I don't know what for postage. I decided I would have a go at making one myself with some latex cushioning. Wonderful idea, though, just what I could do with.

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Mozart22
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Re: Brand New User: APAP makes me MORE Tired!!

Post by Mozart22 » Wed Dec 12, 2012 1:30 pm

Centralia wrote:I liked the sound of the contoured pillow, Mozart, and went to the site. I tried to order one, along with a pillow case, but found they only sell to the US. However, their Ebay shop does sell overseas, on http://stores.ebay.com/Contour-Products ... 581&_pgn=2 So I very cheerfully ordered a pillow and pillowcase, only to notice that the postage on each was astronomical to my part of the world -- $35 for the pillowcase, and $46 for the pillow, a total of $147 odd for the cushion and pillowcase. Interestingly, I could order it here from Independent Living for $135 without the pillowcase, and I don't know what for postage. I decided I would have a go at making one myself with some latex cushioning. Wonderful idea, though, just what I could do with.
Don't buy it! As of last night I stopped using it. The first few days I liked it, but the pillow is so HARD that my neck was starting to hurt. I like the idea of a
pillow with cut outs for the mask, but why did they have to make it hard as a rock. I have gone back to sleeping on my regular, much softer pillow. I might
give the Contour CPAP pillow another try later on, I still own it, but for now I'm sticking with a regular comfy pillow.

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Centralia
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Re: Brand New User: APAP makes me MORE Tired!!

Post by Centralia » Wed Dec 12, 2012 9:37 pm

Thanks for that - it makes me extra glad I backed out of the purchase. I have an old piece of latex I thought I could double over and create a pillow out of, but find it is so old it is crumbling away on the surface. Latex is pretty expensive, but it's not going to cost as much to buy a whole 3 x 6 ft latex mattress overlay as to have a little non-latex pillow sent half way around the world. And I should be able to buy a little piece somewhere to operate on. I'd rather real latex rubber than foam, memory foam or anything else.

I just had my first night on my ResMed and loved it but am sneezing and snuffling today. The ordinary pillow was more of a problem with the mask than before for some unknown reason. So I need my Mozart-pillow.

Yup.

JTtheSleepTech

Re: Brand New User: APAP makes me MORE Tired!!

Post by JTtheSleepTech » Thu Jun 13, 2013 1:51 pm

There are several considerations to your problem - should you still be watching this forum for any information. I'm curious, given how long since any updates, if the issue has resolved as I suspect it might have.

I am a registered sleep tech and have been in the field for 15 years. As you've gathered, it is normal to wake up more tired initially with therapy. With apnea, you are waking from stage 1 or 2 sleep usually - which is pretty easy to shake the cobwebs loose in the morning. With recovery sleep on CPAP/APAP, you are going to be rousing from stage 3 sleep - a much deeper stage - or REM sleep - something you've been denied for some period of time and is also likely happening much longer than usual.

We expect most of these tiredness issues to resolve in 1 to 2 months - usually closer to 1 month for those who adapt to pressure quickly. Setting your APAP higher to start with was probably a good idea - but I would have left the top end at 20. Why? Because of the way REM sleep works. When we dream, we also paralyze our bodies and the airway becomes much more relaxed. As a result, apnea becomes much more pronounced and commonly requires higher pressures to compensate. As you recover, REM sleep will increase initially.

Make time for more sleep (this is for those with similar complaints - I think the original poster is probably doing well now). Initially, it's easy to want to sleep 10 hours or more. Try to make that happen. Get all you can on therapy. If you're in a relationship, address this ahead of time - ask permission - explain that it's just for a period of time and you'll be up and going again soon. For couples, the bed partner is usually happy to have a quieter room to sleep in without the snoring and apnea, but they may not realize you need to catch up from all the missed sleep. Finally, and perhaps most importantly, recognize that sleep effects your entire system - cardiovascular, pulmonary, endocrine, lymphatic - every part of our physiological make up utilizes or responds to sleep in some way. Feeling refreshed is probably the best feeling result a patient can have on PAP therapy, but the least important one for your body and health.

I have just started therapy on an APAP and I average around 5 cm - but I do peak at 8 cm - which I'm willing to bet solid money is during REM sleep. I am tired until about 11 am, and I hate it. I'm about 3 weeks in, so I expect it to change soon.

The problem with a home study is you do not have good data on how much your sleep staging was effected by apnea. Some people actually get good sleep consolidation and deep sleep despite apnea - it's not common, but I have seen it enough to know it happens. The position effect is very normal - most people breathe easier on their sides, but there is the resulting sore shoulder as we sleep most comfortably on our backs.

I think others are right about the average pressure issue - seems there has been a 1 added in more than likely. However, hitting a high pressure of 16 cm in REM wouldn't be surprising. I've had patients who need absolutely no PAP therapy for stages 1 2 and 3, but in REM need upwards of 12 cm for that stage alone!

Leak being an issue is pretty detectable by inspection. If your eyes are dry and itchy or your mouth is like a desert, then leak is a problem. If you just have some mild dry mouth, but your eyes feel fine, then leak is not very likely to be a problem.

If you are still tired 6 months in - get a sleep study done in a lab - the diagnostic difference is considerable and research on the efficacy of autopap titration versus professional titration by a sleep tech still tilts in the sleep techs' favor. We get you more accurate and acceptable pressure settings than a computer reacting to you throughout the night. The problem has to occur for a period of time for the pressure to go up - until then you are having apneas and sleep quality is diminished. A single effective pressure is proactive - little or no apneas occur and sleep consolidation (staying asleep) is improved.

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zoocrewphoto
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Location: Seatac, WA

Re: Brand New User: APAP makes me MORE Tired!!

Post by zoocrewphoto » Thu Jun 13, 2013 3:14 pm

JTtheSleepTech wrote:There are several considerations to your problem - should you still be watching this forum for any information. I'm curious, given how long since any updates, if the issue has resolved as I suspect it might have.

He posted awhile back with his machine for sale.

_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Resmed S9 autoset pressure range 11-17
Who would have thought it would be this challenging to sleep and breathe at the same time?

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NightSky
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Location: Cleveland, Ohio, USA

Re: Brand New User: APAP makes me MORE Tired!!

Post by NightSky » Thu Jun 13, 2013 3:19 pm

I see the original post is old, but it helps me to know this also, as I made a similar post just recently. I was "more tired" as well, but think I am getting better just recently (after a month). It was interesting to hear from a sleep tech.

pugsyno1
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Re: Brand New User: APAP makes me MORE Tired!!

Post by pugsyno1 » Sun Nov 17, 2019 4:42 pm

NightSky wrote:
Thu Jun 13, 2013 3:19 pm
I see the original post is old, but it helps me to know this also, as I made a similar post just recently. I was "more tired" as well, but think I am getting better just recently (after a month). It was interesting to hear from a sleep tech.
I concur, I was initially confused as to why I still felt so rubbish but it's exactly what the sleep tech above said for me, I'm just not used to waking out of deep sleep (so damn groggy now!) and getting more used to it after a month. Best advice is 100% to get as much consistent sleep as possible for the first month to let your body adjust - 10 hrs at the same time every night. I didn't do this because I'm enjoying the extra energy far too much but it's worth it to get it out the way so you can enjoy life asap :)