Fatigue, Brain Fog, & Recovery

You said your doctor told you your test results were normal. I'm wondering what those tests included. Were your magnesium and Vitamin D levels tested? Thyroid function? I would be hesitant to take supplements without knowing there is a need.

I don't see any of those items on my blood tests. I made an appointment with my sleep doc/pulmonologist, but I don't think he is all that great. Wondering if besides bloodwork, there are any tests that would be ordered by a neurologist. I've been on treatment since March, but probably only had it dialed in since June / July.

Hi FoggyBrain24,

I certainly agree with others’ advice, esp finding out if your settings are optimal for you. I’m not a doctor but I do have one other possibility you may want to explore if you don’t get better.

In addition to OSA, you may need to be evaluated for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), also known as just chronic fatigue syndrome. My husband has it so I’m all-too-familiar with it.

It’s a difficult to diagnose illness and most doctors haven’t been trained to do so. The CDC is FINALLY starting to do something about that but it’s taken decades for ME to be recognized as a debilitating medical (vs. psychiatric) illness.

Jane Brody wrote a pretty good article for the New York Times that happened to come out today. For more comprehensive info go to http://www.nationalacademies.org/hmd/Re ... E-CFS.aspx for the report from the National Academy of Medicine. I hope you don’t have this but if you do you should know it. If you go to a doctor and they tell you “it’s all in your head” find another who will take you seriously.

Good luck and I hope you feel better soon!

Julie C

Thanks Julie. Can I ask, how was your husband diagnosed?

FoggyBrain24 wrote:Thanks Nicholas, this is all very helpful. Did you put together this regiment with the help of a doctor or through your own research?

I've always been able to get to the gym and get exercise in, however, I've noticed that my body is not progressing commensurate with my workout partner.

I currently do not take any multi-vitamin or supplement beyond creatine/whey protein. My sleep doctor did offer the prescription for modafinil, however I was apprehensive about taking anything (I am very caffeine sensitive). Do you have a recommendation for magnesium? I try to derive as much as I can from whole foods, but it seems like my brain just isn't grasping difficult concepts or retaining information (these were not problems when I was younger).

Would love to hear a bit more - I will take a look at some of the other items you list below.

Thanks.

Through my own research, I've asked doctors, but they seem pretty clueless on this, however all these supplements are considered highly safe. The only questionable one is Hup A, it is fairly well tested for Alzheimers patients, and used in other "brain supplements" however I should note that I added Hup A late in the regimen, and it seems to have completely cleared the brain fog. It should be noted that you shouldn't take Hup S without sufficient Choline.

Magnesium suggestion I can make?... Not particularly. I barely tolerate my magnesium gut wise (I have other gut issues) so I can't really recomend one over the other, however it's made my mood and exercise so much better that I don't really think I can do without it. the magnesium is relatively new to my regimen (the last month), but I know others on the board swear by it, they may have more experience and I know that many have said they don't get gut issues with it . I do know if I don't take enough calcium with my magnesium my gut issues are worse.


As for the Modafinil - a few things - It's not a CNS stimulant... It is "stimulating" because it is an awakeness drug... Being more awake = taken action and reacting quicker to stimuli... However I have a finger cuff oxygen censor that I got to test myself (it's helped train me out of the daytime central apneas I get) and my resting heart rate on modafinil is the same as off it... because it's not directly stimulating... It's much more naturally stimulating, not in the sense that the drug is natural, but that it's an awakeness promoter, so for me it has caused less issues than caffeine... Also I used to always think I was caffeine sensitive - it made me cranky, etc... coming down from it was awful and if I didn't have a cup in the afternoon I was a bastard by the evening... That's no longer true for me at least (though I stick to low caffeine oolong mostly), and I think it's because caffeine was highly detrimental with untreated apnea. My body is trying to conserve energy during untreated apnea, and it's not able to do that. Long story short, though I'm not suggesting caffeine at all, Modafinil's stimulatory effects are mild in comparison, and the awakeness promotion shouldn't be an issue.... IF you are using your mask. I would never suggest it as an alternative though, it would probably be worse than caffeine.... WITHOUT CPAP. there is a good reason they only prescribe it to CPAP users, not Apnea sufferers. however I'd say it's been a miracle drug for me in that it is abolishing my body/brain habit of wanting to rest during the day.

Also I forgot - Cranberry seems to help. I had a couple weeks ago at a friends party, and suddenly I perked up immensely, I've been taking cranberry supplements ever since. Looking online, it's been said to help with Chronic fatigue syndrome, and adrenal fatigue issues. regardless of what online says though, everytime I take it I perk up, and the original incident was without even thinking it would do anything, so I doubt it's a placebo effect. Of course depending on what it does it may not help for you, but it seems to have made a difference for me.

That's one thing to bear in mind, just like we all know one mask does not fit all, one regimen may not work for others - Cranberry may not work for someone else - exercise is great for me (better after the magnesium supplement) but may completely overtax someone else etc. so I guess I would say listen to your body and brain as an indicator if something is helping (after a few days, not everything works immeditely) and though I know it's tempting, try not to add everything at once... You'll probably feel better, but it will be hard to tell what helped you feel better. However some stuff does go in tandem (such as magnesium and calcium, Hup A and Choline).
I'd recommend flax seed and choline supplements to any recovering apnea sufferer though. There is plenty of brain recovery that needs to go on.

I will also vouch for modafinil. I started taking it a couple weeks before I received my aPAP, and it has done wonders! My psychiatrist knew I had the take-home sleep study and was just waiting for the DME to set my machine appointment, so she went ahead and prescribed it until I could start treatment. I was fatigued to the point of having to take at least 1 nap a day to make it, sometimes as many as 2-3! The modafinil really helped alleviate the fatigue, and I'm staying on it for a while until I feel the therapy alone is enough to take care of it. It's nice because it keeps me awake without being wired up and jittery like some stimulants are known for. Much luck to whatever route you decide to try!

Edit: spelling/grammar

Could sleep deprivation have anything to do with it? I found this link that talks about how hard it actually is to make up lost sleep.

https://www.seventhgeneration.com/enhan ... ou-recover

Thanks ALL! My doctor originally examined me for CFS / ME, and felt I didn't fit the bill. I don't become overly fatigued from the gym or work, it's more that I wake up without feeling refreshed. I noticed myself struggling with topics and unable to concentrate at a meaningful level. Occasionally. I will take a nap on the weekend and feel like a million bucks, but it's infrequent. I've read that it came take a full year of effective CPAP therapy to reverse any potential mental issues/brain damage. I've been using CPAP for 257 days, but only the last 90-150 have been effective (under 2 AHI, which started when I began wrapping my chin with a makeshift bandage to keep my mouth closed). I try to recognize I am on a journey, but it sounds like a prescription medication may be beneficial, especially for my studying. I also have been unwilling to travel, as I am worried about being away from my comfort zone for an extended period and just being exhausted. Hopefully, it continues getting better each day.

USMCVet wrote:Could sleep deprivation have anything to do with it? I found this link that talks about how hard it actually is to make up lost sleep.

https://www.seventhgeneration.com/enhan ... ou-recover

100%. My apnea is mild to moderate, but it disproportionately affects REM, so my mental functioning / mental fatigue. If you are diligent and commit to being in bed for 8-10 hours per night, after a few days, you do feel incrementally better. The important takeaway for me from that article is "do not accumulate new sleep debt." My body has seemed to adjust to 5-7 hours of sleep so laying in bed is almost difficult for me, I don't stay asleep.

Thanks for your service.

FoggyBrain24 wrote:Thanks Julie. Can I ask, how was your husband diagnosed?

It was a long road. He went to many specialists who tested him for everything under the sun. They gave him various diagnoses that usually included the term “idiopathic “ or “atypical”. After about 5 years a doctor we trusted suggested CFS and sent my husband to a doc who is highly regarded in his field (infectious disease) as well as being an ME expert (he is a clinician and also does research). He diagnosed my husband and while initially we were skeptical, the more we learned the more clear it became. He has now had it for a total of 16 years and it has been devastating.

I read a post you wrote after mine where you said you do not get sick or fatigued after exercising. If that is the case ME is unlikely (hopefully I’m right and this isn’t your problem). “Post-exertional malaise” (whether physical, mental or emotional exertion) is one of the defining characteristics. My husband describes the feeling as like the first day ofthe worst flu you can imagine.

Julie