Sleeping a lot, still tired

I’m hoping someone has a similar experience to me and can point me toward a possible solution. My problem is if I get less than 10 hours of sleep, I’m tired for the rest of the day. Even with about 10 hours, I need coffee to get me through the day.

I am a 34-year-old male. I took to sleeping with the CPAP machine easily and have been using it all night every night for the past 6 months. The days of struggling to stay awake at work seem to be past, but I still wake up every day feeling like I barely slept. It’s very difficult to get out of bed.

I have been taking SSRIs for years before starting CPAP therapy. I currently take Zoloft and Abilify and I feel it’s a good combo for me. I am now at a place where I have more I’d like to accomplish with my days than I have energy for it.

My thyroid function has been tested over a couple of years, and aside from one borderline test 2 years ago, all tests have come back normal.

My pulmonary doctor seems to be happy with the numbers coming from my machine. She says I should be more concerned with how I feel. But I don’t feel great. She gave me a prescription for Modafinil, but it doesn't seem to help any better than coffee. On bad days, I'd take it with coffee and still be tired.

My sleep study came back with an AHI of 10. My prescription was for 12. My machine was set up in APAP mode, 8-16. I currently have it set to 11.5-16.5. I’m not sure where to go from here. It seems most people on the boards don’t require more than 12 as a minimum. I tried CPAP mode at 12 and 13 early on, but the results were worse. I can’t help but wonder if I got numbers under 1.0, I would feel much better. Or are my expectations just not realistic?

Thank you!

Roughly half of your AHI above is Clear Airway (central) events and we don't treat CAs with more pressure so we can't expect a pressure increase to reduce them.
That leaves your remaining AHI 1.18 and I doubt that reducing it will make any marked difference in your symptoms.
You will need a little more minimum pressure to reduce that remaining obstructive AHI ....maybe it will reduce with more minimum. Sometimes we get to a point that more pressure doesn't necessarily remove all events. Will it help your daytime symptoms...that's unknown....it might and it might not.

Forget any preconceived notions about "most people don't need more than 12 minimum"...it's really not true and irrelevant anyway. There are lots of people needed much higher minimum...heck even minimums in the 20s.

Your meds...have you looked really hard at the potential side effects? If you haven't then you should. They aren't doing you any favors and while they may not be 100% to blame for your symptoms they likely are a significant factor.
Perhaps something to have a chat with your doctor about...the potential affects of those type of meds on sleep and your daytime symptoms.

Pugsy wrote:Roughly half of your AHI above is Clear Airway (central) events and we don't treat CAs with more pressure so we can't expect a pressure increase to reduce them.
That leaves your remaining AHI 1.18 and I doubt that reducing it will make any marked difference in your symptoms.
You will need a little more minimum pressure to reduce that remaining obstructive AHI ....maybe it will reduce with more minimum. Sometimes we get to a point that more pressure doesn't necessarily remove all events. Will it help your daytime symptoms...that's unknown....it might and it might not.

Forget any preconceived notions about "most people don't need more than 12 minimum"...it's really not true and irrelevant anyway. There are lots of people needed much higher minimum...heck even minimums in the 20s.

Your meds...have you looked really hard at the potential side effects? If you haven't then you should. They aren't doing you any favors and while they may not be 100% to blame for your symptoms they likely are a significant factor.
Perhaps something to have a chat with your doctor about...the potential affects of those type of meds on sleep and your daytime symptoms.

+1

Now that you are successfully on cpap that may lift your depression. I would talk to the doctor.

Our situations sound similar. Male, mid-30s (ok, now late 30s) - burned out mentally and physically for years. Disabling fatigue and headaches -- so many borderline labs. Just recently, things started coming together for me. I'm not sure why, but I'll take it. One thing that's definitely helped is paying more attention to sleep hygiene (plenty of good articles on this from legit websites). An earlier bedtime, NOT oversleeping, and having a wife to physically drag me out of bed when I need it have been key.