BiPap Working, but still tired as ever!!!!

So what the heck? I'm using the biPap. I'm compliant. Using sleepy head software and my AHI are all under 4 every single day. (was 23 before). I don't feel any less tired. I feel just as tired as I used to feel.

What's going on? HELP..

Really if this is the case why bother with the biPap?

danjfoley wrote:... So what the heck? I'm using the biPap. I'm compliant. ... I don't feel any less tired. I feel just as tired as I used to feel. ... why bother with the BiPAP? ...

I'm so sorry to hear that you continue to have problems. In your shoes, I would schedule some time to talk this over with my sleep doctor. It's possible you have some other underlying problem that might be causing the tiredness.

And it's possible that you might need to track down the appropriate doctor to help tackle your situation.

Some questions to help prepare you for that meeting:

• Do you feel sleepy? (ready to fall asleep at a moment's notice)
• Or do you feel fatigued? (run down)
• Do you have a copy of your sleep study?
• Did your sleep study show that you have a lot of spontaneous arousals? (rouse from a deeper level of sleep to a lighter level of sleep)
• Did your sleep study show that you had a lot of periodic limb movements? (twitching and movement of your arms and legs)
• Have you had a physical recently?
• Did your physical show normal thyroid functioning?
• Do you have Type 2 Diabetes?
• Is your blood glucose in normal ranges?

If you have problems with your thyroid and/or diabetes, then you will tend to be fatigued (just worn out) rather than sleepy (ready to fall asleep at the drop of a hat). That might indicate it is something quite different than sleep apnea. In that case, you might want to start with a GP type doctor to try to track down your specific issue.

If you are otherwise in good health, it might be time to see a neurologist, who specializes in sleep medicine.

In either case, bring your SleepyHead print outs with you. This will show both compliance and good AHI numbers. It will allow them to then focus on other possible sources of your tiredness.

Hope that helps. And do keep us updated.

thanks for the reply Before i answer your questions. I should have noted that the nasal mask pillows are making my nose raw!! the first day i woke up feeling decent.. gotten worse every day.. So has the nose getting more raw and raw.

I have used sleepy head and all the numbers are good. Last night i remember waking up a lot adjusting the mask cause my nose hurt. but the numbers still look good. I guess the auto bipap machine doesn't really know that i'm not sleeping.. it only knows that i'm breathing. As in i have damn good AHI numbers when i'm awake

getting under 3 AHI every night. Last night was day #5.

So i did some reading.. and tried the medium swift fx size. Seem to feel better. I also loosened up the straps as much as i could without leaking.. (did a leak test on the machine and passed while laying down).

I also rigged up away for the hose to drape over my head (basically the over the head strap "extra" is taped down to the strap, making a loop for me to put the hose thru.

Feels better. Doing feeling it touching the raw spot so much.

I put petroleum lotion on it for now to get rid of the raw, and will try to put something non petroleum based tonight. (i have ky jelly!)

I also called the dme see if they will let me try a regular nasal mask. I'm sure they will. Once they get back to me. And i have a really good dr. A follow up with him in 2 months, but if this continue i will call him.

Now to answer your questions:

Do you feel sleepy? (ready to fall asleep at a moment's notice)
- without cpap .. yes.. with it.. no expect for today.. yes. (like i said getting worse every day)

Or do you feel fatigued? (run down)
yes.

Do you have a copy of your sleep study?
yes. ahi was 23, lowest oxegen was 80%

Did your sleep study show that you have a lot of spontaneous arousals? (rouse from a deeper level of sleep to a lighter level of sleep)
never got to a deep level of sleep. never got to REM. But i do dream, even now with the bipap. Must just be cause i was in the lab.

Did your sleep study show that you had a lot of periodic limb movements? (twitching and movement of your arms and legs)
no, i had none.

Have you had a physical recently?
yes, passed. did blood work and everything.

Did your physical show normal thyroid functioning?
yes

Do you have Type 2 Diabetes?
no

Is your blood glucose in normal ranges?
yes

danjfoley wrote:... I should have noted that the nasal mask pillows are making my nose raw!! ...

Bummer. You are following the right path to check on the proper fit of your nasal pillows. Once you get the right size you will be amazed at how wonderful they are. I can no longer use them (due to the very high pressure of my ASV unit). But I wish I could. I used them for YEARS and enjoyed them.

danjfoley wrote:... Do you feel sleepy? (ready to fall asleep at a moment's notice)
- without cpap .. yes.. with it.. no expect for today.. yes. (like i said getting worse every day)

Or do you feel fatigued? (run down)
yes.

Did your sleep study show that you have a lot of spontaneous arousals? (rouse from a deeper level of sleep to a lighter level of sleep)
never got to a deep level of sleep. never got to REM. But i do dream, even now with the bipap. Must just be cause i was in the lab. ...

It sounds as if you have some problems with your sleep architecture. The first step was to get your obstructive sleep apnea under control. It's not possible to do any gardening if a forest fire is blazing right next to your house! Now that that fire is out - and under control - your doctor can work with you to try to track down a solution to the poor sleep. Lack of deep sleep can leave you feeling exhausted. Even without deep sleep (or REM sleep) you can dream. Though the sleep lab does tend to interfere with normal sleep, you might have poor sleep architecture (not getting the normal pattern of sleep) due to some other problem. Unfortunately, only your doctor will be able to help you with that one.

Not sure that helps all that much, but I sure do wish you the best!

danjfoley wrote: getting under 3 AHI every night. Last night was day #5.

You may just need to give it more time: Five days into therapy is not that long and most of us do not feel better immediately.

Are you sleeping at least as well as you were pre-BiPAP in a subjective sense? In other words, are you able to go to bed at a normal time (for you) and sleep through the night with roughly the same number of conscious wakes and wake up feeling no worse than you did before starting therapy? If that's the case, just give it more time.

I should have noted that the nasal mask pillows are making my nose raw!! the first day i woke up feeling decent.. gotten worse every day.. So has the nose getting more raw and raw.

Try some Lanisoh. It's a lanolin cream sold to nursing mothers to soothe sore nipples. You find it with baby supplies---it's usually near the bottles, formulas, and breast pumps. A tiny dab put on and around the sore spots before you mask up will help the nostrils and other sore spots on or near your nose heal.

I'm going to get some of that stuff tonight.

Today, i am officially feeling just worse then without bipap. So damn tired i'm PAST sleepy. day 1 felt slightly better. day 2-3 crappy but OK.

Before bipap, i would sleep about 7:30 a night, then go back to sleep for a 1-2 nap an hour after waking up. with bipap i am getting 7:30 and NO nap. (forcing the no nap on myself.)

I'm going to bed early tonight. Enough to get 9 hours of sleep if not more.

I am hoping I'm just not sleeping that much as my nose gets more and more irritated. That would make sense to me. Sleepyhead would still report good numbers if i'm not sleeping.

Had a good night last night.. went to bed early got about 9 hrs of sleep. Used the medium nasal pillow. Put that nipple cream on my nose.. everything was nice a lose. Did NOT wake up with any raw feeling at all.

I woke up feeling slightly tired so i went took a nap for another hour (i work from home so i can do that!) after the kids were out to school.. and i feel good today. Really good.

Unless things are so bad you're really suffering, don't worry about feeling better for a few weeks.

If you really had apnea, your body spent years trying to adapt to apnea. It may take a while to adjust to the absence of apnea.

danjfoley wrote:Had a good night last night.. went to bed early got about 9 hrs of sleep. Used the medium nasal pillow. Put that nipple cream on my nose.. everything was nice a lose. Did NOT wake up with any raw feeling at all.

I woke up feeling slightly tired so i went took a nap for another hour (i work from home so i can do that!) after the kids were out to school.. and i feel good today. Really good.

Comment,

As I understand it the number of hours of sleep are not as important as the quality of the sleep. The fact that you awoke up tired and needed a nap to refresh sounds to me that you are one of those who suffer from RDS (Residual Daytime Sleepiness). I also suffer from a similar problem that in spite of sleeping 8 hours I still am tired and feel crappy in the a. m. till noon. I relate it to my nonproductive sleep treatment or to my underlying medical condition of Peripheral Neuropathy (started with numbness in the soles of the feet and then it became a loss of balance) that I came down with at the same time that I needed CPAPing (a year ago). I am still being treated by specialists about it.

See here an interesting article about RDS:

Prevalence of residual excessive sleepiness
in CPAP-treated sleep apnoea patients: the
French multicentre study


http://erj.ersjournals.com/content/33/5/1062.full.pdf

same deal last night. 8 hrs of sleep with the mask on. Woke up.. feeling slightly tired. Took a nap, now i feel good.