Comments on cognitive improvement?

I have been using my cpap since November 2012. Before that was 3 years of downward spiraling. I was constantly dragging. I went from one of the strongest performers in our office to bottom of the barrel on an administrative action plan. New information just wouldn't stick, it took me longer to process my own thoughts and developed speaking issues (finding the right words and stumbling over words when talking). The stress caused issues with my personal life, I couldn't enjoy much and I like to try writing in my free time but couldn't be creative. Blood work kept coming back fine, no thyroid issues or anything. The doctors kept trying to treat me for depression but nothing worked. Over the years more and more of our friends were getting cpap machines and I started talking to them about the reasons they were using them and found their stories to fairly similar to mine, especially with fatigue issues.

I talked to my doctor and got the sleep study ordered. It was a really rough night and it seemed surprising they were able to get much information at all. I felt like I was fighting the machine and had trouble falling asleep and staying asleep. But I was diagnosed with OSA. I don't remember all my stats but my machine is set at 6. I think there was a slight improvement in the beginning but I don't feel that I really ever got back to the quality of life I remember having. I'll admit I've been pretty lazy to wait this long but I finally talked to my doctor today about having another sleep study for possible retitration.

I've seen a lot of overnight success stories for people having more energy immediately upon starting their cpap, but I'm hoping to find more stories closer to mine. I was incredibly fortunate to have been laid off from a job that had a rapidly declining work environment and immediately hired by a great company that is worlds better but I'm struggling to get my work done and I don't want to risk losing it all. Although I sleep somewhat solidly at night I never wake up refreshed and all day I look forward to just crawling back in bed. I feel foggy all day long I work more reactively than proactively.

Anyone have similar stories with successful endings? Even if they found something in addition to the OSA that was causing issues? I just want to make sure I turn over any possible stone. Thank you for reading and any feedback!

Check out the Success Stories post in the topics section. There are many varying stories of success along with details about bumps in the road.

Can you please confirm your machine model? Look on the bottom of the blower unit for a 3 digit number with probably DS or REF in front of the 3 digits.
The usual first thing we ask people is for confirmation that their therapy is optimal with the AHI being acceptable and leaks well controlled but the machine you have chosen in your profile doesn't collect any useful data...so if you have a 250 or 260 model (or less) model number then we have no useful data to evaluate. I am so hoping you just chose the wrong machine in your equipment profile and you have a full efficacy data machine and we can point you to some software so we can at least see if anything in terms of your therapy could stand improving on.

Do you take any meds of any kind? Even OTC? If so, what is the name of the meds you take, strength and when do you take them?

So...model number of machine and meds???

Hi Pugsy,

It looks like it's a 260P?

I still take Wellbutrin XL 300Mg once in the morning. I'm being treated for Myasthenia Gravis (though it's not a confirmed case, my right eyelid droops down but no other symptoms) so I take Mestinon 60MG 3x a day and Cellcept 100Mg 2x a day. I am also on birth control pills.

The 260 is the 60 series machine with optional heated hose and it is the model PR System One 60 series Plus CPAP...it has a SD card but all it collects on it would be hours of use. So no way to verify therapy effectiveness or leak or anyway to check to see if something in your therapy needs improvement.
We call those type of machines.."bricks"...they still give great therapy but when there are problems with how a person might feel there is zero information available to see what might be going on...all you get is how many hours you used the machine each night.

Do some in depth research on Wellbutrin...not only could it cause some of your symptoms it is also known to disrupt sleep architecture. Go to multiple web sites and read about the side effects to it.

Mestinon doesn't seem to be much of a problem but I just went to a couple of sites to check side effects...and I suspect you can't alter the dose and I don't think it is much of a problem anyway.

Cellcept ... again something you likely can't alter from what I read about why it is taken..... but I did spot that fatigue was/is a common side effect.

Do some serious research on Wellbutrin though...that one screams out at me as a potential factor in your daytime issues.

Now I am not telling you to stop or alter anything. That would be for your doctor and your to discuss and Wellbutrin would be on the top of the list.
Sometimes we have no choice and have to take meds that have side effects we don't like but sometimes knowing that part of why we feel so crappy is due to meds...well, it helps a bit just to know that there's a logical reason for what we feel.

You might call up your DME who supplied your brick machine and explain that you would like to be able to see the data that full data machines can provide just in case something in there stands out that needs improvement. Maybe they will loan you a full data machine that works with your existing humidifier for a week or so...model 460 or 560 would work fine and you could used Sleepyhead software to see what shows up. At least rule out anything in that area as a potential culprit.

Good plan. I'll do the retitration study just in case and then see about renting/upgrading a different model machine to see if I can get better ongoing information. I completely understand your advice on the medication, they do give some possible talking points with the doctor in the future if needed. Thank you for your time!

The repeat titration study won't tell you if you have leak issues which might be impacting therapy.
You are going to need a full data machine for that.

If your pocketbook permits there are ways to get a new or gently used machine on your own.
CPAP.com for new machine...secondwindcpap.com for low hour used or even a new open box special.
Need a RX though which would/should be easy to get. Any medical professional who can write scripts can do it. Doesn't have to be a sleep doctor.
Since you have a 60 series humidifier you will also need a 60 series blower if you want to use the same humidifier to save money...and model 460 or 560 would give you the data.
I don't know if anything exciting will show up but when looking for culprits...have to look at all potential hiding places for them.

Anijel writes... It was a really rough night and it seemed surprising they were able to get much information at all. I felt like I was fighting the machine and had trouble falling asleep and staying asleep. But I was diagnosed with OSA. I don't remember all my stats but my machine is set at 6.

One suspects that the discomfort from the machine and mask may have kept you from the deeper sleep stages; and, that a pressure of 6 was sufficient to rouse you up out of apneic occlusion for the study.

My case was quite similar; and from my initial sleep study, as I recall, I was first prescribed 5 as a cpap pressure. A few months into the therapy process, I asked for another study, and they gave me a recording apap, which suggested a pressure of 8 inches. That made things better, until I bought my own apap and was able to determine (and my doc was on board w my experimentation) that a pressure of 9 was even better. My ultimate sweet spot pressures for me are 9.5-12. These haven't changed now for several years, and my average ahi is nicely down to 0.2.

Cognitively my improvements were surprising (but mostly not immediate). I found myself able to read, speak, think, and multitask as never before.

Good luck on your therapy.

.

I don't know what your insurance coverage or financial situation is like, but a rental for a couple weeks of a data capable machine could possibly help you avoid a retitration. If the data shows the therapy is suboptimal either due to inadequate pressure or leaks, correcting that could be all you need. Either way, you are on the right track to not just continue with poor results without searching for answers. Your description of your cognitive issues sounds very much like mine. Besides OSA I have a limb movement issue when I sleep. My head became clearer as my sleep improved. Good luck going forward.

Don't give up on pursing this further! You've already got some great advice (go for that retitration, and look into a data capable machine which for me really was worth every out-of-pocket penny)--but by way of encouragement, let me tell you that I was initially retitrated at 7, but since I have UARS (so the titration protocol is different) my retitration by an actual pulmonologist who gave the right instructions on what to correct for was at "13 or 14, and look into a bipap." Once I got a data capable auto machine (in my case, I did need a bipap) my ideal pressure has turned out to be 15-19. (!) That's a long way from 7!

I knew as soon as I adjusted to the new settings/machine (took me about 4 weeks) that I was finally on the right track; it took about 3 months of consistent use before I started to get some real recovery in my physical and cognitive health. Your brain/body will need some time to repair itself.