Still tired!

[Nardella]

So I have been using my BiPAP for a month (after using CPAP for about 2 months before that) it took me an extremely long time to adjust to it and be able to sleep more than an hour or two without waking up. However the last 12 days I have used it for 4-5 hours on 9 of the nights and for 6-8 hours on 3 of the nights.

However I am still extremely tired when I wake up after about 8 hours of sleep. I usually sleep an additional 4 hours and feel less tired but still quite tired.

My AHI average over the last 12 nights is 0.95.

I have had no leaks over the last 12 nights.

I am going to consult my RT and my ENT specialist at the next opportunity but I wanted thoughts from this group.

[ChicagoGranny]

Sorry to hear this.

I post this to everyone with those types of problems.

Do you,

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps.
- Practice total abstinence of caffeine including sources like chocolate
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Optimize emotional stress in your life
- Use CPAP software to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular wellness visits to confirm there are no other medical problems.

?

[Julie]

Use SleepyHead (free) that you can download from the forum - it'll tell you if anything needs tweaking (download results to Imgur.com then post a link to this thread - the 1st "Announcement" on main pg will explain better).

[Noctuary]

You are not alone. I've been doing this for 17 months now and still feel bad most days. However, I'm far better than I was in the months before CPAP.

[Wulfman...]

So I have been using my BiPAP for a month (after using CPAP for about 2 months before that) it took me an extremely long time to adjust to it and be able to sleep more than an hour or two without waking up. However the last 12 days I have used it for 4-5 hours on 9 of the nights and for 6-8 hours on 3 of the nights.

However I am still extremely tired when I wake up after about 8 hours of sleep. I usually sleep an additional 4 hours and feel less tired but still quite tired.

My AHI average over the last 12 nights is 0.95.

I have had no leaks over the last 12 nights.

I am going to consult my RT and my ENT specialist at the next opportunity but I wanted thoughts from this group.

It's going to take MONTHS to feel some recovery and then only after you get your therapy tweaked. It's also going to take more hours of sleep than what you've been getting.......and I mean CONSISTENTLY!

It might help if you fill-in/update your profile and with your specific settings.
It's still showing your AutoCPAP......
Machine REF 561CA Philips Respironics REMstar Auto A-Flex
Humidifier REF IN6TFLG

And, you must be in Canada, judging from the machine number you have listed.


Den

.

[BlackSpinner]

However the last 12 days I have used it for 4-5 hours on 9 of the nights and for 6-8 hours on 3 of the nights.

You MUST use it when ever you sleep or it won't help.

And remember, being tired is only ONE of the symptoms and the least important one. Your organs NEED you to sleep with low O2 episodes. Depending on how much damage you have done to them it may take any where from 3 months to a year to repair it enough for you to feel much difference.

[kteague]

Hi. Can you clarify if the hours you used the machine are your total sleep hours? If this is your total sleep hours, it is simply not enough to make you feel good. Better maybe, but not good. I tend to think when one is recovering from the damage of sleep deprivation and untreated sleep apnea it helps to get even beyond normal maintenance sleep. If the hours you mentioned are just machine hours and you slept more time without the machine, you are still getting assaulted during those hours without treatment. Who could feel good after that - especially when it likely happens at the end of your sleep and you wake from that state? Also, a lot of our REM sleep happens late in our sleep. When one cuts their mask time short, it is likely their REM time is shortened by events. Can you describe your wakeup and/or stop treatment experience? Maybe there's a trigger that can be addressed.

[Nardella]

You MUST use it when ever you sleep or it won't help.

Really? My RT and Doctor both said that anything more than 4 hours 70% of nights had no additional positive effects.

Hi. Can you clarify if the hours you used the machine are your total sleep hours

That is hours on the machine. I usually sleep at least 12 hours a day.

[Wulfman...]

You MUST use it when ever you sleep or it won't help.

Really? My RT and Doctor both said that anything more than 4 hours 70% of nights had no additional positive effects.

Hi. Can you clarify if the hours you used the machine are your total sleep hours

That is hours on the machine. I usually sleep at least 12 hours a day.

Your doctor and RT are idiots.
It's going to take months to pay off your "sleep debt"........and 4 hrs., 70% of the time ain't gonna cut it.

But, the 12 hrs. a day may be a good start. Keep at it. It takes time.


Den

.

[OkyDoky]

Really? My RT and Doctor both said that anything more than 4 hours 70% of nights had no additional positive effects.

This is way off base.(watching the World Series ) The above numbers are what is required for insurance (or DOT) to say you are compliant with treatment so they will pay for your machine. For healing to take place you need to wear the machine whenever you sleep. You may have to work up to that but don't ever accept the 4 hours 70% of time as acceptable to stop.

[kteague]

My RT and Doctor both said that anything more than 4 hours 70% of nights had no additional positive effects.

I want to believe that was miscommunication rather than an actual quote, either by how they worded it or how you interpreted it. I'm usually reserved on criticizing medical professionals but IF, and that's a big IF, this was their intended advice, that's scary.

I could see a conversation going something like this... Discussion of compliance (usage) requirements (quoted numbers make me think that was the topic). Patient asks if using it more than required for compliance would help. Doctor answers no, in context of meeting compliance requirements. Patient was asking in context of feeling better and health, but the doctor didn't make that unspoken transition with them. Miscommunication. Happens all the time. Could this be the case?

Maybe you could ask your doctor for clarification. If we look at it logically, if sleep apnea events hurt you the first 4 hours, why would the apneas then not hurt you the rest of the sleep time? Aside from using the treatment the entire sleep time, adequate hours for maintenance and a bit extra for recovery can be helpful until one begins to feel better and naturally need less and less sleep.

If some time of consistent therapeutic and adequate usage doesn't begin to produce improvement, other contributors should be considered, such as medical conditions, other sleep disorders, and medication side effect. I probably wouldn't delve too deeply too soon. See what the right usage does for you. Maybe that will be enough.

[bpt513]

I'm in the same boAt here. I was diagnosed 2 weeks ago. I use nasal pillows and cushions religiously every night. Ahi went from 11 to 2.2. Had apnea about a year I figure. Very active. Resting HR 55. Bp now back to normal but blood oxygen sometimes trends to 91. I'm fatigued and muscle aches every day. Frustrated to read it will take months to recover

Anything else I can do besides sleep more? Get about 7-8hrs with a lot more dreams too.

Thanks

[kteague]

...diagnosed 2 weeks ago. I use nasal pillows and cushions religiously every night. Ahi went from 11 to 2.2. Had apnea about a year I figure. Very active. Resting HR 55. Bp now back to normal but blood oxygen sometimes trends to 91. I'm fatigued and muscle aches every day. Frustrated to read it will take months to recover Anything else I can do besides sleep more? Get about 7-8hrs with a lot more dreams too.

Do you wake up to an alarm or do you wake up naturally after that 7-8 hours? If you wake up naturally, maybe it's simply enough. It is fantastic that in 2 weeks you are seeing better BP readings. Your description of muscle aches makes me wonder if you need to be attuned to the possibility of more going on along with the sleep apnea. Some things come to mind like medication side effect or limb movements of sleep, for starters. Your AHI at this point is not bad but there may still be room for improvement. If you haven't already, maybe starting a separate thread about your issues could garner you some suggestions.

[Nardella]

Can you describe your wakeup and/or stop treatment experience?

Yeah, I wake up needing to go to the bathroom, really badly. Because the walk to the bathroom is so rousing by the time I get back to bed I am almost as wide awake as during the day. This makes it extra hard to fall asleep with the mask on and I really have a strong desire to get back to sleep, so I don't have the patience for the mask. If I was to just wake up and be able to go back to sleep right away then I suspect I would be able to fall asleep quickly with the mask on.

miscommunication

if sleep apnea events hurt you the first 4 hours, why would the apneas then not hurt you the rest of the sleep time?

The way it was explained to me is that the pressure reduces the swelling in my throat. Thus the sleep that happens in the hours immediately following the treatment are apnea free or have few apneas. He even went as far as to say that eventually I may only need a few hours a week. During my last exam when he looked at my throat he mentioned that there is reduced swelling compared to before I started treatment.

As for my RT, that is where I got the numbers from. She said that there was a study that confirmed the case and that I didn't have to be trying to obtain more hours than that. She seemed sceptical of the numbers but not of the actual fact that 100% usage was required.

[kteague]

I really tried to talk myself into giving this premise some credibility, but just deleted my blathering when it hit me that if this premise were reliable:
* An autopap user would not see their pressure rise after the first few hours (Is that true for you anyone?)
* It would negate that most of our REM is later in sleep and events are often worse in REM.
* All of us long term faithful cpap users should be nearly cured by now.

Not denying that swelling can be improved with CPAP. My enlarged tongue went back to normal size after a while on treatment, and has stayed normal since. However, that did not change the severity of my OSA. It has continued to worsen over time, from mild to moderate to severe. I don't see reducing swelling as the end-all solution. Just a piece of the puzzle. Not saying there's not a rare case where swelling caused the apnea and reduced swelling resolved it. But I'd need to see the evidence to be convinced this is more than a rarity. If that philosophy of treatment was working for you, would you be here? Try it our way for a while and see if you start feeling less tired.