Feeling exhausted after a year of CPAP therapy

[mastau12]

Hello,
I was diagnosed with moderate sleep apnea (mostly hypopneas) over a year ago. The sleep test showed an AHI of 18.8 and supine AHI = 30.9. I started using a ResMed CPAP machine about 1.5 years ago, and the doctor says that the apnea is now well controlled. However, I feel even worse than when I started therapy. The CPAP machine has seemed to reduce my snoring significantly, but I'm extremely tired all day, especially towards the end of the day. It took quite a while to get used to sleeping with the nasal mask. But now I feel like I'm sleeping ok (not great, but not horrible either), and getting enough hours of sleep. But still wake up tired. I've also had blood tests to rule out other issues, and bloods results look great. Is there anything else I can try, or is the tiredness not related to apnea?

SleepyHeadReport.jpg (605.95 KiB) Viewed 3524 times

Thanks!

[Julie]

What are your pressure settings? It's possible they've been too low for adequate treatment all along unless you've adjusted them.

[palerider]

See how your pressure is jumping around all night? that means it's too low so you're constantly having some kind of event (there's more to sleep disordered breathing than just apnea and hypopnea)...

https://www.youtube.com/watch?v=-gie2dhqP2c

[zoocrewphoto]

A lot of people still feel bad with an ahi of 2-5 even though doctors say under 5 is good. Most of us try to get it under 2. Also, as palerider mentioned, your pressure is jumping up and down. Some people are fine with that. Others don't sleep as well, even if they don't remember it. Increasing your minimum a little should help both problems, and that should help your sleep quality improve.

[zonker]

What are your pressure settings? It's possible they've been too low for adequate treatment all along unless you've adjusted them.

if you squint closely at his posted chart, it's min 5 max 15.

to the OP, if you are comfortable doing so, you may want to raise your minimum pressure. as others have said, the sleep docs tend to think anything under an ahi of 5 is treated. for all i know, there may be people who do feel good at 5. me? i feel great at around 1 or under.

good luck!

[palerider]

for all i know, there may be people who do feel good at 5. me? i feel great at around 1 or under.

I can't see how anybody can actually feel good at 5....

I think it's that they don't realize how wearing it is on them, just like you hear people that say "Doc says I have moderate apnea, but I feel fine".

it's so easy to get so used to whatever they're feeling, over time, that they don't realize that they could feel better.

[mastau12]

What are your pressure settings? It's possible they've been too low for adequate treatment all along unless you've adjusted them.

min 5, max 15. It usually averages between 8-10 each night.

[Julie]

Bump the 5 to a 7 and see how things go.

[palerider]

What are your pressure settings? It's possible they've been too low for adequate treatment all along unless you've adjusted them.

min 5, max 15. It usually averages between 8-10 each night.

Raise the minimum up until your pressure trace isn't jumping up and down all night... there should be at least a little time it sits at minimum.

[zoocrewphoto]

for all i know, there may be people who do feel good at 5. me? i feel great at around 1 or under.

I can't see how anybody can actually feel good at 5....

I think it's that they don't realize how wearing it is on them, just like you hear people that say "Doc says I have moderate apnea, but I feel fine".

it's so easy to get so used to whatever they're feeling, over time, that they don't realize that they could feel better.

I used to think I slept okay. Woke up a few times, but no big deal. I didn't understand that sleep apnea was more than waking up, and was causing damage. I learned that and requested a sleep study. I did a split night. About 2 1/2 hours for diagnosis phase. Then they put the mask on, and I slept for over 5 hours STRAIGHT. I felt pretty good that day. The next night at home, I slept normally. I felt like crap the next day. Then I realized that I felt normal; I just didn't know that normal was crap.

[mastau12]

Bump the 5 to a 7 and see how things go.

I bumped it up to 8.6, but my AHI didn't change much. Is that normal? The pressure isn't moving around as much, but it's not very flat either. Do I just need to give it a few weeks, or would you recommend bumping the min up even more?

[Pugsy]

When the bulk of anyone's AHI is central/CA we can't expect a reduction with pressure increases because more pressure doesn't fix centrals unless using one of the high end machines designed to treat centrals.

First thing I would do is first try to figure out if those flagged events are real asleep events or more related to being awake/semi awake or arousal.
This will help you learn how to determine real vs not real.
http://freecpapadvice.com/sleepyhead-free-software

I would suggest leaving the settings at these new settings for at least a week and see what happens in terms of the data, sleep quality and how you feel.

Oh....do you take any medications of any kind and if you do...what?

[mastau12]

When the bulk of anyone's AHI is central/CA we can't expect a reduction with pressure increases because more pressure doesn't fix centrals unless using one of the high end machines designed to treat centrals.

First thing I would do is first try to figure out if those flagged events are real asleep events or more related to being awake/semi awake or arousal.
This will help you learn how to determine real vs not real.
http://freecpapadvice.com/sleepyhead-free-software

I would suggest leaving the settings at these new settings for at least a week and see what happens in terms of the data, sleep quality and how you feel.

Oh....do you take any medications of any kind and if you do...what?

I'm taking Lisinopril for high blood pressure, and mometasone for sinus inflammation.

[Pugsy]

Lisinopril

fatigue is a known side effect.

It might be a factor in how you feel.

[Julie]

It also makes many people cough.