Low AHI but no relief, ready to give it another go

[egoody]

33, male, normal weight, BMI, etc
Diagnosed around 4 years ago with ~30+ AHI. AHI when I use the machine is way down, and I've been able to use the machine for up to 6-7 hours some nights, but I wake up unaffected; don't notice a difference.

I'd really appreciate any advice you all have to give to help me trying.
https://imgur.com/a/88qEZiS

[Pugsy]

How many hours of sleep are you averaging? Sleep and not just laying in bed?
I see at least one break in therapy so at least one wake up...why? Do you have more wake ups but didn't turn the machine off?

Exactly what symptoms aren't improving?

Do you take any medications of any kind, if so, what?

How many nights have you actually got 7 hours of real sleep? How many nights at 6 hours? How many nights with less than 6?

[egoody]

1) typical night I sleep around 10 hours (from falling asleep to getting out of bed)
2)I typically leave my mask on and disconnect the hose when I go to the restroom (2 or 3 times a night while using CPAP)
3) I never had the "a-ha" moment that a lot of people get from starting CPAP, but I don't feel an overall improvement really at all. Still lethargic, takes me a while to get out of bed in the morning..my usual amount of tiredness throughout the day. I have a lot more going on nowadays, but I could definitely see myself napping throughout the day if I didn't.
4) I take Prozac, a pretty high dosage daily
5) What exactly do you mean by real sleep?

[Pugsy]

Real sleep....asleep vs just laying in bed for hours but not sleeping.

Prozac....known side effects might explain some of your unwanted symptoms. It's a nasty little drug but I do understand the reason it is dispensed.

https://www.mayoclinic.org/drugs-supple ... 063952?p=1

https://www.rxlist.com/prozac-side-effe ... center.htm

https://www.webmd.com/drugs/2/drug-6997 ... al/details

[boxofrain]

10 hours of sleep per night is way too much for an adult. Studies show the sweet spot to be 7.5 hours. Too much sleep is as harmful as too little. Could your depression be causing you to sleep excessively? Can you try setting an alarm that works wake you after 7.5 hours of actual sleep and see how you feel?

[Pugsy]

Many years ago I took Prozac for a short while (messy divorce thing) and at a low dose. This was before cpap as well.
I used to say it would knock an elephant down. Someone taking a high dose is very likely to feel the need to sleep a lot and still feel like crap. The medication itself could be causing the need for excessive sleeping.
Obviously not something a person wants to go messing with and not having their doctor involved though.
But it can mess with sleep, cause insomnia, make a person want to sleep a lot, cause fatigue and lethargy as well....and some other stuff.
And of course the very reason a person takes the medication could also be a cause for some of the unwanted symptoms.

It wouldn't be impossible for the unwanted symptoms to be related to medication side effects or ...and the best cpap therapy in the world can't fix that.

[boxofrain]

Right on Pugsy, totally agree. On a similar note, after exhausting other options, I was started on Lexapro 10mg per day about two months ago. Also an SSRI. I would say without any doubt it has helped my sleep remarkably!

[Pugsy]

Right on Pugsy, totally agree. On a similar note, after exhausting other options, I was started on Lexapro 10mg per day about two months ago. Also an SSRI. I would say without any doubt it has helped my sleep remarkably!

Everyone reacts differently to all these mood meds. When I took Prozac it was horrible. Made my skin feel like I had bugs crawling under my skin all the time. Sleep was worse with it than without it. I think I lasted maybe a week with it and I told the doctor no more of this crap and I would just bull through my depression from the divorce......and I did.
SSRIs (SNRIs as well) are also known to suppress REM...so while people might sleep a lot they might not get the needed amount of deep sleep and REM stage sleep. We need all the cycles of sleep to get restorative sleep.

Now I realize there is a time and place for all medications and sometimes the problem that the meds are helping with is a bigger problem than maybe the side effects or messing with sleep (too much or too little) or fatigue....so sometimes people have to make a compromise and with the help of their medical team they decide which problem gets priority.

What is sad though is that people blame cpap for "not working or not helping" with their problem or unwanted symptoms so they bail on the therapy when in reality the problem isn't something cpap could ever fix anyway. I see it all the time and that's why I always ask the what medications are you taking when I see people with what would be very acceptable numbers on their report and they still report feeling or sleeping like crap.

[zonker]

10 hours of sleep per night is way too much for an adult. Studies show the sweet spot to be 7.5 hours. Too much sleep is as harmful as too little. Could your depression be causing you to sleep excessively? Can you try setting an alarm that works wake you after 7.5 hours of actual sleep and see how you feel?

i'm the exception that enforces the rule.

nine hours is my sweet spot.