Using CPAP-still tired as ever-why??

[Drowsy_in_Denver]

Diagnosed with sleep apnea about 18 months ago. Had a terrible time with the nasal CPAP, but went to a full face mask and am usually able to wear it the entire night. Of late, in particular, I've used it every night for 2 months with no problems. So why am I still exhausted? I'm talking falling asleep in the bathroom every single day, laying down with the kids to tuck them in at night and out like a light in 30 seconds tired. Going back to see my doctor next month, but anyone have any insights? It is so frustrating that it does not seem to get any better. Isn't there a second type of apnea that is more neurological than physiological? Anyone have that issue-- apnea that is more than just an obstruction issue?

[Guest]

Is Central Apnea what you are thinking about.. Cpap at high levels is not good for central apneas. Some auto cpaps try to detect them or at least minimize them by not increasing pressure when they occur. There are many posts that do a excellent job explaining this. A post last week by SWS was excellent. Search Cardiac oscillations. This should find it.

Good Luck

[rested gal]

Denver, what machine and what pressure are you using? It might be something as simple as that the pressure is not right for you.

Do you have the results of your sleep study that you could post here? If there weren't any/many "central apneas" noted on your study, I'd doubt that's the problem. I'm not a doctor, though.

If you get your cpap treatment optimized but time keeps going on with no real relief from the extreme sleepiness, you might want to talk to your doctor about a medication like Provigil. Some studies have indicated it's possible that years of untreated OSA can do lasting damage to parts of the brain - depending on how severe the hypoxia was, and for how long. Even if that were the case, though, it's very important to continue cpap treatment now, to prevent further damage.

If it's just a matter of the machine and pressure not being right for you yet, you could very well see better results once all that's taken care of. I'd look into that first, if I were you.

[Drowsy_in_Denver]

Thanks folks-- I'm actually going back to see my doctor next week, and am going to request a follow-up sleep study. I went back and read a bunch of the prior posts, and am thinking that maybe an Auto-PAP (I think that is what it was called), that adjusts pressure as need through the night might help. It's just frustrating to wear the darn thing religiously and still be so tired.

[SleepyGuy]

Don't overlook the idea that you may also have some other condition at the same time. If it is just an adjustment of the CPAP machine, that's great, but also ask your doc for the usual battery of tests he would conduct for fatigue such as hypothyroidism, anemia, calcium levels, diabetes, etc..

[Guest]

I was titrated at 11 at my sleep study. A month later I went to my ENT Dr. He said I had a polyp in my Lt nasal cavity. He scheduled me for a biopsy. When I woke up he told me he removed a grape sized tumor .
My average pressure is now 6.5. I breathe much easier now.

My point is: Other things do happen to change our pressures. Changeing the pressure isnt always the way to go . Need to find out why the pressure needs to be increased.

IN MY CASE THERE WAS A TUMOR BLOCKING MY AIRWAY.

THE SLEEP DR. AND CLINIC MISSED THIS. HELL, THEY DIDN'T EVEN LOOK.

Another point : See an ENT specialist also. They know where to look for problems. It is their area of specialty.

Chris

[SleepyGuy]

My doctor checked me for this. Apparently most don't do this, but his specialty is facial reconstructive surgery. He got into this because many sleep apnea patients often need surgery though he certainly recommends surgery only as a last resort.

After my first sleep study, he put a fiber optic cable up my nose through my sinuses and down into my throat to look for obstructions. He didn't find any tumors. He did find that my throat air passage is only about 30% of normal.

The good news is this wasn't at all painful. At one point it was uncomfortable. I told him and he adjusted it.

As the poster above says, have them look for tumors. The procedure to look for them doesn't take long and is not painful.

[Paul B]

Another issue that could cause you to still be tired is that you have PLMD(Periodic Limb Movement Disorder) which may be causing micro-arousals and interfering with the quality of your sleep. This would be noticed if you had an overnight sleep study.

There are also other sleep disorders that can interfere with your quality of sleep, all of which require a sleep study.

[Drowsy_in_Denver]

Thanks everyone-- I really appreciate the responses. I, too, have had the fiber optic tube snaked up/down the nose. That didn't solve anything, but it eliminated some possible causes that might have been exacerbating my situation. I am going to ask about other possible causes (appointment on Monday, yeah!), but alo press hard regaring the authopap. I KNOW I am still having apnea moments at night-- the sudden waking, the DEEP inhalation, like coming up from underwater-- even with my CPAP running at 14. Just have to keep after it aggressively to seek better relief. If I learn anything new at the doc's I'll let y'all know. Thanks again for your thoughts on this everyone.

[Guest]

First you need to figure out if the apnea has been resolved by wearing the mask. If it's leaking then you're not getting the right pressure and then you're having events that will fragment your sleep

If you're still tired you must not be getting any of that good delta sleep that we all need to make it through the day. I'm curious about the night you had in the lab. If it was a rough night then maybe the tech couldn't find the right pressure for you.

Another thought is that maybe you should be tested for narcolepsy. This is done by first correcting the sleep apnea, then doing a daytime test to see if you can fall asleep during a series of naps.

talk to your physician and ask lots of questions
Bob