Still have Excess Daytime sleepiness

[gpap]

So its time for Nuvigil....

I have been close to 100% compliant since February 14, 2011 and have noticed improvements like its easier to wake up in the morning. But still very sleepy and foggy during the day. Some of this could be due to the SNRI that I take as well.

I did miss last week due to a campout and no battery. Driving home Saturday, I almost feel asleep on the road.

[lars4life]

You have the software, check the data. If your AHI is low, then check your oxygen levels with an oximeter.
How many times do you wake during the night. I went from waking 6 to 12 times a night and had a sleep
study AHI of 171, and was given bipap pressures of 25/21 and supplemental O2 by concentrator at night.
My AHI is now consistently less than 2.0, my oximeter records I am over 90% as opposed to in the 70's
without supplemental O2. If things don't improve, see your doctor.
It does take time to feel better, but you should have seen results in the first month or so, especially if your
case was severe like mine.

[robysue]

So its time for Nuvigil....

I have been close to 100% compliant since February 14, 2011 and have noticed improvements like its easier to wake up in the morning. But still very sleepy and foggy during the day. Some of this could be due to the SNRI that I take as well.

Is the medical condition that you are taking the SNRI for well managed and under control? SNRI's are, of course, most commonly prescribed for depression, but they can be used off label for other conditions. Depression, of course, often has severe daytime sleepiness and fog brain as symptoms. So if you're taking the SNRI for depression, the first question to ask is: Is the depression responding to the SNRI? And is it well managed with the SNRI? If you are taking the SNRI for some other reason, it's reasonable to ask whether that medical condition also has daytime sleepiness and fog brain as symptoms. And if so, is the SNRI managing the condition in an effective way.

I bring this up because one dirty little secret about xPAP therapy is this: If you've got medical conditions other than OSA that strongly and negatively affect the quality of your sleep, then you won't be able to feel the full benefit of xPAP until both the xPAP therapy is optimized (in terms of taking care of the apneas) AND the other medical conditions are stable and well managed as well.

[nanwilson]

I did miss last week due to a campout and no battery. Driving home Saturday, I almost feel asleep on the road.[/quote]

Gpap
I'll bet you won't do that again, not only could you have killed yourself but whovever else was on the road at the same time as you. If you are going to go camping...GET A BATTERY! You could even use the battery on your car as long as you keep it charged up.

[davecpap]

Some of this could be due to the SNRI that I take as well.

I was struggling with daytime sleepiness (bad) even after a few months of CPAP treatment. I've also been taking an SSRI, Celexa 20mg. I started taking half, and I noticed an improvement. I stopped taking it all together, and I have NO EDS problems! Its remarkable. It took a couple weeks for my body to adjust, but I've been Celexa free for almost 6 months. NO desire/need to go back, and NO EDS for 6 months since I stopped it!

Now, in order to do so, I saw a PSYCHOLOGIST for many months to deal with the cause of my depression/anxiety problems which led me to SSRIs in the first place. I had to try a couple psychologists until I found one I thought really understood me. I also saw a psychiatrist about how to taper off of Celexa since I'd been taking Celexa like 8-9 years. I really think the CPAP treatment helped with my depression/anxiety, I didn't need to SSRIs anymore, and the SSRI had a side effect which was sleepiness!

[gpap]

AHI < 2
No awakenings

[lars4life]

sounds good, but check your O2 levels while sleeping. You need an oximeter that records during the night.

[lars4life]

SNRI....I only have experience with seratonin uptake inhibitor and it does not inhibit sleep for me!

[gpap]

DOH. Oxygen > 90% on 2 liters of external oxygen.

[Mary Z]

I am one of those with 3+ years on the machine and I take Provigil or Nuvigil for EDS. I suspect the problem to be psych meds I take for Bipolar disorder. In my day to day life untreated or undertreated manic depression is more dangerous to me than the daytime sleepiness (which Nuvigil or Provigil help). There are some days I won't drive if I'm particularly sleepy, but otherwise the EDS has little impact on my life when I take the wakefulness meds.