Still tired

[jnmv1969]

Have you considered using an oximeter to record data overnight just to be sure that you are not having microawakenings due to apnea events that perhaps your machine is not capturing? I tried using the Zeo myself in order to figure out problems that I am having with my cpap, and when I used the Zeo without CPAP, it strangely gave me great ratings for my night of sleep. I asked my doctor about this, and he said that since the Zeo only captures data every 2 minutes (as opposed to every 30 seconds or so in the lab), so it does not capture microawakenings. In other words, things can look better than they actually are. Yet with my oximeter, it captured about 32 or 35 times in the night where my heart rate jumped but my oxygen levels did not desaturate, which I think were an indicator of microawakenings for me. The Zeo could not capture this data.

Good luck and please keep us posted.

Sincerely,
Janet

[andy88488]

Have you considered using an oximeter to record data overnight just to be sure that you are not having microawakenings due to apnea events that perhaps your machine is not capturing? I tried using the Zeo myself in order to figure out problems that I am having with my cpap, and when I used the Zeo without CPAP, it strangely gave me great ratings for my night of sleep. I asked my doctor about this, and he said that since the Zeo only captures data every 2 minutes (as opposed to every 30 seconds or so in the lab), so it does not capture microawakenings. In other words, things can look better than they actually are. Yet with my oximeter, it captured about 32 or 35 times in the night where my heart rate jumped but my oxygen levels did not desaturate, which I think were an indicator of microawakenings for me. The Zeo could not capture this data.

Good luck and please keep us posted.

Sincerely,
Janet

Hi Janet,

Thanks for that suggestion. I would certainly consider it. Is there a specific oximeter that works for this? I have no idea what works for home and personal use.

Andy

[andy88488]

Great list Pugsy. Figuring out daytime fatigue when CPAP fixes AHI but not your tiredness is frustrating & difficult, several of us are suffering through it. I think of it as 3 categories of possibilities:

1) You have residual SDB that isn't showing up in your AHI (ie UARS). But your FL is quite low.
2) You have poor sleep quality for another reason (PLMD, insomnia, caffeine, vitamin deficiency, etc). Catalog & rule out these possibilities, it takes time.
3) You are tired despite good sleep. This is something you can go to a mainstream or alternative doc for testing. Thyroid function, hormones, vitamin levels, etc. Not straightforward, and takes time too, but maybe you will get lucky and something will stand out in a test.

Personally I'm still exploring all these options for myself, so persevere. It's your life at stake.

I did realize that one element of my sleep hygene needs work. I'm reading my iPad in bed, and that's not good. So I'm making a concerted effort to turn it off earlier and then also to get to sleep a little earlier. I did that last night and felt a bit better this morning. I also saw my therapist yesterday, and he pointed out that I've got a lot on my plate at the moment. That helped. Earlier this week, I was so tired that I felt like I just wanted to cry.

I guess the purpose of my posting right now is to ask, if I have sleep problems (1 or 2 on your list), will a Zeo help me find them? I was all ready to buy one when I discovered that the company appears to be going out of business. And which model Zeo? The headband only model is cheaper, but from the comments in the Android store, it doesn't look like their Android app works all that well with newer phones.

Regarding item 3, that is the most likely, and i have started to investigate this. Thyroid is okay, bloodwork is okay, so far I haven't found any culprits.

Andy

[khauser]

I'm going to "vote" for blood pressure medications, ESPECIALLY if you are taking the class of meds known as Beta Blockers. These are generally the first thing doctors go for today, which is a shame because they DO have a lot of unwanted side effects.

True story: I started taking beta blockers in my 20s because I had marginally high BP AND panic attacks that were manifested as racing heart. Doctor said "on a beta blocker your heart rate will be maintained at a lower rate", which is very true.

Fast forward about 20 years (!!!) and my new doctor (I've moved, lots has changed) and I decide to stop the beta blocker. At the time I was experimenting with a low carb diet and beta blockers interfere with the weight loss benefits (they interfere with the liver's ability to turn fat back in to energy!)

Suddenly I am noticing a change in myself. Things that had interested me and over time I lost interest in became interesting again. My taste changed, for the better (well, except that won't encourage weight loss). Long story short I had become clinically depressed, and because the onset was so gradual I didn't notice! But I sure noticed the change when I got OFF that medicine. WOW!

I am by no means saying the beta blockers cause this in everyone ... or even that all beta blockers should be avoided in those that are sensitive to one (though my doctor doesn't want me to go near any of them). But I see "markers" in what little I know of your story to be suspicious that this might be something you should look in to. You may simply be clinically depressed, which most definitely can cause the symptoms you are experiencing.
-Kevin

[andy88488]

On further investigation, it really seems like Zeo is no longer an option. They took their phone numbers off the website. Googling them got the phone number, but the call doesn't go through. Zeo's forums are "temporarily" unable to accept new posts, since early January. None of the retailers they list are stocking their product any longer. Amazon still has a few being sold by third parties. The comments on Google Play make it seem like the Android app does not work, so I would have to get the bedside unit. But if their website is disabled or discontinued, I don't think I can get the data out of the bedside unit to look at it.

Too bad. It doesn't seem like there is anything even remotely comparable, unless someone knows something I haven't found.

[andy88488]

I'm going to "vote" for blood pressure medications, ESPECIALLY if you are taking the class of meds known as Beta Blockers. These are generally the first thing doctors go for today, which is a shame because they DO have a lot of unwanted side effects.

True story: I started taking beta blockers in my 20s because I had marginally high BP AND panic attacks that were manifested as racing heart. Doctor said "on a beta blocker your heart rate will be maintained at a lower rate", which is very true.

Fast forward about 20 years (!!!) and my new doctor (I've moved, lots has changed) and I decide to stop the beta blocker. At the time I was experimenting with a low carb diet and beta blockers interfere with the weight loss benefits (they interfere with the liver's ability to turn fat back in to energy!)

Suddenly I am noticing a change in myself. Things that had interested me and over time I lost interest in became interesting again. My taste changed, for the better (well, except that won't encourage weight loss). Long story short I had become clinically depressed, and because the onset was so gradual I didn't notice! But I sure noticed the change when I got OFF that medicine. WOW!

I am by no means saying the beta blockers cause this in everyone ... or even that all beta blockers should be avoided in those that are sensitive to one (though my doctor doesn't want me to go near any of them). But I see "markers" in what little I know of your story to be suspicious that this might be something you should look in to. You may simply be clinically depressed, which most definitely can cause the symptoms you are experiencing.
-Kevin

Hi Kevin,

Thanks for your comment. Apparently, Lisinopril is not a beta blocker. However, I am going to discuss it with my doctor as a possible candidate for this fatigue.

Andy

[Pugsy]

Let me add one personal experience regarding time asleep.
Sometimes just a little more time asleep helps a person to feel better the next day.
When I get maybe 7 hours of sleep...I feel okay...but when I get another 45 minutes of sleep I notice that the extreme need for napping pretty much is totally eliminated and my general overall energy level is also improved.

Everyone's a little different. Also sometimes its a cumulative thing....maybe a little related to med side effects and maybe little related to not quite enough sleep due to less than optimal sleep hygiene. So not totally related to one thing but maybe several little things bundled together.

The night's that are really short for me...like dogs or whatever and I get 6 hours or less...I can pretty much guarantee a nap in my future.

[khauser]

Hi Kevin,

Thanks for your comment. Apparently, Lisinopril is not a beta blocker. However, I am going to discuss it with my doctor as a possible candidate for this fatigue.

Andy

No, Lisinoprio is an ACE Inhibitor (I take quinopril, same type of medicine).

Certainly any BP med can contribute to these symptoms. Keep chasing it. Another thought I had is that depression isn't ALWAYS due to a medicinal side effect. It could simply be that you are, indeed, depressed!

[andy88488]

Let me add one personal experience regarding time asleep.
Sometimes just a little more time asleep helps a person to feel better the next day.
When I get maybe 7 hours of sleep...I feel okay...but when I get another 45 minutes of sleep I notice that the extreme need for napping pretty much is totally eliminated and my general overall energy level is also improved.

Everyone's a little different. Also sometimes its a cumulative thing....maybe a little related to med side effects and maybe little related to not quite enough sleep due to less than optimal sleep hygiene. So not totally related to one thing but maybe several little things bundled together.

The night's that are really short for me...like dogs or whatever and I get 6 hours or less...I can pretty much guarantee a nap in my future.

Yeah, I'm definitely going to try to get a little more sleep. I have had low energy for years, and I don't think that more sleep will cure that. I think I slept more when I was married, because my wife would conk out at like 9:30 or 10, and I would follow not that long after. But I do think it would help.

I also think that I'm going to get off the statin. Thanks to this whole conversation, I've been checking in with myself, and I think that I'm feeling the side effects of the statin. Again, this won't cure my problem, but will hopefully lessen the severity.

Andy

[andy88488]

Hi Kevin,

Thanks for your comment. Apparently, Lisinopril is not a beta blocker. However, I am going to discuss it with my doctor as a possible candidate for this fatigue.

Andy

No, Lisinoprio is an ACE Inhibitor (I take quinopril, same type of medicine).

Certainly any BP med can contribute to these symptoms. Keep chasing it. Another thought I had is that depression isn't ALWAYS due to a medicinal side effect. It could simply be that you are, indeed, depressed!

Oh, no, I KNOW I'm depressed. I've been working on my issues for years. I don't think that my lack of energy is mood, because it's been consistent for years, whether I'm doing (relatively) well, or poorly.

[patrissimo]

Have you considered using an oximeter to record data overnight just to be sure that you are not having microawakenings due to apnea events that perhaps your machine is not capturing? I tried using the Zeo myself in order to figure out problems that I am having with my cpap, and when I used the Zeo without CPAP, it strangely gave me great ratings for my night of sleep. I asked my doctor about this, and he said that since the Zeo only captures data every 2 minutes (as opposed to every 30 seconds or so in the lab), so it does not capture microawakenings. In other words, things can look better than they actually are. Yet with my oximeter, it captured about 32 or 35 times in the night where my heart rate jumped but my oxygen levels did not desaturate, which I think were an indicator of microawakenings for me. The Zeo could not capture this data.

I think the Zeo scores every 15-30s, but it only reports it in 5 minute increments. But it's count of sleep stages uses the tighter scoring.

I'm not sure if an oximeter would be more sensitive than a CPAP's pressure sensor. SP02 changes more slowly during apnea events than pressure/obstruction, but it sounds like heart rate responds very quickly. One beneficial thing is that it's measuring a different body system, which is great, the broader the coverage of sensors, the more likely to debug. All I know about pulse oximeters is the SP02 part, how accurate are pulse jumps? Are there other things that cause them (REM?).

[Cuda]

I had the same issue and it turned out to Vitamin D. I took 4,000 UI a day and after a few months I felt better.

[andy88488]

I had the same issue and it turned out to Vitamin D. I took 4,000 UI a day and after a few months I felt better.

That's interesting. Did you have a Vitamin D deficiency? I have Osteoporosis, so my doctor actually checked my Vitamin D level, and has me taking 2000 IU a day. My understanding is that with this dosage, my Vitamin D level is now normal.

[John from Brookston]

Same questions we always ask when reports look good on paper and someone still feels "no energy" " not well rested" "need to nap" "hard to wake up in the AM".


No serious health issues. My testosterone is low so I use a testosterone gel. Now, aided, it's quite high. I also have osteoporosis, so I take Actonel once a month, and a lot of Vitamin D, Calcium, Magnesium. Oh, and a small dose of statin at night.
Sleep Hygene is okay. I do drink a fair amount of caffeine. I don't smoke.

Any red flags that you see?

Andy

I was going to suggest having your testosterone checked, since my symptoms included extreme fatigue and physical weakness. Indeed, once my levels approached normal my falling asleep everywhere wasn't as bad as it was before treatment but I still have "severe" OSA, so I'm treating that, too.
See if you can get your doctor (your GP) to focus on other possibilities besides your apnea.

[Always tired]

Hi guys,

I'm 100% compliant. I'm a mouth breather, so I wear a full-face mask. According to Encore Basic, my AHI numbers are very low. Since 1/1/13, my average AHI is 0.5, my average RERA is 0.3. My Flow Limitation is 0.7 and my Vibratory Snore Index is 2.8. No leaks.

But I don't wake up refreshed, and I have little energy. I was thinking about getting a Zeo to see if it would shed any light on this, but now Zeo looks like they are circling the drain. And it doesn't look like there is anything similar on the market.

I have no idea if my issue is sleep-related or some other medical issue. I recently tried a new sleep doctor, and he didn't even look at my sleep study. He listened to my story and prescribed Nuvigil and Provigil. Both of these had a short-term effect, but I quickly developed a tolerance/resistance, so they didn't solve any problems. It's occurred to me that maybe I have an undiagnosed sleep issue, but if I had Central Apneas, for example, wouldn't they show up in my CPAP data?

Any ideas or feedback would be helpful.

Andy,
Just a few comments.
If Zeo is still available the pairing with an IPhone is very difficult.

Regarding the Low T, the gels are not absorbed as efficiently as the shots (for some people) and with the shots the correct amount is always given. If your T numbers are normal then excellent, however T replacement can wire you.
A T