CPAP in the long run?

[GreenSleeper]

Hi All,

Share your stories of long term CPAP treatment, those who has been on CPAP for a while (years), compliant, both success and failures, what worked and what did not

My story is not very optimistic yet.
40 yo male, diagnosed 2 years ago, with mild sleep apnea (AHI between 5 and 17 in different sleep stages). Had declining memory (more short term than long term), lowering IQ, difficulties thinking and making decision, remembering names, studying anything new. Feel like I peaked my abilities in my thirties and was in decline ever since. I assume I had sleep apnea for 15-20 years not diagnosed, mostly because I was "not the right guy"
Got on CPAP 2 years ago; treated AHI was 2, went to zero with a new machine 6 month ago.
The only thing which has improved on CPAP was daytime sleepiness (not immediately, probably over a year of treatment), don't really have that one anymore. But the brain is still foggy, poor memory, difficult to concentrate on anything (somewhat similar to ADHD symptoms), slow thinking. Don't know if it has improved over the last two years, feels about the same.
Doc prescribed me Nuvigil at some point, but I could not tolerate it - it made my stomach sick. Another doctor suggested that my sleep pattern is still fragmented and put me on low doses of gabapentin for the last 4 months. It somewhat worked in terms of giving me better sleep, but I don't feel any positive impact on the cognitive abilities.

What surprises me that doctors don't seem to know much about brain recovery on CPAP. There isn't even seem to be a widely accepted conclusion if CPAP is able to reverse cognitive impairment of sleep apnea, not even talking about developing a treatment to aid in such reversal.
I tried B1 vitamin, but wasn't persistent enough I think. This time decided to boost vitamin levels again - staying on C, D, B1, magnesium

Still hoping I can get part of my brain back. Or at least not to lose what I have left.

What's your story?

[LSAT]

At the top of the home page there are about 400 stories.

[GreenSleeper]

I am reading them right now, thank you.
I probably should have been more specific though. Wondering if there are many of those for whom cognitive abilities took years to recover, and if there was anything additional to CPAP to aid in such recovery.
I read several threads where people were telling that CPAP, although working on AHI, didn't help much with poor memory and foggy brain over a year or two. So wondering how do they feel years later.

[Todzo]

I am reading them right now, thank you.
I probably should have been more specific though. Wondering if there are many of those for whom cognitive abilities took years to recover, and if there was anything additional to CPAP to aid in such recovery.
I read several threads where people were telling that CPAP, although working on AHI, didn't help much with poor memory and foggy brain over a year or two. So wondering how do they feel years later.

Hi GreenSleeper,
Please note the following link to a web interview that might interest you:

http://doctorstevenpark.com/expert-inte ... leep-apnea

I am suspicious that it is the hypocapnic swings, which tend to be exacerbated by xPAP therapy, that tend to cause the cognitive decline.
I am at the store right now so not too much I can do on my little Kindle Fire.
Please respond of no one else does as it will make it easier to find/remember this post.
Thanks!
Todzo

[GreenSleeper]

Hi Todzo,
Thank you, I will definitely follow the interview
What is the hypocapnic swing? Never heard of it before, wiki says it is something related to CO2 level in the blood?

[chunkyfrog]

In my case, the brain has enjoyed the first benefits from CPAP.
The rest followed. I feel like 100%, except I'm older.

[Julie]

Spell it hypnocampic and google it.

[ReadyforRest]

Greensleeper, you should list your equipment and mask so we know what you're using. And tell us what your machine settings are, if you're on straight cpap or autopap and your pressure settings. There must be some reason why, after 2 years of treatment, you are still experiencing brain fog. Is your machine data capable? Do you have software that allows you to display your data so you can see what is going on each night? If you have those things, then please post your graphs so people here can look at them and try to figure out what's causing your problem.

It's normal for us to occasionally have a bad night, when the aliens visit (like I did last night!!) and you wake up with brain fog and a higher AHI than normal. But if your treatment is going well, and you are on top of your data, and everything's working properly, those nights shouldn't happen every night. So something is off. There are some very knowledgeable people on this board who will add their 2 cents to help sort you out, if you give us more information.

Last, you might try vitamin E. It's good for the brain. But DO post your information.

[Todzo]

Spell it hypnocampic and google it.

No I definately mean hypocapnic. Hypo = low -- capnic = carbon dioxide blood gas level.

Probably a good search term to begin with would be "hypocapnic central apnea".

[GreenSleeper]

ReadyforRest, following your suggestion I was going to post graphs from SleepyHead, and discovered that sd card slot is empty
Stupidme took it to the doc appointment in February and apparently lost it..
I put a new card in today, should be able to get some data tomorrow
I listed my equipment as you suggested

Todzo,
That's interesting.. sounds like OSA treatment with CPAP can trigger CSA?
But then AHI should be recorded by my machine shouldn't' it?

I had SystemOne 450 series machine before for about a year, and it was always showing average AHI around 2. No matter what I did it stayed at this level - sometimes dropping to 1.6 then rising again to 2.6 or so, on average being about 2.0
Then the old one failed and I got replacement, 460p. That one consistently shows AHI 0.0

So I am wondering if central apnea could be suspected while the machine detects no events

Thanks everyone for your help

[Pugsy]

Then the old one failed and I got replacement, 460p. That one consistently shows AHI 0.0

You have chosen the wrong machine in your profile.
You might want to correct it so you won't be getting a lot of suggestions about your machine not being a full data machine.
The correct choice in the equipment menu is the PR System One 60 series CPAP machine.
The one you have right now is model 260 not the 460.
If your correct choice doesn't show up properly just manually add it to your comments section like I have mine here.
Some of the equipment machine links are broken for some unknown reason.

That one consistently shows AHI 0.0

So I am wondering if central apnea could be suspected while the machine detects no events

It's unlikely that central apnea would be suspected if your AHI is 0.0. The 460 will flag clear airway events which is essentially what a central is. A few of them doesn't automatically mean central apnea anyway. We all have a few centrals every now and then even people who don't have the full OSA diagnosis. It's when the centrals are present in large numbers...causing oxygen level drops...or are severely disrupting sleep that they are a problem.

[GreenSleeper]

I think I got the right equipment now.

Is there any data from the machine that can give useful insight if AHI is zero? (large leaks are also at 0%)

My sleep doc glanced at the data once and lost interest to it, saying "I think your therapy works fine now".
I wish my brain could tell me the same..

[Pugsy]

Is there any data from the machine that can give useful insight if AHI is zero? (large leaks are also at 0%)

Sure...There's the snore event flagging or the RERA flagging.
I would say Flow limitation but the 460 machine doesn't flag FLs unless you are in apap mode. The 460 has some limited APAP mode capability.

Just because your AHI is 0.0 that doesn't mean that you got good sleep and guarantee that you are not going to feel crappy.
There's lots of stuff that can go on that the machine can't fix.
Short hours of sleep, fragmented sleep, side effects from medications, pain, mask issues, general health, etc..you get the idea.

Good quality sleep is so much more than an AHI number. Often people expect that slapping the mask on is going to fix everything in the world that ails them when in fact it really only fixes one thing...it keeps the airway open.
If the sleep itself is bad because of things unrelated to sleep apnea it doesn't stand much of a chance of fixing bad sleep.