So tired.. any ideas?

[Telle]

I have been just absolutely exhausted for the past few weeks. I've been on cpap treatment for over three years now, and nothing has changed... but I did decide to take a look at my numbers just in case. My AHI is around 1.0 and my leak values are fine as well.

I'm thinking it could be my vitamin D levels again. They're chronically low. But on the advice of one doctor I've been taking double my normal amount since the beginning of October (so I'm taking 4000iu in the colder / less sunny months and 2000iu otherwise). I just got a blood draw on Tuesday that included vitamin D, and usually they have my results at the doctors office within two days. I called this morning and am rather impatiently awaiting a call back.

Any other thoughts on what it could be? I don't want to go to WebMD and scare myself, but I'd like to have some ideas of what could be making me so tired without any other symptoms. None of my medications have changed in months. I already have a blood pressure follow-up appointment with my doctor scheduled for Tuesday.. but I'd like some ideas to bring up then. Last time I went in there complaining of being tired, they did some routine blood work and gave me a pregnancy test.. everything came back normal, and then the physician's assistant I was seeing for it didn't have any ideas as to where to go next and just sent me on my merry way. I don't recall the eventual outcome of that.. it either cleared up on its own or ended up being my vitamin D again.

Thanks for reading, and for any suggestions.

[Pugsy]

How many hours of sleep are you getting?
Are those hours fragmented with a lot of wake ups?
I know you say your meds haven't changed but maybe your body's response to them has changed...so what meds are you taking and when?

[Telle]

I get 8 hours of sleep at night with few if any wake-ups.

Every morning I take viibrid (antidepressant), abilify (atypical anti-psychotic), vyvanse (for ADHD symptoms), and HCTZ (water pill for blood pressure). Plus I take my vitamin D and a multi-vitamin. I'm not taking anything in the evening.

[squid13]

Have you ever had your thyroid checked? It can cause you to feel like that.

[Telle]

I don't recall if I had my thyroid checked in this most recent round of blood work, but I do believe it was checked within the past year and was fine. I suppose it could have gone wonky more recently though.

[Pugsy]

Research your mood medications thoroughly...I don't have the time right now but they all come with the "tired" "fatigue" side effect and sometimes our body changes its response to meds...so maybe they weren't a problem in the past but your body may have changed just a little and the normal side effects are more evident.
Also...take a hard look at yourself and your moods...depression itself causes extreme fatigue symptoms.

Now I am not saying that it's all related to your meds or to the reason you are taking those meds...but it is something that needs to be looked at.

While looking at the side effects for those meds...look into how they mess with sleep architecture...some diminish the deeper stages of sleep which are normally the most restorative stages of sleep...so even though you get 8 hours with minimal wake ups...you might not be getting the deeper stages of sleep in the % that you need to feel optimal.

And of course follow up with the doctor about the blood work and any other of the typical causes for extreme fatigue..thyroid, hormone, etc.

[Telle]

Well I finally got through to my doctor's office. It very well could be my vitamin D levels again. I'm sitting at 30, even with taking 4000iu a day, and normal is 30-100 but they like to see people around 50. The nurse recommended that I bump my intake up to 5000iu, but will also speak to my doctor (who hadn't yet had a chance to review the results herself).

As for the medications I'm on.. I've been on the abilify for probably 5 years now and the viibryd about 2, so I'm pretty skeptical about either of those causing issues just all of a sudden without there being any other obvious changes in me. And the vyvanse is a stimulant.. so if nothing else it should be perking me up

I am keeping a very close eye on my mood. I've definitely had experiences in the past where I was so depressed all I wanted to do was curl up and sleep. But this feels different. I'm not down, I'm just really really tired.

Thank you for all your advice/suggestions.

[Pugsy]

It could very well be the Vitamin D...let's hope it is easy to fix.
I always have to look at meds...it's not totally impossible for meds to play a role..
And that stimulant...look at the half life and how it might affect sleep stages and percent in each stage. It isn't totally out of your system by bedtime.
Just educate yourself when you feel up to researching your meds. Maybe it is all related to Vit D...maybe partly a combination of Vit D and meds.

I do hope that increasing the vit D level fixes things though...that's just so much easier to deal with. It's nice to have a nice clear face to fight.

[avi123]

Any other thoughts on what it could be? I don't want to go to WebMD and scare myself, but I'd like to have some ideas of what could be making me so tired without any other symptoms. None of my medications have changed in months. I already have a blood pressure follow-up appointment with my doctor scheduled for Tuesday.. but I'd like some ideas to bring up then. Last time I went in there complaining of being tired, they did some routine blood work and gave me a pregnancy test.. everything came back normal, and then the physician's assistant I was seeing for it didn't have any ideas as to where to go next and just sent me on my merry way. I don't recall the eventual outcome of that.. it either cleared up on its own or ended up being my vitamin D again.

Thanks for reading, and for any suggestions.

Comment,

Telle, before looking at your age (thanks for posting it) I was almost certain that you are relatively young. I am posting below a link and an abstract to a survey that found about 15% of those who are treated with CPAPs for sleep disorders, and the treatments are "satisfactory," still feel lousy during daytimes:

(The survey was done in France but many U.S. studies agree with it)


Eur Respir J. 2009 May;33(5):1062-7. doi: 10.1183/09031936.00016808.

Prevalence of residual excessive sleepiness in CPAP-treated sleep apnoea patients: the French multicentre study.

Pépin JL, Viot-Blanc V, Escourrou P, Racineux JL, Sapene M, Lévy P, Dervaux B, Lenne X, Mallart A.


Source

HP2 Laboratory (Hypoxia Pathophysiology), INSERM ERI 0017, EA 3745 Joseph Fourier University, Grenoble, France. JPepin@chu-grenoble.fr

Link:

http://www.ncbi.nlm.nih.gov/pubmed/19407048

Notice that young age was also an indicator
Are you interested in a link to the full report?

[avi123]

Have you seen this:



Should we both be careful while wearing new shoes?

Regards

[SleepyToo2]

Telle, check out Abilify - many of the atypical antipsychotics do cause sedation, so that could be contributing. Maybe it's time to change to another one?

[Julie]

And whatever you do ignore Avil's appalling thread hijack!

[Bevie]

Having the same difficulty. Was just at my Nephrologists (brand new Dr. since old one decided to retire rather than deal with anymore regulation changes and having non-doctors telling him how often and when he can give his kidney patients dialysis treatments.) Anywho, she said that some people who have chronic Vit. D. deficiencies have it because they can't absorb the D3 type and she is considering trying me on the D2. Since my Kidneys are at a good level at this time, she didn't feel she needed to put me back on prescription D. She also said in my next blood draw she was going to test my magnesium levels. She said low magnesium can cause excess tiredness as well as the leg cramping I have been happening lately. Just another suggestion to look into. My new Nephrologists spent time in practice at an alternative health based medical clinic that also included traditional western medicine. She is from India. Thank goodness, since she is the only Nephrologist in our area.