therapy break

[darco]

Well after a couple of rough back to back nites (waking up too early,struggling to fall back asleep) I decided to take a break from my cpap therapy. The interesting thing is, the next few nites w/o cpap i feel the same, meaning still waking up tired and fatigued, I have been using my machine for almost 6mos w/o missing a nite, have great numbers on paper but I still struggle with fatigue. The insomnia comes and goes and I can never put my finger on why but thats a whole different story. I am on my 3rd mask and feel ok with it, my leaks are tolerable. I do everything by the book, sleep schedule, no caffeine after 2, eat last meal 4hrs before bedtime, no computer screen glare etc,....
Last nite I slept solid but again feel tired this morning.....So at this point I am not sure when I will go back to my cpap because I dont see the benefit.

d

[49er]

Well after a couple of rough back to back nites (waking up too early,struggling to fall back asleep) I decided to take a break from my cpap therapy. The interesting thing is, the next few nites w/o cpap i feel the same, meaning still waking up tired and fatigued, I have been using my machine for almost 6mos w/o missing a nite, have great numbers on paper but I still struggle with fatigue. The insomnia comes and goes and I can never put my finger on why but thats a whole different story. I am on my 3rd mask and feel ok with it, my leaks are tolerable. I do everything by the book, sleep schedule, no caffeine after 2, eat last meal 4hrs before bedtime, no computer screen glare etc,....
Last nite I slept solid but again feel tired this morning.....So at this point I am not sure when I will go back to my cpap because I dont see the benefit.

d

Hi darco,

I am so sorry to hear about your struggles. A few thoughts.

Have you considered revising the caffeine rule so you don't have any past early am just to see if that makes a difference? It may not but it might be worth a shot.

Additionally, have you had the usual blood tests to rule out other issues like thyroid, etc?

How is your nasal congestion as that can also impact your sleep? Do you have any issues that might need the attention of an ENT?

Hang in there.

49er

[squid13]

Maybe you have other medical problems that are causing your fatigue. I had thyroid problems besides my sleep apnea problem and taking care of both of them solved my problem, so I had two things going at once. I had to solve both of them to get rid of the fatigue.

[darco]

Well after a couple of rough back to back nites (waking up too early,struggling to fall back asleep) I decided to take a break from my cpap therapy. The interesting thing is, the next few nites w/o cpap i feel the same, meaning still waking up tired and fatigued, I have been using my machine for almost 6mos w/o missing a nite, have great numbers on paper but I still struggle with fatigue. The insomnia comes and goes and I can never put my finger on why but thats a whole different story. I am on my 3rd mask and feel ok with it, my leaks are tolerable. I do everything by the book, sleep schedule, no caffeine after 2, eat last meal 4hrs before bedtime, no computer screen glare etc,....
Last nite I slept solid but again feel tired this morning.....So at this point I am not sure when I will go back to my cpap because I dont see the benefit.

d

Hi darco,

I am so sorry to hear about your struggles. A few thoughts.

Have you considered revising the caffeine rule so you don't have any past early am just to see if that makes a difference? It may not but it might be worth a shot.

Additionally, have you had the usual blood tests to rule out other issues like thyroid, etc?

How is your nasal congestion as that can also impact your sleep? Do you have any issues that might need the attention of an ENT?

Hang in there.

49er

I drink 3 cups in early AM , then Ill have a Energy drink usually no later than noon time....(I even stopped those for awhile and no effect)
I did have extensive blood work and nothing came up...
I had Septoplasty about a year and a half ago and was hoping this was my the answer to all my problems, but unfortunately it wasnt.

[HoseCrusher]

So...

Did you start CPAP therapy because of the way you felt? Or did you start because a sleep study revealed a structural problem and CPAP therapy can help resolve that structural problem?

If you have a structural problem (airway collapses during sleep) and have not done anything to repair it, you should probably keep using CPAP therapy.

Many times addressing the structural problem results in better feelings, but many times it doesn't. It appears that you felt tired, discovered you had a structural problem, and started therapy to address that problem. At this point you can eliminate sleep disordered breathing from the list of things that can make you feel tired and move on to discover what else is going on.

[mellabella]

Well after a couple of rough back to back nites (waking up too early,struggling to fall back asleep) I decided to take a break from my cpap therapy. The interesting thing is, the next few nites w/o cpap i feel the same, meaning still waking up tired and fatigued, I have been using my machine for almost 6mos w/o missing a nite, have great numbers on paper but I still struggle with fatigue. The insomnia comes and goes and I can never put my finger on why but thats a whole different story. I am on my 3rd mask and feel ok with it, my leaks are tolerable. I do everything by the book, sleep schedule, no caffeine after 2, eat last meal 4hrs before bedtime, no computer screen glare etc,....
Last nite I slept solid but again feel tired this morning.....So at this point I am not sure when I will go back to my cpap because I dont see the benefit.

d

CPAP is about feeling less fatigued, but if you're someone who was desaturating a lot and/or had a high AHI, it's also about not dying in your sleep or suffering other longer term health consequences that may not be immediately obvious. So keep that in mind.

It's also not a fix all. Thyroid issues, anemia, vitamin or mineral deficiencies, prescription medications, etc. can all keep you exhausted even if you're at the perfect pressure on the perfect machine with perfect compliance (and maybe all of those aren't even true--my "numbers", AHI, on high pressure auto bipap aren't much better than they were on CPAP at 7, but that's because my issue is UARS/flow limitations/RERAS, and I'm much better on the current setup.)

[archangle]

I find I feel better if I turn my minimum pressure up a bit, even though I have a low AHI even at the lower setting.

[JDS74]

darco:

Perhaps its time to start with the basics.
Did you get a copy of your sleep study AND you sleep titration study?

Looking those over may give you some insight as to what was going on and how well it was addressed by your machine and the settings. Look for things like arousals, RLS/PLMD rates, central apneas, etc.

Then, it would be helpful to get and install appropriate software so you can see how well your current apnea treatment is working. Now look and see if things are better or worse. Are your obstructive apneas being stopped by your treatment pressure? Is there an increase in central (CA) events. Sometimes proper treatment for obstructive apneas leads to the development of central apneas and is then called complex apnea.

What was the basis of your pressure change?

You can review your food intake. The conventional wisdom says that caffeine in the morning has little or no effect by night time. In my case, any caffeine at all screws up my sleep. Other foods do the same. So a food log for a few days might point to something. It does depend on looking at the numbers.

As far as labs are concerned, did your labs include:
CBC,
Complete metabolic panel,
Thyroid panel,
Testosterone level,
Vitamin B-12 level?

That should cover the usual suspects that lead to overall fatigue.

Finally, a review of your sleep hygiene could point to something there. No TV or reading while in bed. No staying in bed more than 30 minutes if you wake up at night (if so, get up and do something truly boring in a different room), etc.

Hang in there, it will get better over time even though there may need to be some adjustments.

[Todzo]

Well after a couple of rough back to back nites (waking up too early,struggling to fall back asleep) I decided to take a break from my cpap therapy. The interesting thing is, the next few nites w/o cpap i feel the same, meaning still waking up tired and fatigued, I have been using my machine for almost 6mos w/o missing a nite, have great numbers on paper but I still struggle with fatigue. The insomnia comes and goes and I can never put my finger on why but thats a whole different story. I am on my 3rd mask and feel ok with it, my leaks are tolerable. I do everything by the book, sleep schedule, no caffeine after 2, eat last meal 4hrs before bedtime, no computer screen glare etc,....
Last nite I slept solid but again feel tired this morning.....So at this point I am not sure when I will go back to my cpap because I dont see the benefit.

d

Many find it impossible to make CPAP work and I am not sure it is even healthy to try to make it work if you really do see no benefit after you have tried to make it work.

As time progresses they will probably produce better CPAP systems and you may well be able to use them.

In the mean time work toward health in other ways.

[49er]

As time progresses they will probably produce better CPAP systems and you may well be able to use them.

The problem isn't that better CPAP systems need to be produced. The issue is if you don't adapt to pap therapy right away, trying to find assistance in troubleshooting what the issues are takes going to a "million" different providers which is very exhausting, particularly if you are impaired from not being able to tolerate pap therapy.

49er

[star444]

Other sleep disturbance factors (such as: PLMD, RLS, and general anxiety) keep me from feeling well-rested each morning; however, that does NOT mean I will be stopping my CPAP therapy. Without CPAP I stop breathing over 70 times per hour and my O2 sat rate drops into the low 70's! My body was suffering from nightly oxygen-deprivation which had me on a fast-track to heart attack or stroke!

My CPAP can't "fix" my other sleep disturbance problems, but it can help keep me alive while I work on those problems!

[sleeplessinaz]

Please have your vitamin D levels checked. My husband and I both had low Vit. D levels and once we started taking 5,000 IU Vit. D daily we started feeling tons better!

[Wulfman...]

Settings 9-13 cm

Quite possibly the pressure changes are wrecking your sleep.......bouncing you out of the needed deeper sleep stages and REM which may keep you in lighter sleep stages........and leaving you feeling the way you do. It's a very common problem with people who use APAPs in a range of pressures. Your breathing changes as you go into those sleep stages and the machine interprets it as a need to increase pressures.......which bumps you our of the needed sleep stage.


Den

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[zoocrewphoto]

Have you posted any graphs of a typical night? It could be that you still have too many events, or not many, but long events that can cause problems. As Den mentioned, you may be having trouble with the range of pressures and need a straight pressure. For some people, having a range is great, but others are bothered by it. There are lots of things that can cause problems, and they need to be ruled out.

Unfortunately, going untreated means long term damage that can cause serious health problems and shorten your life. I know there are some people here who don't feel major improvement, but continue using it anyway as it prevents further damage. For me personally, I don't feel much more energy unless I have an awesome night, but I do have a lot of improvements - no nightmares, fewer bathroom trips, less Gerd, more cheerful (less grumpy, less reactive), very few headaches now, fall asleep faster, sleep better in hotels (1000% times better in hotels, used to be a clock watcher every hour, now solid sleep). Some of these improvements were noticeable after a few weeks, many were subtle and took months for me to realize they had changed.

[darco]

Hey guys, thanks for the responses and my lack of...thought thread died....

anyways....I restarted my therapy. Just to give you quick background, my sleep study indicated I have moderate sleep apnea (23 ahi) I believe the oxygen level was a high 92% which my Health Ins originally denied therapy but relented after my Sleep Dr. intervened. I was using a range but switched to straight apap, thanks to help here (wulfman, et al).
I had extensive test and all came back negative...Never thought to check Vit D level but I did just start taking around 4000 IU. Friday nite I slept solid for 9.5 hrs only because the previous two nites I was at a 2day meeting and we partied like crazy and slept very little....
Last nite I slept well, feel sluggish today/...sorry if I didnt address all issues posted....