My setting is too low

[SoooTired]

I've had Obstructive Sleep Apnea since January of 2010. In May, I thought that the symptoms were returning and made an appointment with my Pulmonologist. Unfortunately, I thouoght a new mask cured the symptoms so I cancelled the appointment. I had to make another one and the doctor, being human, is going on vacation for two weeks, so I can't see him until July.

Have you heard of this happening before? I had my machine checked twice and also had my annual physical to rule out any other problems. Luckily, there weren't any except a marginally low thyroid reading which was not low enough to do anything about.

I'm only an 8 which I thought was so low it was probably not even worth fixing but since May, I've stopped dreaming; feel like I didn't sleep in the morning, and now I'm beginning to forget words when I'm talking; whichi is a lot of the time! I also fall asleep when I'm watching television at night, so it was working.

Is this a common occurrence? Have other had similar experiences?

[Wulfman...]

I've had Obstructive Sleep Apnea since January of 2010. In May, I thought that the symptoms were returning and made an appointment with my Pulmonologist. Unfortunately, I thouoght a new mask cured the symptoms so I cancelled the appointment. I had to make another one and the doctor, being human, is going on vacation for two weeks, so I can't see him until July.

Have you heard of this happening before? I had my machine checked twice and also had my annual physical to rule out any other problems. Luckily, there weren't any except a marginally low thyroid reading which was not low enough to do anything about.

I'm only an 8 which I thought was so low it was probably not even worth fixing but since May, I've stopped dreaming; feel like I didn't sleep in the morning, and now I'm beginning to forget words when I'm talking; whichi is a lot of the time! I also fall asleep when I'm watching television at night, so it was working.

Is this a common occurrence? Have other had similar experiences?

Have we ever heard of WHAT happening?

The only thing I can make from the bits and pieces of your post is that you're probably leaking air out of your mouth while you sleep (you have a nasal mask) and that is why you're backsliding with your therapy.
You have a machine that is not data capable and therefore you have no idea how your therapy is working other than by "how you feel".
Increasing your pressure without making sure you're not leaking air out your mouth would probably be useless.......you'd only be leaking MORE air out your mouth.

The solutions are: Chinstrap, tape your mouth shut or a full face mask.


Den

[cowlypso]

There are a lots of different possibilities that could be going on.

1. Your pressure needs have changed. It's been 1.5 years since your titration study, so it's possible that something has changed in your body and you now require a higher pressure. Ideally, with a data-capable machine, you would be able to see your AHI over time and see if it's gone up. Since you don't have that, your doctor could have you come in for another titration study, give you a loaner APAP for a few weeks to retitrate at home, or just bump up your pressure and see what it does to your symptoms.

2. You have developed a leak somewhere in the system (mask or mouth). If you have a leak, then the pressure goes out that leak rather than keeping your airway open. Do you wake up with a dry mouth? If so, you may have a mouth leak (if you aren't using a full face mask). Do you notice more leaks with your mask than before?

3. You have developed a comorbid sleep disorder. PLMD is a possiblity, along with other sleep disorders. You might need an in-lab sleep study for diagnosis.

4. You have developed an unrelated physical condition which causes fatigue. Thyroid, vitamin D, vitamin B12, iron... All of these can cause fatigue if they are off. How low was low on your thyroid? Lots of doctors won't treat you unless your TSH is above 5, but evidence shows that it should probably be treated if it gets close to or above 3. Unfortunately, even though this evidence has been around for years, it's been very slow to be adopted.

In short, yes, symptoms can come back. If nothing changes, then they shouldn't come back, but we all know that things can change at any time. So now you are on the quest to find out what changed and fix it.

[Emilia]

Actually,the American Thyroid Association recommends a TSH reading between .5 and 2.5 to be normal. Most labs use anything up to 4 as in the normal range....so if your TSH was a 3.5 or anything above 2.5, you might benefit from a small dose of Synthroid. Keep in mind that many folks slowly progress with this and the thyroid becomes slower and slower. I started out on Synthroid with 25's and now take 100's. I am tested every 6 months and I have been able to keep my TSH around 2.5.

Vitamin D is another culprit.... and it should be checked. The 25hydroxy test is the one to get for D3. Again, labs will use 30-100 as the normal range; however, the latest studies show that optimal is in the 50-75 range. I was a 33 and now test out at 60 after supplementation.

Fatigue is an awful thing, and it can be caused by many different things. I still feel tired more than I'd like even with cpap, a good TSH and D levels.... it is a struggle.