Just a question on tiredness

[DJL]

I have been back on APAP for about 3 weeks after not using it for over 3 years.
The other day my sleep doctor said that he has found that it takes about 100 days of treatment for the bodies system/nerves/muscles to adjust and to start working properly before you stop feeling tired. I have read on the forum that some people feel better quickly and others take a long time, but is the doctors theory correct?
Since I started treatment again I have noticed (even in 3 weeks) that my AHI has gone down from over 6 to under 1. But most days I need to sleep in the afternoon.

Thanks Dave

[kteague]

Seems that doctor is stating what they've seen in their practice, not necessarily a scientific study. Results are so varied, as the influencing factors are many. For instance, how many hours a night one is sleeping, if there are other sleep disruptors (sleep disorders, medical conditions, medication side effects, etc.)., and how much recovery is needed. You are on the right path now. Let us know how your progress goes. Always good to hear other people's stories to better understand the world outside our own. My own recovery was fraught with limb movement issues, so mine is one that would mess up the average.

[stage0]

Really, sounds like most ppl needing a nap in the afternoon.

You may also be in your current habit of sleeping or nappng in the afternoon.

Along with your cpap, look into your diet for energy; any meds you take could be overprescribed as OSA therapy sometimes decreases this need andsleep hygiene.

[Julie]

Just a reminder to use Cpap when you nap, because if you don't, you're wasting the good overnight sleep you've been getting. Sleep is sleep .

[Wulfman...]

I have been back on APAP for about 3 weeks after not using it for over 3 years.
The other day my sleep doctor said that he has found that it takes about 100 days of treatment for the bodies system/nerves/muscles to adjust and to start working properly before you stop feeling tired. I have read on the forum that some people feel better quickly and others take a long time, but is the doctors theory correct?
Since I started treatment again I have noticed (even in 3 weeks) that my AHI has gone down from over 6 to under 1. But most days I need to sleep in the afternoon.

Thanks Dave

It's only a "guess" on the doctor's part and more importantly only applies if your therapy is optimized.

If you're running your APAP in a range of pressures, don't put money on feeling well rested, even though your "numbers" look good. Too many users with that setup get bumped out of their much-needed sleep stages by pressure changes and as long as that's happening, they don't get the restorative sleep they need. These forum pages are full of those examples.

If you're not monitoring your data with software, I highly recommend it.


Den

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[Sheriff Buford]

The sleep debt issue has been discussed many times on this forum, and I have read a lot of studies on the issue... so I think the jury is still out. Most folks go several years with this disease and treating it will not repair the damage done overnight. I personally think around the 6 month mark... your body probably realises that you aren't fooling around and the sleep debt SLOWLY begins to do what repairs it can. I had a "ah-ha" morning around 20 days after starting treatment. I realize I was blessed. A lot of folks here never get that privilege. I think that you are repairing your body from the damage apnea caused and repaying your sleep debt. If you never get that "ah-ha" morning... don't despair or quit! Your "feeling better" may be gradual and you may not notice it. The other night, my house had 3 power outages, and I slept a great deal of the night without my machine. I felt like crap the next day. Bad for my body, but a good wake up call to me. I have gotten used to wearing the mask and receiving therapy for years. Then I go one night and I realise I still have the disease, I need to continue to treat it and thank God for that ugly-ole machine.

Sheriff

[Pugsy]

There's no set number of days/nights that seem to be the magic number where most people finally see the miracle (if they ever do).
There's more to not feeling tired than just using a cpap machine.
Often people have other issues that also promote feeling "tired" that are unrelated to sleep apnea and if the problem isn't related to sleep apnea then the use of a cpap machine (not matter how great the therapy and the numbers) is unlikely to produce the feelings we want if the cause of those feelings are unrelated to OSA.
We want it to because we like to blame everything that is wrong with us on sleep apnea but the cold hard facts of life is that there is a ton of stuff out there that affects how we sleep and how we feel.

After 4 years of therapy I still will have a day when I need to nap if I don't get about 7 hours of sleep the night before. I can pretty much count on the sleepies setting in around 4 PM if I have had less than the hours of sleep I normally get. Also if for some reason my 7 or so hours of sleep are highly fragmented for some reason...I will see the need to nap.
Keep me around 8 hours of sleep and I don't get horribly sleepy.

So...you have to use the machine anyway but while using it you can do some detective work to see if something else is a factor in how you feel during the day.

Make sure your therapy is optimized first....this involves using the software to make sure that at least things look good on paper.
If therapy is sub optimal..no amount of time is going to make it better.
Then start evaluating the other things in our lives that impact how we feel and the list is huge.
Common starting points.
Hours of sleep? Fragmented sleep? Insomnia? Meds that mess with sleep or how we feel? Bed comfort? Mask comfort? Body aches and pains (this one is my most major problem as I have bad arthritis and I hurt so it affects my sleep).?
General health issues? Outside factor and the list goes on an on.

[Drowsy Dancer]

If you're running your APAP in a range of pressures, don't put money on feeling well rested, even though your "numbers" look good. Too many users with that setup get bumped out of their much-needed sleep stages by pressure changes and as long as that's happening, they don't get the restorative sleep they need. These forum pages are full of those examples.

This is an excellent point that frequently gets overlooked when people get enthusiastic about self-diagnosis and self-titration (or even self-verification of numbers assigned during a PSG). I like to keep my machine in APAP mode because it records a little more data that way, but I'm using a pretty tight range that is, by gum, awfully close to the pressure my doc suggested to me would allow me to sleep on my back.

[I Like Soup]

I must admit, I heard more stories about feeling fantastic and conquering the world the first day after using CPAP than not. My own experience was more akin to waking up and not feeling, well, tired. Almost as if I thought I should go back to sleep, but why should I?

Over the last roughly two months the one thing that I have definitely noticed is I don't have a hair trigger temper with regards to the most stupid things. I'm not talking in dealing with people on a regular basis as I'm a pretty outgoing and positive person. Something dumb like taking the trash out and the door closing before I get all the way out with my hands full would almost send me in to a rage and then taking it out on inanimate objects. That never happens anymore. Oddly, I just realized this morning that I don't wake up biting my tongue either (not that it was that frequent, but certainly noticeable). I do feel like it is making a difference, even after a relatively short time, but I don't think I was running around with apnea for more than a couple of years. I do feel like my memory is already improving and I can maintain better focus. I am definitely in this for the long haul and it can only do me and my family good!

Good luck!

[bbbmmmlll]

If the tiredness is the result of sleep apnea and assuming the therapy is working it seems like most people report feeling better by six months with a median around three months. If you're not feeling rested by six months, then there is probably something else going on.

Being hooked up to a CPAP machine can interfere with sleep for some people. Mask leaks, being attached to a hose, mouth leaks, the noisy venting of the mask, pressure sensitivity, moisture issues etc... You can probably identify many of these issues yourself, but some might require looking at your data or an observer. Personally I know when a mask leak wakes me or when I get tangled up with the hose, but my wife really notices the mouth leaks (they are loud) or points out that I toss and turn all night if I wear a full face mask.

There are a multitude of other reasons why someone wouldn't feel rested ranging from poor sleep habits or environmental issues to complex medical conditions.

[CpapWife]

Have you checked your oxygen saturation?
We have APIs close to 1 (give or take a little over time), but we are finding saturation is lower and is possibly positional (e.g. what position are you sleeping).

Both need to be considered to get an accurate picture.
And I bet that both could make you sleepy.