2+ Years of CPAP and not enough DEEP sleep so still tired

My sleep study has shown only a small increase in sleep quality... from 45% (without CPAP) to 60% with - yet apparently I am not getting enough deep sleep which may explain:
I am still not feeling rested at all.
I am questioning so many things... my caffeine intake, though I only have a couple of cups a day
My diet, I have to admit fruits and veg are not part of my daily diet
I don't drink or smoke
The CPAP shows me as having slept 8-9 hours with minimal interruptions
I am not diabetic
My bloodworks show everything is fine
Is it my complete lack of exercise?
Is it the Irbesartan - avapro (blood pressure medication) I have taken for 3 years?
Last night I ate spinach, fish and sweet potato for dinner, I also took a multivitamin AND a Magnesium supplement
I still don't feel any significant difference in tiredness when waking up and throughout the day; it is also affecting my mood big time
I often wake up with a fluttering heart beat - probably because I am in REM sleep, maybe?

The sleep Dr asked me to try (for 8 weeks) Zopiclone, 2 months on and 1 month off and come back and discuss. I have not met him yet to follow up but I found weeks 2-3 they were pushing me into a deeper sleep, I was dreaming too and had a bit more energy in the day
After 6 weeks I came off them: irritable, anxious, borderline depressed, I didn't like them at all - plus I don't feel they can be a long term solution really - though I know they work well for many who struggle to get to sleep in the first place but i don't have that problem, my problem is lack of DEEP SLEEP!

Please, can anyone help with advice?

Hi Steve,
Folks that can help you are going to want to know your pressures low to high.
Possibly some sleepy head screenshots to further eval you.

welcome to the zoo!

each of us react to cpap in a different way. we each need to have little tweaks made to our therapy to insure we are getting the best results. it sounds like you aren't quite there yet.

so you will have to end up taking matters into your own hands. as was mentioned, the experts are going to need to know your minimum and maximum pressures.

the answer to your sleep MAY be as simple as changing the pressures. but no one wants to do that until we learn more.

eventually, you may want to download the free software, sleepyhead. this will present you with all kinds of data that, again, the experts here will be able to interpret.

good luck!

Hi, thanks for the replies.

My pressure 2 years ago was 9, this was recently increased to 10 after my 2yr follow up study. The study showed the only issue was lack of deep sleep - I think the CPAP is doing its thing but I am not feeling the benefit because of the 'something else - whatever that is' which is causing me to have only a 60% total quality sleep

In addition to all the other things I have mentioned in my first post, I am also wondering if using the blue light (Apple iMac) screen at night is causing this tiredness.

I am doing some online research to see if CBD oil or melatonin could be a good option for me before I see the Sleep Dr again next month.

Sleep-hygiene principles can help anyone sleep better. That includes limiting use of devices and other sleep-environment considerations, but it also includes many other things. There are many helpful lists on sleep-hygiene principles at reputable sleep sites.

(1) Quantity of time asleep in general and (2) troubleshooting anything that is having a negative effect on quality of sleep in general (such as disruptions from bad breathing, noise, temperature, worries, pets, etc.) are really the only two things most of us need to focus on because those two broad aspects combined are basically all we can do to allow the most "deep sleep." Medications generally have some bad effect on sleep, so keeping them to the bare minimum is usually best, although it can be worth it to have some negative effects on sleep in order to treat some illnesses. There is no magic pill that will reliably change what percentage of our sleep is "deep," so just improve sleep to the extent you can and then let your brain decide what stages it needs when.

Several things that helped me get better sleep...
1, use darkening shades on windows, darker the better, no light
2, keep the room temp around 69-70 deg at night or whenever u sleep
3, no noise unless u need white noise to help u relax

my wife researched this info and I would say it works for us...wont hurt to try. Good luck

Hm, it looks like you have a sleep disorder but not because of OSA, it can be a thyroid disorder, restless legs syndrome, anxiety or depression, etc. You may need an antidepressant (sertaline, escitalopram) or calming medication...

I have the same problem as you. I had this since I was 4. Do you nap during the day?

steven79421 wrote: ↑

Thu Aug 23, 2018 9:25 am

My sleep study has shown only a small increase in sleep quality... from 45% (without CPAP) to 60% with - yet apparently I am not getting enough deep sleep which may explain:
I am still not feeling rested at all.
I am questioning so many things... my caffeine intake, though I only have a couple of cups a day
My diet, I have to admit fruits and veg are not part of my daily diet
I don't drink or smoke
The CPAP shows me as having slept 8-9 hours with minimal interruptions
I am not diabetic
My bloodworks show everything is fine
Is it my complete lack of exercise?
Is it the Irbesartan - avapro (blood pressure medication) I have taken for 3 years?
Last night I ate spinach, fish and sweet potato for dinner, I also took a multivitamin AND a Magnesium supplement
I still don't feel any significant difference in tiredness when waking up and throughout the day; it is also affecting my mood big time
I often wake up with a fluttering heart beat - probably because I am in REM sleep, maybe?

The sleep Dr asked me to try (for 8 weeks) Zopiclone, 2 months on and 1 month off and come back and discuss. I have not met him yet to follow up but I found weeks 2-3 they were pushing me into a deeper sleep, I was dreaming too and had a bit more energy in the day
After 6 weeks I came off them: irritable, anxious, borderline depressed, I didn't like them at all - plus I don't feel they can be a long term solution really - though I know they work well for many who struggle to get to sleep in the first place but i don't have that problem, my problem is lack of DEEP SLEEP!

Please, can anyone help with advice?

Steven, I'm having the same problem as you. I got diagnosed with OSA almost two years ago. At first, it was really just an issue when I slept on my back. If I slept on my side I usually slept pretty well. I'd be a little tired during the day, but nothing real bad. Earlier this year even sleeping on my side didn't stop the snoring and throat fluttering and it was keeping me up half the night, so I finally gave in and got a CPAP. I've been using it since March and feel the same way you do. My events per hour have dropped from 6.5 to 1 or less, so the snoring has pretty much stopped, but I still feel crummy all day long. The past couple of months I've started getting dark circles under my eyes. They are real bad in the morning and in the evening, but kind of fade away in the afternoon.

One problem I still have is that even though I can fall asleep relatively quickly, I don't stay asleep. I wake up several times throughout the night, usually just for a few seconds or so, and will typically roll over and change sleeping positions. I do this probably five, six, seven times a night and I think that might be why I still feel so crappy during the day. I told this to my doctor at the sleep clinic and he had my try Cognitive Behavior Therapy, but after a few weeks of that I didn't feel any different. I just had an appointment with my regular doctor earlier this week. He's doing a lab panel to check to make sure I don't have something else entirely going on (Low T, Iron Deficiency, etc.) He suspects I might also have Centralized Sleep Apnea which would explain why even with the CPAP I keep waking up. He gave me a prescription for Adderall to help with the day time drowsiness. It worked great the first day. I felt better than I have in years, but it didn't last. The proceeding days it had little affect and I stopped taking it because I was having undesirable side affects.

I'm waiting for the labs to come back, but I have a feeling everything is going to be normal. At that point I'm going to back to the sleep clinic and tell him that it's time to try something else. I'm not big on pills, but if I have to start taking sleeping pills, even if just every few nights, I'm willing to go that route now. I'm also wondering if getting a chin strap to go along with CPAP might help. If I do have a combination of OSA and CSA I might be opening my mouth a lot, which might be waking me up.

That's awful you've been dealing with this for over two years. It's only been six months for me and I'm already close to losing my mind. My life has totally changed from a year ago and it sucks.

How are your leaks? I feel much better when I get zero leaks.

Sometimes there are issues at the root of your fatigue/tiredness that can't be cured by cpap. It doesn't mean you are not benefiting other ways though.

After a year of pretty much successful Cpap treatment, I still struggle with the fatigue that got me the sleep study in the first place. Cpap therapy seems to have very little impact on that issue in my case, but I hope it will still be of benefit for several other things, including heart health, long term.

I'm starting to feel my fatigue is most likely a consequence of dealing with severe back/neck/shoulder pain all day long, as dealing with pain 24/7 for years, can really take it out of you. There are other members here that know of what I speak.

I have switched the night modes on, on my Iphone and Mac, hopefully this will make a difference but having done that for 2 days, right now i don't feel the benefit.

My sleep hygiene is good, I follow all those checks that have been mentioned.

Thyroid, not, my blood tests are all sound.

No restless leg - recent sleep study showed none of that happening.

I have done antidepressants in the past - I am considering going back on (300mg Wellbutrin) as I think I could be dealing with anxiety/depression/overthinking.

I don't nap during the day at all. I did a day sleep study - no daytime sleep occurred. I just feet fatigue, tired, hard to focus.

My eyes are really tired looking/drooping. I get small bursts of energy throughout the day but it is mostly a can't be bothered kind of attitude My T levels are fine (then again they are on the low side of normal), I believe T levels have a ridiculous range like 100-900 units, I know I was around 150 at some point. I might go back on the Androgel for a bit to see if that boosts me.

I don't wake up in the night.

I wouldn't say I was lazy by any stretch, I love long walks, but haven't squeezed one in for a while.

Friday I tried melatonin/Magnesium, doesn't seem to be doing anything better for me at all.

It is really so annoying, I can see from everyone else's comments they too have or are experiencing similar

steven79421 wrote: ↑

Mon Aug 27, 2018 9:50 am

I have switched the night modes on, on my Iphone and Mac, hopefully this will make a difference but having done that for 2 days, right now i don't feel the benefit.

My sleep hygiene is good, I follow all those checks that have been mentioned.

Thyroid, not, my blood tests are all sound.

No restless leg - recent sleep study showed none of that happening.

I have done antidepressants in the past - I am considering going back on (300mg Wellbutrin) as I think I could be dealing with anxiety/depression/overthinking.

I don't nap during the day at all. I did a day sleep study - no daytime sleep occurred. I just feet fatigue, tired, hard to focus.

My eyes are really tired looking/drooping. I get small bursts of energy throughout the day but it is mostly a can't be bothered kind of attitude My T levels are fine (then again they are on the low side of normal), I believe T levels have a ridiculous range like 100-900 units, I know I was around 150 at some point. I might go back on the Androgel for a bit to see if that boosts me.

I don't wake up in the night.

I wouldn't say I was lazy by any stretch, I love long walks, but haven't squeezed one in for a while.

Friday I tried melatonin/Magnesium, doesn't seem to be doing anything better for me at all.

It is really so annoying, I can see from everyone else's comments they too have or are experiencing similar

150 is too low for testosterone levels. If I were you I would get that checked again. That could be the reason why you’re still tired during the day. My brother’s level was really low like that too and he started getting testosterone shots and it fixed his problem being tired.

I tend to wake up several times throughout the night, usually just for a few seconds at a time, and rollover and go back to sleep. I think that might be the reason why I am still getting so much daytime fatigue, but I don’t know how to get it to stop from happening. I have another appointment at the sleep clinic tomorrow to talk to the doctor about it again

I would suggest to post some sleepyhead data. It is worth while to check that the CPAP is set properly. If this is the case than other roots need to be adresses.