Great AHI but more tired with CPAP than without?
Posted: Mon Oct 30, 2023 1:41 pm
Hi,
I'm hoping for feedback on this question: given everything below, is it worth it for me to keep trying to use the CPAP?
In short: I'm more tired when I use the CPAP than when I don't. My current theory: I have relatively mild sleep apnea, and, just because of "who I am" ("sleep type", genetics, mental health), my sleep is more disrupted than is usual by wearing the CPAP mask. Therefore, even though the CPAP is handling my sleep apnea events, I'm more tired with than without it.
See two Oscar screenshots images of recent nights; these are representative of my data over the last 1.5 months.
https://i.imgur.com/hXY2Vew.png
https://i.imgur.com/3mkqQgn.png
Details:
After many years of false starts, leaky masks, exhaustion, I finally was able to get a setup where I could get through most of a night wearing the mask, with a consistent AHI of between .5 and 1.5, usually below 1.
For a month and a half (aug, sept), I did the following: lights out at 10:00 PM, wear the mask until 6:00 AM or so, then get another ~hour of sleep without the mask. I just wanted to wear the mask as much as possible while still being able to function somewhat during the day. But, often on the weekends, I just had to sleep for a night or two w/out the CPAP. I would just get progressively more and more tired during the week. Not subtle at all, but still, I've been tracking my sleep closely, esp. my 'subjective tiredness' on a scale of 1-10, and it's very, very clear that I'm more tired when I wear the CPAP.
My goal was to get comfortable with the mask, and then go for wearing all night, every night. I recently did 6 nights straight: lights out at 10:00, out of bed at 7:15, pushing that until ~8:30 on the weekend. Again, I'm just exhausted, significantly more so than without the CPAP, even though my AHI is great, and the CPAP seems to be functioning well (see Oscar screens). I wanted to go for 2 weeks, but I got very sick, all bets off.
During both of these "experiments", there were no significant stress events, etc., that I think negatively affected my sleep; at least nothing more than is usual for me.
I have other issues that affect my sleep/sleep quality. Esp., pretty severe generalized anxiety disorder, for which I take both celexa and lamotrigine. I've struggled with insomnia (esp. maintenance insomnia) most of my adult life. I have developed great behavioral techniques for going to sleep and getting back to sleep, and the medication helps a lot with my anxiety, so that is all well managed. Overall, I seem to just "need a lot of sleep" -- this has been true since my teens: these days, 9 hours in bed with lights out seems a minimum. On a good night, that means 8-8.5 hrs of time when I don't know that I'm awake (i.e., subjectively asleep). I also recently started wearing a Whoop strap; I'm not %100 convinced on the accuracy of the data, but it seems like I get less deep and REM sleep than average.
So. Many people seem to say that you just have to keep sticking with the CPAP, and eventually, it will pay off. But, are there cases where, for whatever reason, using the CPAP is just too "disruptive" to a person's sleep, so that, even though the CPAP is doing its job and handling the apnea events, overall, it's just not worth it? How long do I have to stick with this before I know? I'm guessing there's not hard and fast rule/answer here, but I'd love any guidance.
Lastly, I haven't checked in with my sleep doctor about this yet, because he's hard to schedule with, and I don't want to go back to him and have him just say, "You need to wear the CPAP more", which is essentially what he's been saying for a long time. I want enough data so that, if the CPAP is just not working for me, he will believe me and we can move on.
Thanks in advance,
Hawkeye Parker
I'm hoping for feedback on this question: given everything below, is it worth it for me to keep trying to use the CPAP?
In short: I'm more tired when I use the CPAP than when I don't. My current theory: I have relatively mild sleep apnea, and, just because of "who I am" ("sleep type", genetics, mental health), my sleep is more disrupted than is usual by wearing the CPAP mask. Therefore, even though the CPAP is handling my sleep apnea events, I'm more tired with than without it.
See two Oscar screenshots images of recent nights; these are representative of my data over the last 1.5 months.
https://i.imgur.com/hXY2Vew.png
https://i.imgur.com/3mkqQgn.png
Details:
After many years of false starts, leaky masks, exhaustion, I finally was able to get a setup where I could get through most of a night wearing the mask, with a consistent AHI of between .5 and 1.5, usually below 1.
For a month and a half (aug, sept), I did the following: lights out at 10:00 PM, wear the mask until 6:00 AM or so, then get another ~hour of sleep without the mask. I just wanted to wear the mask as much as possible while still being able to function somewhat during the day. But, often on the weekends, I just had to sleep for a night or two w/out the CPAP. I would just get progressively more and more tired during the week. Not subtle at all, but still, I've been tracking my sleep closely, esp. my 'subjective tiredness' on a scale of 1-10, and it's very, very clear that I'm more tired when I wear the CPAP.
My goal was to get comfortable with the mask, and then go for wearing all night, every night. I recently did 6 nights straight: lights out at 10:00, out of bed at 7:15, pushing that until ~8:30 on the weekend. Again, I'm just exhausted, significantly more so than without the CPAP, even though my AHI is great, and the CPAP seems to be functioning well (see Oscar screens). I wanted to go for 2 weeks, but I got very sick, all bets off.
During both of these "experiments", there were no significant stress events, etc., that I think negatively affected my sleep; at least nothing more than is usual for me.
I have other issues that affect my sleep/sleep quality. Esp., pretty severe generalized anxiety disorder, for which I take both celexa and lamotrigine. I've struggled with insomnia (esp. maintenance insomnia) most of my adult life. I have developed great behavioral techniques for going to sleep and getting back to sleep, and the medication helps a lot with my anxiety, so that is all well managed. Overall, I seem to just "need a lot of sleep" -- this has been true since my teens: these days, 9 hours in bed with lights out seems a minimum. On a good night, that means 8-8.5 hrs of time when I don't know that I'm awake (i.e., subjectively asleep). I also recently started wearing a Whoop strap; I'm not %100 convinced on the accuracy of the data, but it seems like I get less deep and REM sleep than average.
So. Many people seem to say that you just have to keep sticking with the CPAP, and eventually, it will pay off. But, are there cases where, for whatever reason, using the CPAP is just too "disruptive" to a person's sleep, so that, even though the CPAP is doing its job and handling the apnea events, overall, it's just not worth it? How long do I have to stick with this before I know? I'm guessing there's not hard and fast rule/answer here, but I'd love any guidance.
Lastly, I haven't checked in with my sleep doctor about this yet, because he's hard to schedule with, and I don't want to go back to him and have him just say, "You need to wear the CPAP more", which is essentially what he's been saying for a long time. I want enough data so that, if the CPAP is just not working for me, he will believe me and we can move on.
Thanks in advance,
Hawkeye Parker