davep700 wrote: ↑Fri Nov 29, 2024 7:33 am
I have been using CPAP at night for several years with no improvement. Daytime fatigue has become worse; my activities are more limited.
and
davep700 wrote: ↑Fri Nov 29, 2024 10:05 am
I take Lexapro,
Modafinil (for daytime fatigue),
Lorazepam (for anxiety) and Olanzapine (helps me get more time asleep in the early-morning).
I know some or all of these medications affect sleep architecture.
I stopped Modafinil entirely for 12 days but did not feel I got more refreshed sleep ( maybe I should have tried a longer term experiment?)
Since the Modafinil was prescribed for
daytime fatigue, the more appropriate question is: Did you feel
more daytime fatigue when you stopped the Modafinil for 12 days? If so, then, the Modafinil is probably doing you some good. If not, then you ought to have a long chat with the doctor who prescribed the Modafinil for the daytime fatigue.
davep700 wrote: ↑Fri Nov 29, 2024 7:33 am
I use the AirFit P10 mask because it seems to be the only one I can tolerate.
If the leak data you posted is typical, then your leaks are quite acceptable and there is no real reason to be trying other masks.
davep700 wrote: ↑Fri Nov 29, 2024 7:33 am
Removing the mask was a major problem but now I think i am better at replacing it, as I can see in my usage time going up. Last year average: 6:00 hrs per night, last 30 days: 6:55 hrs.
Are you sleeping only with the CPAP? Or are you taking the CPAP off in the morning and sleeping another hour or two without it?
If you were only getting an average no more than 6 hours of sleep a night, that could explain the on-going fatigue. Most people's bodies want and need more sleep than that. If you are now getting an average of (almost) 7 hours of sleep a night, all with the mask, then in time your body might start feeling better in the morning and all through the day. But if your body really wants and craves at least 8 hours of sleep, then you still need to work on getting the usage up to where you are sleeping with the mask for as many hours as your body wants/needs to sleep.
If your body is "stuck" at only being able to get about 6 or 7 hours of sleep, then it's time to talk with your docs about all of your medications and the underlying conditions for which they were prescribed.
On the other hand, if you are simply taking the mask off around 7:00 AM and then getting another hour or two of sleep without the cpap, then that could explain the continuing problems with daytime fatigue: When you sleep without the mask, your untreated OSA can come roaring back and an hour or two of apnea filled sleep can destroy the rest achieved by 6 hours of decent, non-apnea filled sleep.
davep700 wrote: ↑Fri Nov 29, 2024 10:05 am
before midnight I may be getting up because I'm not sleepy yet.
If you didn't have to worry about waking up for a job or family obligations, when do you think your body would most like to sleep? Please list both a bedtime and wake up time. Some people have circadian rhythms that just aren't in sync with what our culture expects. I'm lucky enough that my job as a college professor can accommodate the fact that my body really wants to sleep from about 2:00AM until about 9:00 or 9:30AM, and if I had a job that forced me to get up before 7:30 five days a week, I would be pretty exhausted most of the time simply because my body really wouldn't get enough decent sleep simply because it is not sleepy by midnight almost all of the time, no matter how much or how little I slept the night before.
I understand your frustrations. It is hard to keep on PAPing night after night when you are still feeling bad during the daytime. But given the CPAP data, it looks (to me) like there may be something else going on in addition to your now reasonably well treated OSA. In other words, you should consider
other things that might be causing your sleep to be less restorative than you want it to be.