More tired now, please help!!!!!

Plowboy · Post by **Plowboy** » Sat May 02, 2009 8:27 am

I am on my 4th night with CPAP. I have worn it all 4 nights, all night. I seem to be more tired/shaky/weak than I was before I started. Can anyone relate to this? Is it only a matter of time before I improve? I am very committed to following through and honestly I am, at this point having minimal discomfort. I had my DME provider (she is a RT) download my data card after 3 nights and it shows minimal leaks, no uncontrolled apneas and the 3rd night my AHI was 2.7.

HELP!!!!!

Phil

ozij · Post by **ozij** » Sat May 02, 2009 9:49 am

Are you taking BP medication? Is your BP OK? Sometime CPAP makes it drop.
More tired - yes, it take time for some of us. Shaky / weak? It always good to kkep in mind that not every change is CPAP related - even though it may come concurrently.

Plowboy · Post by **Plowboy** » Sat May 02, 2009 9:58 am

I am on 5mg lisinopril (lowest dose) my readings at the Doc yesterday:

126/84 lying down

116/82 upon standing

His opinion is that I have mild hypertension and it is well under control. My SpO2 at any given time (when conscious ) is 97/98. I just posted another thread with a link to an SpO2 monitor with data capability so I can correlate with my dailey BiPAP readings. Before my back went kamakazi on me last week I could run at 5+ mph for a mile plus, was on a run/jog regime for 30+ minutes a day. I am hoping BiPAP will help me increase this, my goal is a continuous run of 5 miles a day X 4 days a week.

Thanks for the reply, I really apretiate it.

Phil

Raj · Post by **Raj** » Sat May 02, 2009 10:13 am

Phil, it may take a full week or more before you begin to feel the benefits if you've had OSA for some time. Your blood pressure is unlikely to drop after such a short time on therapy, so your increased tiredness may be the result of your body trying to make up for an accumulated sleep deficit. Are you experiencing a deeper sleep than without CPAP?

Plowboy · Post by **Plowboy** » Sat May 02, 2009 10:44 am

I am going to word this carefully. Befoe thereapy I would sleep thru the night most of the time. I had been off sleep aids for approximately 2 months and my wife would agree that I seemed to sleep for 7+ hours most nights, but when I would wake up I would still be tired and slow to get ready for work, naps every day at lunch time, tired when I got home and passing out on the couch at about 8:30 at night. This still seems to be the case except for a vauge feeling that my brain is running faster, yet my body does not seem to be able to keep up. I am tolerating the mask well from all accounts I read here and have been fully compliant for 4 nights in a row. After night 2 I added a chin strap and slightly tightened my head gear. Data says I have a very low rate of leaks. What I am wondering, is there a period of adjustment that I have to go thru that will eventually lead to some better results?

Thanks for your response,

Phil

riverdreamer · Post by **riverdreamer** » Sat May 02, 2009 12:13 pm

Plowboy wrote:I am on 5mg lisinopril (lowest dose) my readings at the Doc yesterday:

126/84 lying down

116/82 upon standing

His opinion is that I have mild hypertension and it is well under control.

Blood pressure is supposed to go up when you stand up, not go down. If this pattern of blood pressure going down when you stand up, you may have a mild case of orthostatic hypotension.

From the Mayo Clinic:

Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint.

http://www.mayoclinic.com/health/orthos ... on/ds00997

Your's is not going down severely, though that amount could vary during the day. Your doctor may not have thought it serious enough to comment on, or may not have thought of it. If it continues, or gets worse, I would look up more about it, and demand to be checked. Make sure you are drinking enough fluids to keep your blood volume up, that can help. Though extremely unpleasant, it isn't necessarily, by itself, dangerous. It can be caused by a few more serious things, however, including heart issues and diabetes.

The most common symptom of orthostatic hypotension is feeling lightheaded or dizzy when you stand up after sitting or lying down. This feeling, and other symptoms, usually happens shortly after standing up and lasts a few seconds or minutes. Signs and symptoms of orthostatic hypotension include:

* Feeling lightheaded or dizzy after standing up
* Blurry vision
* Weakness
* Fainting (syncope)
* Confusion
* Nausea
* Headache

I don't have any idea if CPAP could have any causative action here, unless you are getting dehydrated using it, or it is changing how you respond to medications.

jonboy · Post by **jonboy** » Sat May 02, 2009 12:50 pm

Could someone help me with these abbreviations? What does DME, RT, and BP stand for?

Plowboy · Post by **Plowboy** » Sat May 02, 2009 12:54 pm

Syndromes

Orthostatic hypotension, also called "postural hypotension", is a common form of low blood pressure. It occurs after a change in body position, typically when a person stands up from either a seated or lying position. It is usually transient and represents a delay in the normal compensatory ability of the autonomic nervous system. It is commonly seen in hypovolemia and as a result of various medications. In addition to blood pressure-lowering medications, many psychiatric medications, in particular antidepressants, can have this side effect. Simple blood pressure and heart rate measurements while lying, seated, and standing (with a two-minute delay in between each position change) can confirm the presence of orthostatic hypotension. Orthostatic hypotension is indicated if there is a drop in 20 mmHg of systolic pressure (and a 10 mmHg drop in diastolic pressure in some facilities) and a 20 bpm increase in heart rate.

Neurocardiogenic syncope is a form of dysautonomia characterized by an inappropriate drop in blood pressure while in the upright position. Neurocardiogenic syncope is related to vasovagal syncope in that both occur as a result of increased activity of the vagus nerve, the mainstay of the parasympathetic nervous system.

Another, but rarer form, is postprandial hypotension, which occurs 30–75 minutes after eating substantial meals. When a great deal of blood is diverted to the intestines to facilitate digestion and absorption, the body must increase cardiac output and peripheral vasoconstriction in order to maintain enough blood pressure to perfuse vital organs, such as the brain. It is believed that postprandial hypotension is caused by the autonomic nervous system not compensating appropriately, because of ageing or a specific disorder.

I picked this up from wikepedia, they checked my BP immediately after standing and even then the differance was less that stated for clinial diagnosis of orthostatic hypotension, as well as the fact that taking BP on the same arm within a few seconds usually shows a lower BP (my wife is an ER RN). Also, lisinopril (BP med) can cause this also. Thanks for the reply though, I appreciate it.

Phil

Raj · Post by **Raj** » Sat May 02, 2009 2:10 pm

Phil, to answer your question about a possible period of adjustment before you notice improvement, I would say that's very likely. See how you feel after two weeks and if there's no definite improvement, apnea may not be the primary cause of your tiredness although that doesn't mean you should discontinue using CPAP.

Plowboy · Post by **Plowboy** » Sat May 02, 2009 3:40 pm

Thanks Raj, I am going to stick with it no matter what!! Anyone else want to chime in, I would appreciate it.

Wulfman · Post by **Wulfman** » Sat May 02, 2009 4:51 pm

jonboy wrote:Could someone help me with these abbreviations? What does DME, RT, and BP stand for?

Durable Medical Equipment - Store/provider or employee of same.

Respiratory Therapist

Blood Pressure

Den

Daddysaur · Post by **Daddysaur** » Sat May 02, 2009 8:22 pm

Things came together for me after a week of adjustment to sleeping with this alien blowing into my face. Give it some time, you have the right attitude to succeed.

Plowboy · Post by **Plowboy** » Sat May 02, 2009 8:53 pm

Thanks, I am hanging as best I can!!

More tired now, please help!!!!!

More tired now, please help!!!!!

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Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!

Re: More tired now, please help!!!!!