Seeing new Sleep Doc...how do I help him help me?

Hey gang...I have decided to see a new sleep doc. I have an appt to see a doc in the Atlanta Area that only specializes on Sleep. It is a Sleep Disorder Clinic...appt is Tues. My previous sleep doc was also my Pulmonary Doc and he wanted to focus on that. My pulmonary problem is now gone so I have decided to get a second opinion on my sleep apnea. My problem is that I am entering my 4th month of CPA therapy and my fatigue is not getting any better. At this point, I still feel like it is most likely sleep related, somehow (and hopefully not some chronic fatigue). I wear my mask every night and my AHI is 3.0 or lower, pretty consistently.. My leaks are low and AI's are almost non-existant. I do wake up at least one time a night and sometimes two...I usually get up, get something to drink and go right back to bed. I am not sure why I wake up - just dont know. I cannot remember that last time I slept all the way through the night and woke up refreshed. It has been at least 6+ months. I have looked back at my #'s for the past 3 months and they are below.

Median Pressure - 7.2
95% Average - 9.8
Leaks Median - 0.0
Leaks 95% - 0.1
Median Daily Usage - 7.34 hours.
AHI - 3.0
HI - 2.8
AI - 0.2


So overall, I feel like my CPAP is doing what it is supposed to be doing. Unfortunately, I just feel like crap every single day and really need to figure out what is going on. I eat great, exercise a ton, don't drink or smoke, have lost about 15 lbs in a couple months and do everything I am supposed to do. Something is just not right. I don't think that my O2 saturation is off....I don't know for sure though, since I don't have an overnight pulse Ox to measure it. Is it possible to have something else (restless legs, waking up each night, whatever) that is keeping me from getting good refreshing sleep, even though my CPAP is doing it's job? Isn't the fact that I feel like a zombie with this grogginess everyday, an indication that something is not right? I just want to help the doc help me...hopefully by giving him all the data he needs. I will have my data on a spreadsheet for him at my appt. Maybe I should request another sleep study? I have not had one since my titration back in early Dec.

Thanks in advance.

Brian

Do you have details from your last sleep study? I would expect that info to be helpful to the new doc. Plus you might avoid another uncomfortable night (can you tell I don't like sleep studies?).

Joanne

I will definitely have my sleep study and titration report in the packet I am preparing for the new doc. I actually do not mind the sleep study. Last time I really did not what exactly was going on, what sleep apnea even was or what questions to ask at the sleep study. This time I would actually prefer to have one...perhaps they can help me figure out my I am so tired.

B

Isn't the fact that I feel like a zombie with this grogginess everyday, an indication that something is not right?

Yes, it is.
And a new sleep study is a good idea.

Considering you lung embolisms, the very first thing I'd do for the sleep doc is bring along pulse oximetry for a few nights of sleep. Hasn't your pulmo even suggested that?

What are your recent settings? (Min, Max EPR)? You've been making changes along the way, It would be better to show results per setting, and not aggregated.

I'd keep an open mind for non-sleep reasons as well. For example, my recent months of fatigue and muscle pain turned out to be related to very very low Vitamin D. I thought the muscle pain was related to exercise -- but my muscles just kept on hurting even when I stopped all excercising for 2 weeks.

I eat great, exercise a ton, don't drink or smoke, have lost about 15 lbs in a couple months and do everything I am supposed to do.

I realize you are an experienced athlete, but I'll still ask: could it be that you are over-training, now that you can finally get back to the activity you missed?

Good luck, and keep us posted!