Tell me a co-existing condition

Okay, I have mild-moderate OSA. The lack of relief I've gotten from CPAP therapy has pointed highly toward the fact that I might have some other co-existing condition going on. My testosterone and thyroid levels are both high/normal. I've gone extended periods of time injecting 1000 mcg of liquid vitamin B12 every 3rd day with no relief so it's not a B12 deficiency. Insomnia has been a problem in the past but pretty infrequently. I've gone extended periods of 8+ hours of sleep per night and have still felt very crappy. Been on continuous CPAP for 9 months with AHI's consistently under 5. Very little relief!

Please list any other co-existing conditions that could contribute to severe daytime lethargy:

These could by one's that you've had experience with yourself or any that you've possibly heard about.
Thanks!

Given your young age, low AHI, etc, check here in these reports about the underlying medical conditions (comorbids= existing together with the sleep disorder).

For Central Sleep Apnea and Complex SA syndromes:

http://emedicine.medscape.com/article/304967-overview

Next, check here, also for comporbids associated with Obstructive Sleep Apnea and Complex Sleep Apnea syndromes:


http://emedicine.medscape.com/article/295807-overview

My co-existing medical conditions are Diabetes, and Hi Blood Pressure (both borderline with midications)

I would consider the following which can affect sleep quality:

Sugar consumption
Caffeine consumption
Smoking
Medications (prescription + OTC)
Recreational drug use
Alcohol consumption
Anxiety issues
Disturbances by sleep partner (snoring, moving around, etc)
Other disturbances (living in a noisy building or neighborhood)


Could any of the above be a factor? Sometimes it's something you hadn't considered, like medications such as SSRIs which can shorten REM sleep. You can also test for low vitamin D; there is research recently that points to relationship between poor sleep quality (and daytime fatigue) and low vitamin D.

Paul Van Dyk wrote: I've even tried hyper dosing of caffeine, ephedra, adderall and other stimulants.

Are you well versed in good sleep hygiene? Do you practice good sleep hygiene?

Do you exercise regularly?

Could you get in for another sleep study?

Get your vitamin D levels checked. Lab normal values generally say that 30 is the minimum normal, but I've been told by a some doctors (although others disagree) that it's better to be above 50. They tested mine before my sleep study and it was 9. Fortunately, if it's low, they just prescribe high-dose pills for a few weeks.

asthma
wrong diet (too many carbs can make you tired)
poorly adjusted xPAP therapy (one night in the sleep lab only works for some people; the rest of us must titrate our own)
not sleeping enough hours

You're in San Francisco. Can you go to Stanford and have the sleep docs there work you up?

use the software to monitor how well your treatment is doing. Jim

Goofproof wrote:use the software to monitor how well your treatment is doing. Jim

on Wed Nov 16, 2011 5:22 pm, Paul Van Dyk writes:
"Been on continuous CPAP for 9 months with AHI's consistently under 5."

RandyJ wrote:I would consider the following which can affect sleep quality:

Sugar consumption
Caffeine consumption
Smoking
Medications (prescription + OTC)
Recreational drug use
Alcohol consumption
Anxiety issues
Disturbances by sleep partner (snoring, moving around, etc)
Other disturbances (living in a noisy building or neighborhood)


Could any of the above be a factor? Sometimes it's something you hadn't considered, like medications such as SSRIs which can shorten REM sleep. You can also test for low vitamin D; there is research recently that points to relationship between poor sleep quality (and daytime fatigue) and low vitamin D.

None of the above issues are present or present any longer. Been off all my psych meds for a while now because I wanted to rule those out (as far as being the culprit for the lethargy). I think I might buy some vitamin D and load. Thanks.

avi123 wrote:Given your young age, low AHI, etc, check here in these reports about the underlying medical conditions (comorbids= existing together with the sleep disorder).

Next, check here, also for comporbids associated with Obstructive Sleep Apnea and Complex Sleep Apnea syndromes:

http://emedicine.medscape.com/article/295807-overview

... okay so I clicked on the above link and I don't see where to click to check the comorbids. Where do I find them?

So Well wrote:

Paul Van Dyk wrote: I've even tried hyper dosing of caffeine, ephedra, adderall and other stimulants.

Are you well versed in good sleep hygiene? Do you practice good sleep hygiene?

Do you exercise regularly?

Could you get in for another sleep study?

Can you post the article about good sleep hygiene again? I'll read through it again to make sure. I exercise regularly. I'm a master's level exercise physiologist by trade. I can't get in for another sleep study. I've been fired from every job I've had in the last couple years due to my sleep apnea so I live in poverty with no money or health insurance.

SleepingUgly wrote:You're in San Francisco. Can you go to Stanford and have the sleep docs there work you up?

Doubt it. I've been fired from the last two positions I've held in my lucrative career field (medical device sales) due to sleep apnea. I have no permanent residence, no health insurance, no money and live in poverty conditions as a result.

Paul Van Dyk wrote:

So Well wrote:

Paul Van Dyk wrote: I've even tried hyper dosing of caffeine, ephedra, adderall and other stimulants.

Are you well versed in good sleep hygiene? Do you practice good sleep hygiene?

Can you post the article about good sleep hygiene again?

I can't find my favorite article now, but here is plenty of good reading - http://www.google.com/search?q=sleep+hy ... =firefox-a

I disagree with all the articles that say "no caffeine with x hours of bedtime".

The half-life of caffeine in the human body is quite long and I think CPAPers should avoid all caffeine.

Paul Van Dyk wrote:

SleepingUgly wrote:You're in San Francisco. Can you go to Stanford and have the sleep docs there work you up?

Doubt it. I've been fired from the last two positions I've held in my lucrative career field (medical device sales) due to sleep apnea. I have no permanent residence, no health insurance, no money and live in poverty conditions as a result.

I am in CA near you and know one family who was unemployed for a long time and got something (I assume Medicaid) that paid for all their health care costs. I pushed the dude to get a sleep study and he did - he told me all the costs, including the costs of CPAP equipment, were paid by his government health benefit. These people owned two cars and a house and still qualified.

They also got food stamps and welfare checks for themselves and the two kids. They are not having much fun but the basic necessities are being covered.

The dude lost his job because of falling asleep in his cubicle and being incompetent. His stupid doctors misdiagnosed him and he thanks me for pointing him toward a sleep study.

I think there are government help options for you besides disability and as soon as you can get your health straightened out it sounds like you will get back in the job market and become a winner again.

On the government aid I suggest you start looking here http://www.cdss.ca.gov/cdssweb/PG181.htm

I have read that the Federal government has 73 separate programs to help people in poverty. The stupid idiots should have one program that would give people in poverty comprehensive help. It would be much better for you and they could layoff dozens of bureaucrats that are doing non-value added work and wasting the taxpayers money.

My prayers that everything works out for you very quickly,

Wow! Thanks for the great responses So Well! Let me know if you ever find your favorite sleep hygiene article