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6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
#1
6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
                   


Hi,  

I am 6 weeks into CPAP therapy and still not feeling refreshed and experiencing daytime sleepiness.
My AHI is below 5.
I have an appointment with the sleep physician in a weeks time so I will discuss my concerns with him.

In the meantime, appreciate comments or suggestions and need help to interpret the data.
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#2
RE: 6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
G'day sylviay.

On the face of it, your numbers are excellent and you should start to see some positive results. It does sometimes take a little while for the benefits to manifest themselves, though some lucky people get instant results.

One suggestion I would make is to reduce the pressure range, to minimise the pressure swings you're experiencing. Your machine is currently running "wide open" (ie 4 - 20). Some people find that the very low pressure makes them feel starved for air, and swings between high and low are disturbing. In your situation I would increase the minimum pressure to 6 (which is near your current median) and reduce the maximum to 15 or 16. This should give you a more consistent pressure through the night, and in turn your sleep should be more restful.

Finally, there can be other reasons for daytime sleepiness not related to apnea. For example, haemoglobin levels, thyroid function, vitamin D and a range of others. To say nothing of stress and depression. It might be worth talking to your GP to ensure these other factors are eliminated.
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#3
RE: 6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
There are two things: 1. you apnea is "treated" and that is mostly what insurance companies and Doctors are concerned about. 2> having the apnea treated does not mean that you are tolerating the treatment. There are things that can be done to make adjustments so you are more comfortable using CPAP
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#4
RE: 6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
I agree that you should increase your minimum pressure so that your treatment pressure varies less. Also noted is that you are not getting enough sleep. If you are having trouble falling asleep, the higher minimum pressure may make you more comfortable.
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#5
RE: 6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
I think a pressure range of 6.0 to 11.0 probably covers your needs better, and really the increase in minimum pressure is the only important one in terms of reducing pressure swings. Good point by Tedvpap that 6 to 7 hours may leave you a bit short on sleep. Everyone's needs vary, but skipping the late shows after midnight might help.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#6
RE: 6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
I get by with between 5.8 hrs and 6.5 hrs essentially indefinitely.  I only developed a desire to doze during the day after I commenced CPAP, not before, and I'm already 66.  Strangely, I also don't have to rise at all during the night; never have.

The essential truth of it is, as SleepRider states above, that people vary considerably in their need for sleep.  Where they don't vary is on the need for quality of the sleep.  Those who go short on REM don't do well in the long run, and sometimes just an extra 30 minutes of sleep can make a big difference.  My respiratory therapist urged me to try to rise a bit later, if at all possible, to ensure that I had some nights where I awakened after dreaming, and added that those late onset dreams are golden for mental and physical health.  That's apparently what the science tells us these days.  I see that your bedtime varies by as much as 45 minutes.  Sleep specialists would caution you to get rid of that impediment to sleep right away.

I don't want to go on at length...I tend to...but many people would benefit from shutting down the fun and important stuff in their lives earlier in the evening.  Stop watching youtube videos where the site sucks you into a never-ending cascade of, "Hey, this one looks interesting..."  Get off the social media and news.  Read, or watch TV reruns as these tend to relax you and help your mind to want to drift off.  Then, if you get that desired response.....ACTUALLY GO TO BED.  Don't drift off for a couple of hours in front of the TV where you will never get into REM and, oh yeah, where you aren't getting your PAP therapy...!!!
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#7
RE: 6 Weeks into CPAP- Still Experiecing Daytime Sleepiness
Depending on how deep your sleep debt is, it can take a while for your body to recover from the bad sleep you were getting pre-CPAP treatment. Some patients will begin to start feeling better sleep rather immediately upon CPAP use, others take weeks or months to realize any better feeling benefits. It's just another individual PAP treatment variable. Regardless, stick with it, and the better feeling will come along soon. Best to the successful treatment.
Coffee
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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