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[CPAP] Two years with low AHI and still very tired
#1
Two years with low AHI and still very tired
I have been using CPAP for over 2 years following a sleep study which provided an untreated AHI of 23. Despite full compliance with an average of 7 hours sleep per night I am completely exhausted every day. I had a MLST which proved inconclusive and have been prescribed Modafanil 400mg per day, this makes little difference and I can still fall asleep whilst taking them. I was also diagnosed with REM sleep behavior disorder but don't take any medication for this.

The consultant has taken numerous blood tests and I was low on Vitamin D for which I was given tablets, there was also some questions around B12 levels but at the follow up the range was at the lower end of normal. I have been checked for thyroid issues and diabetes both being negative.

My AHI averages just under 2 and I have minimal to no leaks.

I currently use a full face Air Fit F20 mask with a ResMed Air Sense Autoset, the settings being 7.8 - 16 with the average pressure being 10.

My thoughts now are to try an oximeter and run the data also through sleepyhead to see if that shows anything I may be missing.

My consultant is excellent and is thinking of now diagnosing idiopathic hypersomnia however the treatment would remain the same as I already take Modafanil.

I am on no other medication and have no other health problems, weight is slightly above normal but neck size is 15.5.

Does anyone have any suggestions as to why I continue to be tired, not only sleepy but this impacts on concentration levels etc.

Many thanks
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#2
RE: Two years with low AHI and still very tired
For clarification (I have no theories)...


Quote:I was low on Vitamin D for which I was given tablets

Did the tablets resolve the Vitamin D level?
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#3
RE: Two years with low AHI and still very tired
Kiwii, thanks for the reply, I am unsure about the vitamin D levels as they will only test once a year in the UK but the consultant stopped that tablets after a few months.
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#4
RE: Two years with low AHI and still very tired
I don't a answer but can give you a couple of things to look at. First check your flow limitations. If your getting a lot of them to the point your pressures keep increasing and decreasing during the night that can disturb your sleep. Also check your RERA's if you have that and see if you have a lot of activity. You could try bumping your minimum pressure up 1cm that would help with any obstructive events and flow limitations.

Of course I'm just guessing at a lot of this without a sleepyhead chart to look at. When you get 4 posts you should be able to post charts. The links below with help you.

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#5
RE: Two years with low AHI and still very tired
Walla Walla, thanks for taking the time to answer, I will have a look at my flow limitations to see if it shows any issues.
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#6
RE: Two years with low AHI and still very tired
(12-13-2017, 07:25 AM)orzabal Wrote: Kiwii, thanks for the reply, I am unsure about the vitamin D levels as they will only test once a year in the UK but the consultant stopped that tablets after a few months.
You did not mention how low your vitamin D level was. Here (Western Washington State, USA - notorious for rainy weather) they would re-test after a period of time to see how well the supplementation is working, or if the amounts need adjustment. At least that has been done for me, but my levels were very low.

I don't mean to take your thread off track. I don't know if low vitamin D would contribute to the problems you are having.

Another question for clarification, in case it may help someone sleuth this out...

Are you on any other medication?
(oops... I see you already said that you are on no other medications. Sorry about that!)
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#7
RE: Two years with low AHI and still very tired
I would like to add to the subject of low vitamin D levels.  

I was checked 3 years ago, and my levels were so low, my doctor joked they were non existent.  
He immediately started me on a high dose prescription vitamin D until my levels came up.

Then I started to take over the counter Vitamin D3 at 5000iu.
This is a high dose, my blood levels were checked every 3 months.  I am now taking D3 at 2000iu daily.

The take away from this is that you need to know your levels.  Ask your doctor and request a copy of your blood work.  

I wouldn’t take Vitamin D without having your levels checked first.  Low levels can affect your sleep and how well you feel.
OpalRose
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Two years with low AHI and still very tired
(12-13-2017, 09:40 AM)OpalRose Wrote: I wouldn’t take Vitamin D without having your levels checked first.  Low levels can affect your sleep and how well you feel.

And too high of levels can affect your REM sleep and how well you feel.  I did the 5000 a day for a little too long and found that out.  But the OP's sleepiness seems worse than that would explain.
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#9
RE: Two years with low AHI and still very tired
Allessio77,
Your posts have been moved to a new thread for you here:
http://www.apneaboard.com/forums/Thread-...imitations

Sent you a PM
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Two years with low AHI and still very tired
(12-13-2017, 06:41 AM)orzabal Wrote: I have been using CPAP for over 2 years following a sleep study which provided an untreated AHI of 23. Despite full compliance with an average of 7 hours sleep per night I am completely exhausted every day....

My consultant is excellent and is thinking of now diagnosing idiopathic hypersomnia however the treatment would remain the same as I already take Modafanil.

... I continue to be tired, not only sleepy but this impacts on concentration levels etc.


Is the main issue sleepiness or fatigue?  Do you have an daily episodes of an irrepressible need to sleep?
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