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Can mild apnea cause severe fatigue?
#11
RE: Can mild apnea cause severe fatigue?
Your starting pressure, or minimum pressure, is very low.  My guess is that, with the advice of one or two savvy advisers here, you'll have that up by 2 cm before long.  

Your 'minute vent' numbers are somewhat lower than I see typically in people getting successful treatment.  Again, stand by for an interpretation from the 'others'.

You have some leaking going on, nothing truly objectionable, but it's there.  These have the effect of making the machine adjust and work harder (sometimes noisier...meaning arousals), and the air leaking by can make noises or tickle you, which will also arouse you.  Arousals are bad.  They interfere with your REM attainment.  Failure to get much REM will make you feel exhausted eventually.

This problem of tunnel vision when ascending stairs.  Do you feel faint, have a pounding heart, get dizzy?  Do you feel breathless and cold at times?  It could be an iron deficiency, heme iron to be precise.  I would suggest, if this hasn't been investigated, that you have an internist or endocrinologist do a full workup.

Also, your main trouble, when you get them, comprises central apneas.  To maintain perspective, the last chart you posted has your AHI for the night at just under two, which is well under the 'treated' range of 4.9.  But we need to get a grip on the centrals if they persist.

Final comment: a great many users of the various PAP therapies report that they don't feel any different, and certainly don't see what they feel would be an improvement in their well-being.  This is discouraging, but...it's also common.  For many, the little gains come months into therapy, especially if they're having some trouble getting 'dialed in' to the correct range of pressures.  So, as others have said already, you'll have to be patient...maybe even forget hope for the time being.  Instead, get some 'learning' about your condition, how best to treat it, and how to manage your own recovery.  From there, we should all hope to see you come back and report little miracles now and then.  Smile
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#12
RE: Can mild apnea cause severe fatigue?
(06-13-2019, 12:22 AM)mesenteria Wrote: Your starting pressure, or minimum pressure, is very low.  My guess is that, with the advice of one or two savvy advisers here, you'll have that up by 2 cm before long.  

Your 'minute vent' numbers are somewhat lower than I see typically in people getting successful treatment.  Again, stand by for an interpretation from the 'others'.

You have some leaking going on, nothing truly objectionable, but it's there.  These have the effect of making the machine adjust and work harder (sometimes noisier...meaning arousals), and the air leaking by can make noises or tickle you, which will also arouse you.  Arousals are bad.  They interfere with your REM attainment.  Failure to get much REM will make you feel exhausted eventually.

This problem of tunnel vision when ascending stairs.  Do you feel faint, have a pounding heart, get dizzy?  Do you feel breathless and cold at times?  It could be an iron deficiency, heme iron to be precise.  I would suggest, if this hasn't been investigated, that you have an internist or endocrinologist do a full workup.

Also, your main trouble, when you get them, comprises central apneas.  To maintain perspective, the last chart you posted has your AHI for the night at just under two, which is well under the 'treated' range of 4.9.  But we need to get a grip on the centrals if they persist.

Final comment: a great many users of the various PAP therapies report that they don't feel any different, and certainly don't see what they feel would be an improvement in their well-being.  This is discouraging, but...it's also common.  For many, the little gains come months into therapy, especially if they're having some trouble getting 'dialed in' to the correct range of pressures.  So, as others have said already, you'll have to be patient...maybe even forget hope for the time being.  Instead, get some 'learning' about your condition, how best to treat it, and how to manage your own recovery.  From there, we should all hope to see you come back and report little miracles now and then.  Smile

Thanks for the in depth comment. I'll consider upping the pressure soon if I don't see an improvement.

I tend to move about a lot in my sleep. I suspect that may be what's causing the minor leakage. I'm considering switching to the Dreamwear nasal mask since I've seen good things about it. 

I have a multitude of mystery symptoms that my doctors have not been able to give me a diagnosis for. I've seen an endocrinologist, rheumatologist, cardiologist, and I've been tested for MS, Lupus, RA, fibromyalgia, thyroid and hormonal issues, Lyme disease, and have had extensive bloodwork performed too many times to count. My iron is good. The only things they have found are an elevated ANA and low Vit D and folate (both of which I now supplement for). The fatigue is the worst, but I'm often dizzy, have extreme heat and exercise intolerance, heart palpitations, unusual skin rashes, hot flashes, flushing of my face and chest, chills, neuropathy, severe joint pain, brain fog, and shortness of breath. All my symptoms started at once, and seem to come and go in "flares". My primary doctor is convinced I will be diagnosed with Lupus at some point.  I know poor sleep can lead to a multitude of health complaints so I was hoping with the apnea diagnosis that maybe I finally had an answer to my recent downturn in my health. 

I'll be patient and give the therapy time to work, tweaking along the way if need be.
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#13
RE: Can mild apnea cause severe fatigue?
The thing about AHI is that it's a fairly crude marker of sleep disorder. One thing it does not do is pay any attention to the duration of the events. You may have a low AHI but if each apnea is 50 or 60 seconds then the effects can be quite severe. In Oscar, click on the "Events" tab in the left sidebar of the daily page (just above the big orange AHI number). Each individual event will be listed with the duration shown in brackets. See here: http://www.apneaboard.com/wiki/index.php...t_side-bar
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#14
RE: Can mild apnea cause severe fatigue?
Your pressure in s jumping around for no reason that is showing. I'll bet it is Flow Limitations, this is why we like to see that graph.
Since your obstructive Apnea is under control and flow Limitations are what's left let's treat these with a pressure difference between inhale and exhale pressures by increasing EPR to 3
Your initial min pressure should typically be EPR + 3
In summary set your min pressure to 7 and EPR =3
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#15
RE: Can mild apnea cause severe fatigue?
(06-13-2019, 03:01 AM)DeepBreathing Wrote: The thing about AHI is that it's a fairly crude marker of sleep disorder. One thing it does not do is pay any attention to the duration of the events. You may have a low AHI but if each apnea is 50 or 60 seconds then the effects can be quite severe. In Oscar, click on the "Events" tab in the left sidebar of the daily page (just above the big orange AHI number). Each individual event will be listed with the duration shown in brackets. See here: http://www.apneaboard.com/wiki/index.php...t_side-bar
Thank you, I had no idea how to see each individual event. I just took a look at them and frankly they are usually not long at all - most seem to be between 11 and 16 seconds or so.

(06-13-2019, 06:25 AM)bonjour Wrote: Your pressure in s jumping around for no reason that is showing.  I'll bet it is Flow Limitations, this is why we like to see that graph.
Since your obstructive Apnea is under control and flow Limitations are what's left let's treat these with a pressure difference between inhale and exhale pressures by increasing EPR to 3
Your initial min pressure should typically be EPR +  3
In summary set your min pressure to 7 and EPR =3
Thank you so much! I'll do as you suggest and see how it goes.
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#16
RE: Can mild apnea cause severe fatigue?
Really sorry to hear about your symptoms. I had undifferentiated connective tissue disease, so the fatigue, flaring, joint pain, and elevated ANA caught my eye.

As you probably know, CT diseases don’t always fit neatly into categories. I wonder whether the rheumatologist considered trying you on steroid treatment despite bloodwork and symptomology that don’t cohere into a specific CT disease profile. Plenty of good reasons not to do that, of course.

I wish you the very best. And with the help of people here, you can get your apnea therapy dialed in. It would be fantastic if that helped you feel better.
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#17
RE: Can mild apnea cause severe fatigue?
(06-12-2019, 11:45 PM)Big Guy Wrote:
(06-12-2019, 10:53 PM)Lachrymosa Wrote: Big Guy thanks for the insight... I hope you find improvement soon as well. Maybe I just need to be patient.

I think you hit the nail on the proverbial head. It's all about being patient. I've been told that by others on here more than once. I'm doing my best to do so.

Haven’t you ever wondered why the customer of a doctor is called a patient? This quality of being patient is oftentimes required of us for therapy to improve our life quality but also when in the waiting room.

Coffee
Dave

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#18
RE: Can mild apnea cause severe fatigue?
(06-13-2019, 10:13 AM)Dormeo Wrote: Really sorry to hear about your symptoms. I had undifferentiated connective tissue disease, so the fatigue, flaring, joint pain, and elevated ANA caught my eye.

As you probably know, CT diseases don’t always fit neatly into categories. I wonder whether the rheumatologist considered trying you on steroid treatment despite bloodwork and symptomology that don’t cohere into a specific CT disease profile. Plenty of good reasons not to do that, of course.

I wish you the very best.  And with the help of people here, you can get your apnea therapy dialed in. It would be fantastic if that helped you feel better.

I've seen CT disease come up quite a lot while trying to do research into my symptoms, and I've wondered if I do suffer from it. My rheumatologist did not want to treat me with anything but plaquenil, which I refused because of the danger it can pose to eyesight and I was not willing to take even a small risk with that since my eyesight is already horrendous. Maybe it's time I see a different rheumatologist.

Thank you, and I wish you the best as well!

One other thing I wanted to ask about... The last two mornings I have woken up feeling kind of like I'm hyperventilating. It took me about 10 minutes to feel normal again. Is this to be expected when starting therapy?
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#19
RE: Can mild apnea cause severe fatigue?
I can't say it's to be expected because I have never experienced what you describe (hyperventilating at awakening), but maybe that is the 'new normal' for you...at least, in your current condition and with the settings you have on the machine.  I think you should go with the flow, so-to-speak, and just endure and note what happens as you change things.  A record, written and comprehensible later, might be useful for you when you feel you have to revert to previous settings for some reason.
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#20
RE: Can mild apnea cause severe fatigue?
(06-13-2019, 10:50 AM)mesenteria Wrote: I can't say it's to be expected because I have never experienced what you describe (hyperventilating at awakening), but maybe that is the 'new normal' for you...at least, in your current condition and with the settings you have on the machine.  I think you should go with the flow, so-to-speak, and just endure and note what happens as you change things.  A record, written and comprehensible later, might be useful for you when you feel you have to revert to previous settings for some reason.

Makes sense... Thank you!
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