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New User - Help with Identifying Cause of Fatigue after starting CPAP

I am a new cpap user. I was diagnosed with mild/moderate sleep apnea (16 events per hour).

I received my cpap machine (in CPAP mode) 7 days ago today. I have been 100% compliant in that time.

Here are the 7 day averages from SleepyHead:

CPAP Usage
Average Hours per Night 7:20 (this is slightly skewed. The first two nights were 4.0hrs and 6hrs respectively but this has increased steadily to over 8 hours for 2-3 nights and 9+hrs as of last night).

Compliance 100%

Therapy Efficacy
AHI 0.19
Obstructive Index 0.1
Hypopnea Index 0.02
Clear Airway Index 0.02
RERA Index 0.02

Leak Statistics
Average Leak Rate 0.33
90% Leak Rate 0
% of time above Leak Rate threshold 0.35%

While I do have a lot to learn, based on my research, these numbers seem to be ok. Nothing major appear to be out of order.

However, ever since I started, I have felt much more fatigued than before. I am finding myself wanting to sleep longer and longer.

Whereas before CPAP, I would have no problem staying up late (11, 12, 1 AM)--in fact, it was quite easy to do so. Now, I am lucky if I can make it much past 10:00 PM. and despite going to bed earlier than normal, it's tough to wake up--by which I mean, I wake up a little groggy, but not terribly so. I have low energy through out the day--although, sometimes my energy picks up after I work out (I walk ~2 miles a day most days and lift weight for about an hour 3x times a week).

Generally speaking, I do feel like the quality of my sleep has improved somewhat. While I have been adjusting much better than I ever imagined, I am still not 100% comfortable with the mask. That is, I am still conscious of it and I do find that I wake up once or twice because of it (roll over and it pulls just enough to wake me but not enough to actually pull the pillows out of place).

I have had others tell me that they have noticed a profound difference after starting therapy. Indeed, a few said they noticed the difference right after the night of their sleep study--more energy, feeling refreshed, etc. I expected their experience may be related to the severity of their condition (50+ events).

Naturally, I was expecting something similar--albeit, not to the same degree because I wasn't as severe.

I have read about "sleep debt." There seems to be mixed opinions about it.

I decided to download the SleepyHead software in case there was something going on with my setup/settings. That is, since there wasn't a consensus on "sleep debt," I decided it was prudent to check my stats (of course, I was also curious). I admit that I don't have much idea where to look.

I'd appreciate some feed back on this experience. If there are key stats that I should looking at, please let me know


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Possibly you are paying off a big "sleep debt" that you accumulated before you started therapy. Give it a month or so before you worry all that much. If you are getting lots of good quality sleep the body has more time to repair the damage you did for all those years of strangling yourself many times each night. Maybe your body is telling you to give it lots of sleep to help it repair you.

It took me a good three months of persistant use to start feeling better. CPAP is not a miracle cure (though it seems that way for some) and if you've done a lot of damage to yourself for a long time you might have to be satisfied a slow recovery, or even with just not getting any worse. But I expect you will do a good deal better than that if you stick with it.
Ed Seedhouse

Part cow since February 2018.

Trust your mind less and your brain more.

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Don't know if it's sleep debt or what but I felt the same for several weeks after starting. I think our bodies are now craving the "good" sleep we are getting now. So it wants to sleep more. That's my theory anyway. Your numbers are very good so just keep at it.
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I agree with Buckey. My cute little body has discovered it really likes to sleep. So I let it do that as much as it wishes to do. It used to be that bedtime was not all that happy of an occasion for my cute little body. It new it would not sleep well, would wake up with it's hip hurting, or it's back hurting, or its side hurting from where Mrs. R_G poked it in the ribs because it was snoring. All that stuff. Now it lays down, goes to sleep and is a very happy camper.

But I do find that in spite of it enjoying bedtime so much that it would really like to do that more often, I can do whatever I want in the daytime without fear of dozing off. So that's good.
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I appreciate all the replies and feedback. It is reassuring that this fatigue should eventually pass. Have there been any studies with respect to sleep debt and cpap users? I'd like to read an article or two. I have read some of the forum posts and they all seem to be anecdotal.

Also, I forgot to mention that I seem to have an issue with chest/throat congestion while my nose is often runny in the morning. My guess is my nose is draining while I am sleeping and causing the congestion. Does this seem reasonable or could there be something else at play?

Is there anything I can do to help the runny nose or is it a matter of my nasal passages getting used to the cpap? I have a humidifier and climate control hose - both are set to auto.
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Hi rogue01,
WELCOME! to the forum.!
It takes time for your body to repair itself from not having good sleep for so long, just stick with it.
Hang in there for more responses to your post and much success to you with your CPAP therapy.
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Maybe turn down the humidity a bit. I don't need as much as they DME thought I did.

That tired/sleep feeling seems to be common for the first 3-7 weeks. Your brain and body wants that restful and oxygenated sleep with no arousals.
Enjoy your new machine sleeping buddy and the journey to a new you.
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Maybe try a sinus rinse before bed time. May help with the congestion. And agree with the above.........maybe drop the humidity a bit.
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