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[Symptoms] Using CPAP while awake
#11
(12-11-2016, 10:31 PM)LowAHI Wrote: Thanks srlevine1, i'll come back with more comments.

All the checked elements of my blood are fine: ferritine, hemoglobin, B1, B1, B6, D, thyroid, magnesium.

So anemia is excluded

Now that you have ruled out anemia and thyroid issues, is it possible that you have a heart arrhythmia that could reduce the amount of blood being pumped through your system. Sleep apnea and atrial fibrillation seem to be correlated to some degree. Perhaps your doctor will give you a ZIO patch recorder (about the size of a large Band-Aid) that will capture up to two weeks of heart data to rule out arrhythmias. Since the patch captures essentially the rhythm, the data can be interrogated for time-dependent relevance. Have you done an A1C test for diabetes ... it sums about 3-months of past sugar levels?

You may wish to read Predictors of residual sleepiness in adequately treated obstructive sleep apnoea patients which claims that "predictors of residual excessive sleepiness in adequately CPAP-treated OSAS were a history of depression, diabetes and heart disease."

Sorry that we are discussing such a negative subject, but knowing is halfway to treatment. -- steve


"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#12
Adrenal hormones might be worth a check. High or low levels may affect one adversely.

Have they ever given you a steroid for the allergy response?
Do you take a regular antihistamine to help block the histamine release in allergy?
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#13
HI steve, sorry for being late.

I know that depression - fatigue of ex-OSA link.

I'll think about your other suggestions. Thanks
(12-11-2016, 11:08 PM)Beej Wrote: Adrenal hormones might be worth a check. High or low levels may affect one adversely.

Have they ever given you a steroid for the allergy response?
Do you take a regular antihistamine to help block the histamine release in allergy?


Hi there, I am new to all the terms you mentioned.
I will find the better moment of concentrations to digest your post. Thanks
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#14
Perhaps I can be more clear.

The fatigue may not be solely apnea, nor your lung issues. Checking some of the body's hormones might provide clues. Hormones may affect you if excessive or deficient.

You indicated lung hypersensitivity; allergies can do that. Allergies happen when a foreign protein contacts the body. There is a series of biochemical reactions which happen after that and one of them includes the release of histamine. Histamine cause stuffed up nose, reddening tissues, swelling, and can even stop breathing. It may cause some fatigue, too.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#15
(12-15-2016, 10:49 PM)Beej Wrote: Perhaps I can be more clear.

The fatigue may not be solely apnea, nor your lung issues. Checking some of the body's hormones might provide clues. Hormones may affect you if excessive or deficient.

You indicated lung hypersensitivity; allergies can do that. Allergies happen when a foreign protein contacts the body. There is a series of biochemical reactions which happen after that and one of them includes the release of histamine. Histamine cause stuffed up nose, reddening tissues, swelling, and can even stop breathing. It may cause some fatigue, too.

Hi there,

What hormones can I check? My TSH is fine

The fatigue I have seem to be more severe, more chronic (happen everyday) than the one caused by allergies

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#16
re: thyroid - TSH is not the only test, plus the doc is treating you, not the lab. I say this after I experienced 20+ years with borderline tests ... getting on thyroid let me stay awake after eating! Labs change criteria. Even if your numbers were in the 'normal' range, that doesn't mean they were your normal. That can be true of all lab tests, by the way, not just ones for hormones.

Some other hormones:

pancreas - diabetics, or even folks with a very reactive pancreas may have a problem with energy levels rise or fall abruptly due to how the pancreas is working in response to glycemic load. Tracking your fatigue levels plus what you ate and when may allow you to see if that could be true for you.

adrenal glands - too much or too little from these may affect energy levels. Adrenalin is the 'fight or flight' hormone and can become elevated from excessive stress or gland malfunction.

parathyroid glands - too much or too little from these may affect energy levels and muscle function ... like lung muscles.

Another area to consider - autoimmune diseases, typically arthritis types, may come with a lot of fatigue. If you have a family history of rheumatoid arthritis, lupus, etc., it can be worth it to do some screening tests for these.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#17
Part of our path we share. I used to wake a lot during the night, even though my numbers all looked good. I was not getting good sleep and not from apneas, but it turned out it was from the treatment. CPAP machines have trigger points for detecting when you start to inhale and when you start to exhale. For my this turned out to be one of my issues.

This is called Dyssynchrony, the machine is not triggering correctly for me and it disturbs be enough that I needed to wake and take a break many times during the night. A BiLevel CPAP machine (Resmed at least) has several adjustments for this. If you want to read up on Dyssynchrony you will need to look at "Patient-Ventilator Dyssynchrony" as this is were this issues is talked about most. And yes I know that CPAP is not a bentilator, however they both blow air into and both have triggers to sync that up with you. So for the sake of this one issue they share common cause.

The second thing that was bothering me was that my exhale pressure (BiPAP) was a little too low and that would allow my airway to start to close down enough to disturb me during the night. I increased it by 1.4cm and found that to be much better

Now that I think of it, I also had an issue with how long it took me to complete one breath. The machine was trying to cut off my inhale and I had to increase how long it let me inhale as I no medical reason to have my inhale cut off.

Hopefully a few more things to consider.
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#18
(12-18-2016, 03:07 PM)Beej Wrote: re: thyroid - TSH is not the only test, plus the doc is treating you, not the lab. I say this after I experienced 20+ years with borderline tests ... getting on thyroid let me stay awake after eating! Labs change criteria. Even if your numbers were in the 'normal' range, that doesn't mean they were your normal. That can be true of all lab tests, by the way, not just ones for hormones.

Some other hormones:

pancreas - diabetics, or even folks with a very reactive pancreas may have a problem with energy levels rise or fall abruptly due to how the pancreas is working in response to glycemic load. Tracking your fatigue levels plus what you ate and when may allow you to see if that could be true for you.

adrenal glands - too much or too little from these may affect energy levels. Adrenalin is the 'fight or flight' hormone and can become elevated from excessive stress or gland malfunction.

parathyroid glands - too much or too little from these may affect energy levels and muscle function ... like lung muscles.

Another area to consider - autoimmune diseases, typically arthritis types, may come with a lot of fatigue. If you have a family history of rheumatoid arthritis, lupus, etc., it can be worth it to do some screening tests for these.

Thanks for these tips Beej, I'll digest it when my concentration permits.

(12-18-2016, 06:05 PM)PoolQ Wrote: Part of our path we share. I used to wake a lot during the night, even though my numbers all looked good. I was not getting good sleep and not from apneas, but it turned out it was from the treatment. CPAP machines have trigger points for detecting when you start to inhale and when you start to exhale. For my this turned out to be one of my issues.

This is called Dyssynchrony, the machine is not triggering correctly for me and it disturbs be enough that I needed to wake and take a break many times during the night. A BiLevel CPAP machine (Resmed at least) has several adjustments for this. If you want to read up on Dyssynchrony you will need to look at "Patient-Ventilator Dyssynchrony" as this is were this issues is talked about most. And yes I know that CPAP is not a bentilator, however they both blow air into and both have triggers to sync that up with you. So for the sake of this one issue they share common cause.

The second thing that was bothering me was that my exhale pressure (BiPAP) was a little too low and that would allow my airway to start to close down enough to disturb me during the night. I increased it by 1.4cm and found that to be much better

Now that I think of it, I also had an issue with how long it took me to complete one breath. The machine was trying to cut off my inhale and I had to increase how long it let me inhale as I no medical reason to have my inhale cut off.

Hopefully a few more things to consider.

Hi PoolQ.
I have a CPAP machine, which does not have exhalation help (it has a C-Flex+ feature, but I don't use it). I'ts not the BiPAP, so does it count to take a look at https://en.wikipedia.org/wiki/Ventricular_dyssynchrony ?

Thanks
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