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What else could be wrong with me?
#1
Wanted to get some opinions here. I've been using my CPAP every night for a few months, but sometimes I just don't feel like I'm as well as I can be. Even with the CPAP my symptoms include being tired/fatigue and having the tired/pressured eyes that feel like I've been up all night. Maybe my leaks are too high? Maybe the air isn't getting to me as well as it should? Maybe apnea isn't the problem in the first place? I've attached two files from ResScan:
'Capture1' is an overall snapshot of usage, leaks, and AHI for the past couple months. 'Capture2' is a detailed snapshot from last night. It shows an hour-by-hour view of events, AHI, leaks, flow limitation, and flow.

Looking back through my data I can see that my AHI has never risen above 3.0 (it usually hovers around 0.7 to 1.5 or so). My leaks have stayed under the compliance threshold with the exception of a couple of times. My usage has ranged from 7-10 hours for the most part so I am getting enough sleep. If there is any other data on ResScan that I can provide let me know.

One night I would like to not use my machine and see if I feel any different than with it, but I don't want to get behind again. I'd really like to stop using it if I don't have to, but don't want to throw away all the work I've put into using it. I'm still a couple weeks out from getting to see my doctor again so I thought I'd hop on here and see if anyone can shed some light on what else might be the problem for me.

Some things it's not:
-Narcolepsy (I had a daytime sleep test done)
-Diabetes (blood work from October of last year showed normal sugar levels)
-Lack of exercise (at least I think it's not. I'm not as active as I could be, but this stuff went on even when I was a regular runner and was into sports)
-Depression (I was on an anti-anxiety/depression med for a while for anxiety and it only addressed that issue. Unless the med I was on didn't catch it all)

I know this is a lot of information. Please let me know if I left anything out or if I can provide any additional information. Thanks in advance, I'll be watching for replies Thanks


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#2
The cpap therapy seems to be working as far as I can tell. I don't think I'd change anything right now, and I would sure continue using the machine each and every night.

That leaves environmental sorts of issues. It does appear you're getting a solid 8, but are you actually asleep? I can't tell that. It could be you aren't really getting all that good of a rest due to life stresses, coffee, job demands, no telling what all.

Then too, it might just be taking you longer to adapt to this new life of yours.

You've got a doc appointment coming up, so let's wait and see what he has to say about all this.
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#3
(07-19-2014, 05:58 PM)retired_guy Wrote: The cpap therapy seems to be working as far as I can tell. I don't think I'd change anything right now, and I would sure continue using the machine each and every night.

That leaves environmental sorts of issues. It does appear you're getting a solid 8, but are you actually asleep? I can't tell that. It could be you aren't really getting all that good of a rest due to life stresses, coffee, job demands, no telling what all.

Then too, it might just be taking you longer to adapt to this new life of yours.

You've got a doc appointment coming up, so let's wait and see what he has to say about all this.

Thanks for reply. You reminded me of some things I can add. I do get at least 8, and sleep all the way through the night usually without waking at all. When I wake up I'm normally extremely groggy to where it's hard to get out of bed and when I do it takes maybe half an hour to an hour to get over it. I normally don't have any caffeine after midday.
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#4
Then I think you want to explore with the doc whether or not you are actually getting into that deep, restorative sleep you need to get during the 8. If you're just sort of "twilighty," then you're going to feel like crap when you wake up.

But your cpap is doing it's job. So don't rock that boat. Just continue on from where you are until you get all of the issues resolved.

You'll get there! I'll bet Diamaunt's reputation on it.
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#5
Diamaunt has a reputation???
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#6
Sometimes, there is more to it than just plain OSA. Your apnea been treated at pressure 7 but the persistence of flow limitation is an indication that the machine might use a bit more pressure. Avoid sleeping in supine position may helps, show the chart to your doctor, maybe a trial the machine on autoset mode on a narrow range
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#7
(07-19-2014, 06:17 PM)PaytonA Wrote: Diamaunt has a reputation???

news to me, but it's probably a bad one... I'll wager Laugh-a-lot
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#8
There is no way to know how long you had untreated OSA and it can take a long while to repair or begin to heal the damage done from untreated OSA.
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#9
(07-19-2014, 06:26 PM)zonk Wrote: Sometimes, there is more to it than just plain OSA. Your apnea been treated at pressure 7 but the persistence of flow limitation is an indication that the machine might use a bit more pressure. Avoid sleeping in supine position may helps, show the chart to your doctor, maybe a trial the machine on autoset mode on a narrow range

Actually I find that lying on my back helps more than on my side. When I first started treatment I was on auto set, but the doctor determined that 7 was a sufficient setting.
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#10
jbuchanan6196,

Sometimes it's not about apnea. Your machine is managing your apnea quite nicely, but it only fixes obstructive sleep apnea; it does NOT fix bad sleep caused by other problems. Nor does it fix a host of other conditions that can lead to daytime fatigue and tired/pressured eyes that makes it feel like you've been up all night.

You write:
(07-19-2014, 05:49 PM)jbuchanan6196 Wrote: My usage has ranged from 7-10 hours for the most part so I am getting enough sleep. If there is any other data on ResScan that I can provide let me know.
The Usage chart shows that on a lot of nights, there are multiple sessions---i.e. you are waking up enough to turn the machine off and back on. The Usage chart also shows a fair amount of variability in both bedtimes and wake up times, mainly coming from Friday and Saturday nights (i.e. weekends). You might try sticking to the same sleep schedule on weekends as well as weekdays. That may improve things in the long run.

And as zonk points out, there is some real activity in the flow limitation graph. Some people are bothered a lot by flow limitations, others are not. But it may be worth trying a very small pressure increase to see what happens to the flow limitation graph and what that does for how you are feeling. And it's well worth bringing the sleep doc a printout of the ResScan detailed data and asking about whether the flow limitations are an issue.

Quote:I've been using my CPAP every night for a few months, but sometimes I just don't feel like I'm as well as I can be.
...
One night I would like to not use my machine and see if I feel any different than with it, but I don't want to get behind again. I'd really like to stop using it if I don't have to, but don't want to throw away all the work I've put into using it. I'm still a couple weeks out from getting to see my doctor again so I thought I'd hop on here and see if anyone can shed some light on what else might be the problem for me.
I know that it feels like it has been a very long time since this (mis)adventure into hosehead land started. But it does take some people several months to even a year to start noticing any real differences in how they feel with PAP vs. without PAP. And sometimes the first signs that PAPing is doing something positive can be subtle and be related to things other than fatigue. For many people, the first positive thing they notice is a reduction (or elimination) in the number of times they get up to pee each night. Others notice a lessening or elimination of morning headaches. In my case, the first positive thing I noticed was waking up with much less hand and foot pain each morning.

You also write:
Quote:Some things it's not:
-Narcolepsy (I had a daytime sleep test done)
-Diabetes (blood work from October of last year showed normal sugar levels)
-Lack of exercise (at least I think it's not. I'm not as active as I could be, but this stuff went on even when I was a regular runner and was into sports)
-Depression (I was on an anti-anxiety/depression med for a while for anxiety and it only addressed that issue. Unless the med I was on didn't catch it all)
You probably need to get a good, thorough general physical exam from your PCP. Blood tests should be done for anemia, thyroid problems and vitamin deficiencies. If there's any chance of heart disease, that should be checked out. If there's any chance of pulmonary problems, such as COPD or asthma, that needs to be checked out.

Lack of exercise may be an issue: Remember that when you WERE actively exercising, your body was also suffering from untreated OSA. The untreated OSA may have explained the fatigue then, while the lack of exercise may (partially) explain the fatigue now.

Chronic pain of any sort can lead to problems with fatigue. So that's another thing to consider.



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