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Chronic fatigue, I need some help.
#11
RE: Chronic fatigue, I need some help.
Any other advice on what to try or get tested for? I think will start using my BiPAP again and look into adding in the EERS.
#12
RE: Chronic fatigue, I need some help.
The patterns I see are Ideopathic (unknown) Central Apnea, not the waxing and waning that is evident when the CO2 apneic threshold is in play. I doubt that the EERS approach will help you.
#13
RE: Chronic fatigue, I need some help.
I would wait on testosterone results as it is a common issue. See what you can do to increase physical activity. Whether you walk or use an exercise bike or just get out, try to hit some goals and your mood should follow. Many of us have been locked down, and after vaccination I felt freed up to move around and go places. Keep on supplemental vitamin D.
Sleeprider
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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.
#14
RE: Chronic fatigue, I need some help.
Thanks Sleeprider. I do need to exercise more, that could definently be a factor. I've been on Vitamin D for a couple years now. I used to have low levels. Supplementing did raise my numbers but fatigue continues. I've even given up coffee which was the hardest. Been 2 weeks and sleep has actually gotten worse. Hopefully it improves or just goes back to the way it was while I was having coffee. I'm running out of time so I hope I can figure it out soon. I've dumped so much money trying to figure this out. Nice new mattress, several doctors, several lab tests, dozens of supplements, sleep trackers, BiPAP machine. Negative side affects of the antidepressants suck so I kinda hope is low T but even TRT probably has it's own issues too. I will focus on more exercise outside for now.
#15
RE: Chronic fatigue, I need some help.
If you have questions about TRT, ask away. I have used it for a number of years, injecting a relatively low dose of 0.3 mg T-cypionate S.C. weekly. I have had to titrated the dose downward to deal with the side-effect of elevated hematocrit.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Organize your OSCAR Charts
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How To Deal With Equipment Supplier


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.
#16
RE: Chronic fatigue, I need some help.
Hi mate, it looks like you are not being tested properly since they only looked for AHI in your test.
You can not be having sleep apnea but still an other sleep disorder breathing issue going on.

Most of the breaths i see on the graphs are flow limited and this is a big red flag for UARS aka Upper Airways Resistance Syndrome, symptoms of this syndrome are even worse then OSA more often.

Take my opinion with a grain of salt, but if i were you, i would be checked for UARS with a test that counts RDI value.

Diagnosis for UARS is:
AHI<5
RDI>=5

A pretty cheap test you can do at home is watchPAT. Most tests you will do at home won't count RDI value.

Maybe you still feel really bad because you have UARS and it's not being properly treated.

Good luck
#17
RE: Chronic fatigue, I need some help.
Thanks Sleeprider and KillerFitfh. I am trying to get another in lab sleep study done. Been trying for about a year now. I used to have chronic nasal congestion due to swelling. I ended up having surgery due to chronic sinus infection. Got turbinate reduction, septoplasty and balloon sinuplasty. It did open up my nasal passage but fatigue has continued to get worse. I don't feel any restriction in my nose anymore. This was 1 year ago. At home sleep study was 5 before and 8 mixed after surgery. It was an Alice NightOne by Philips. I don't think it was that accurate. If I am unable to get another in lab sleep study then I will look into that WatchPAT. Thank you.

For testosterone I seem to have all of the symptoms of low T but my libido is just fine. Have noticed zero changes there. I do have an enlarged prostate though as I have a low stream plus sometimes cloudy urine. When I go for the T check on Monday they are going to check PSA too. I have heard you can have low T while also having no changes in libido so we will see I guess. I am 5'11", 150lbs, 36yo, M. I've been about the same muscle mass and weight for the past 15-20 years.
#18
RE: Chronic fatigue, I need some help.
Thanks Gideon. I don't plan on doing anything anytime soon. I'm still trying to turn this fatigue around that continues to get worse. It just seems like no doctors take my fatigue seriously since on paper everything looks good. If I tell them I am contemplating something they will just look at my problem as just depression and will dismiss the fatigue. Maybe the fatigue is cause by depression, just seems unlikely to me but I don't know yet. I would have quit work already, but I have a wife and 3 kids. I should have some answers in the next week or two. If not then I will get back on my antidepressants.

Just feels like over the last 7 years that my gas is running out and now the gas light has finally came on. Severe fatigue and brain fog suck. Everytime I wake up I am more tired than the day before. Naps seem to make me even more tired. So nothing is helping. And I can't even have caffeine anymore since it gives me issues. Imagine being extremely tired and sleep doesn't help and you can have no coffee.
#19
RE: Chronic fatigue, I need some help.
I can see where KillerFith sees flow limitation, but the main problem is that your therapy is based on extremely low pressure and pressure support, with a range of only 4.0 to 5.0 cm with 0.4 cm pressure support. Most events are central, and I think if we want to focus of your sleep disordered breathing, your therapy is failing, because you are treating mostly central apnea. More accurately, you are avoiding central apnea by using very low pressure. There is nothing we can do to remedy the flow limits unless you can tolerate a higher pressure support, but that would likely greatly increase your CA events.

In your 9-threads you have only posted the data below from nearly a year ago. Your two therapy threads clearly pointed to a higher incidence of CA events rather than obstructive apnea http://www.apneaboard.com/forums/Thread-...on-results A year ago, we suggested that you might need to move to ASV therapy, and here we are in 2021 discussing the same chronic fatigue and general lack of efficacy due to CA, which prevents you from treating the flow limitations. While you are pursuing other potential sources of fatigue, it seems you are down to TRT before you are going to finally have to confront the fact your problem may be complex apnea rather than obstructive sleep apnea. It might be worth finding a used ASV and giving that therapy a try. We can find something under $500 easily enough and it would not take long to figure out if it's an answer or not. If not, then resale will let you recover your investment. Just navigate to the SearchTempest search engine on your browser and enter the search terms, Resmed ASV. You should find about a half-dozen results.

We can't do much to help you navigate the depression issue, other than try to get therapy on-track. You have multiple doctor's appointments coming up. Please discuss your feelings honestly and openly with your doctors. There are some alarming statements in your earlier posts and they are beyond the scope of this forum to address.

[Image: attachment.php?aid=22568]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
#20
RE: Chronic fatigue, I need some help.
Thanks Sleeprider for all that info. We'll see if my testosterone is normal or not. If it is normal then I will pursue antidepressants again. If after 4-6 weeks on meds I notice nothing then I will sell my BiPAP and buy a used ASV. Something should come off all these doctors visits and tests. In the meantime I will start to exercise more outside, that should only help. That's a really good excuse to buy a new mountain bike (fat tire) which I will do. I will keep yall updated. Thanks again.


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