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Mental fatigue but no physical fatigue?
#1
Mental fatigue but no physical fatigue?
Some background information...

I went to a sleep clinic and my initial study numbers were:
3 obstructive, 4 central, 2 mixed apneas, 106 hypopneas in 5h45m of sleeping time, with a mean SaO2 of 96.4%

I went back for the CPAP titration and my numbers were:
2 obstructive, 10 central, 6 mixed apneas, 16 hypopneas in 5h of sleeping time, with a mean SaO2 of 97.3%

I didn't feel any difference in the morning of the titration but the doctor said my numbers improved.
But because I felt that wearing the CPAP mask and tube all night would be uncomfortable/inconvenient, I opted to get a dental appliance, which I wore for a month.
Unfortunately I didn't notice any improvement either.

I'm starting to wonder if maybe the fatigue that I have isn't purely caused by sleep apnea?
I've noticed that only my mind is fatigued. There are times where I would be going for a jog, and I would be struggling to stay awake and keep my eyes open, but my body seems to be fine and I can run without any muscle fatigue.

I'm curious about what other people have experienced in terms of fatigue on the mind and/or body.

I do have other health problems such as hyperthyroidism (which I take Tapazole for), and digestion problems as well (some intractable IBS).
So I'm starting to doubt if sleep apnea is my only problem.

Thanks all!
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#2
RE: Mental fatigue but no physical fatigue?
Quote:I went to a sleep clinic and my initial study numbers were:
3 obstructive, 4 central, 2 mixed apneas, 106 hypopneas in 5h45m of sleeping time, with a mean SaO2 of 96.4%

This is a AHI of 20. This means you have Sleep Apnea.

You need to get a machine.


Quote:I didn't feel any difference in the morning of the titration

It doesn't happen that fast.

Quote:I felt that wearing the CPAP mask and tube all night would be uncomfortable/inconvenient.
Its your health you get used to it.

Quote:I opted to get a dental appliance, which I wore for a month.

Unfortunately I didn't notice any improvement either.
Your AHI is too high for it.  They dont work for most people.

Quote:I'm starting to wonder if maybe the fatigue that I have isn't purely caused by sleep apnea?
You have Sleep Apnea based on the info you provided.  It is for sure part of the fatigue.
Go back to the Sleep Clinic and get a CPAP.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
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#3
RE: Mental fatigue but no physical fatigue?
Yup, most of the symptoms take weeks/months to go away even with ideal settings as it takes your body a while to adapt to the change.

You have only tried sleeping with CPAP for one time in a strange place with a bunch of electrodes etc hooked up to you. That is not a normal night of sleep and until you try treating apnea with CPAP you can't rule it out yet.
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#4
RE: Mental fatigue but no physical fatigue?
The thing is, the Obstructive events went down while Centrals more than doubled. Then as was mentioned, this was only one night. Most that suffer from Apnea have had it for years. One night to fix years of damage isn't possible.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Mental fatigue but no physical fatigue?
"Mental fatigue" is absolutely one of the symptoms of sleep apnea. Struggling to stay awake and keep you eyes open while you are jogging is a sure sign that you are lacking restorative sleep!

Apnea means lack of breathing. During an apnea, your O2 level will begin to drop. The brain, in its wisdom, will react to bring you to a lighter stage of sleep so that you breathe, and therefore survive. This means that your brain is unable to get sufficient stage 3 deep restorative sleep and REM sleep to be well and healthy, even if your O2 level doesn't drop significantly. 

During your sleep study, you had an AHI of 20, which means that you had an interruption to your breathing an average of 20 times per hour. This is a breathing interruption every 3 minutes! Yes, you have sleep apnea that needs to be treated.

Before I was diagnosed and treated, I was exhausted. I had brain fog, difficulty focusing, memory problems. All I wanted to do when I got out of bed in the morning was go back to bed and sleep, even though I had just slept for 8 hours. When I did sleep, it didn't help or change anything.

For the first 2-3 weeks that I was on CPAP treatment, I had vivid dreams! Not nightmares, and it was not distressing, just a lot of dreams. My sleep doctor told that it was REM sleep rebound, which happens when one has been deprived of REM sleep. My first early sign of healing from lack of quality sleep!

My brain is working much better now, after 2 months of quality sleep with the CPAP. It takes time for the brain and body to heal and  "catch up" on missed sleep. I have my life back!

CPAP requires getting used to, but the improvement in quality of life is well worth it. I hope that you try it and give it time to work. There are many good and knowledgable people here that can help you with any issues that you have with CPAP.

I have attached a description of the 4 stages of sleep from VeryWell Health. I hope you will note how important each stage of sleep is to the health of your brain and body.

NREM Stage 1
The first stage of the sleep cycle is a transition period between wakefulness and sleep.
If you awaken someone during this stage, they might report that they were not really asleep.
During stage 1 sleep:1
  • Your brain slows down
  • Your heartbeat, your eye movements, and your breathing slows with it
  • Your body relaxes and your muscles may twitch
This brief period of sleep lasts for around five to 10 minutes. At this time, the brain is still fairly active and producing high amplitude theta waves, which are slow brainwaves occurring mostly in the frontal lobe of the brain.2
NREM Stage 2
According to the American Sleep Foundation, people spend approximately 50% of their total sleep time during NREM stage 2, which lasts for about 20 minutes per cycle.4
During stage 2 sleep:1
  • You become less aware of your surroundings
  • Your body temperature drops
  • Your eye movements stop
  • Your breathing and heart rate become more regular
The brain also begins to produce bursts of rapid, rhythmic brain wave activity, which are known as sleep spindles. They are thought to be a feature of memory consolidation—when your brain gathers, processes, and filters new memories you acquired the previous day.5
While this is occurring, your body slows down in preparation for NREM stage 3 sleep and REM sleep—the deep sleep stages when the brain and body repairs, restores, and resets for the coming day.6
NREM Stage 3
Deep, slow brain waves known as delta waves begin to emerge during NREM stage 3 sleep—a stage that is also referred to as delta sleep. This is a period of deep sleep where any noises or activity in the environment may fail to wake the sleeping person.
Getting enough NREM stage 3 sleep allows you to feel refreshed the next day.1
During NREM stage 3 sleep:1
  • Your muscles are completely relaxed
  • Your blood pressure drops and breathing slows
  • You progress into your deepest sleep
It is during this deep sleep stage that your body starts its physical repairs.
Meanwhile, your brain consolidates declarative memories—for example, general knowledge, facts or statistics, personal experiences, and other things you have learned.7
REM Sleep
While your brain is aroused with mental activities during REM sleep, the fourth sleep stage, your voluntary muscles become immobilized.
It's in this stage that your brain's activity most closely resembles its activity during waking hours. However, your body is temporarily paralyzed—a good thing, as it prevents you from acting out your dreams.1
REM sleep begins approximately 90 minutes after falling asleep. At this time:1
  • Your brain lights up with activity
  • Your body is relaxed and immobilized
  • Your breathing is faster and irregular
  • Your eyes move rapidly
  • You dream
Like stage 3, memory consolidation also happens during REM sleep. However, it is thought that REM sleep is when emotions and emotional memories are processed and stored.8
Your brain also uses this time to cement information into memory, making it an important stage for learning.
Repair Work in Progress
During deep sleep (stage 3 and REM), your cells repair and rebuild, and hormones are secreted to promote bone and muscle growth. Your body also uses deep sleep to strengthen your immunity so you can fight off illness and infection.1
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