Narcolepsy despite VPAP 10 years
Good morning. I wonder if anyone could offer some help.
I cannot stay awake more than 4 hours without 1 45 min nap. I sleep 9 to 9.5 hours, get up for an hour then have to sleep 1.5 hrs more because it is just too draining to stay awake.
I may have some insulin resistance because I get sleepy if I over eat or eat sugars. My glucose is never more than 140. I started Metformin 200 just to add some sensitivity to insulin. Not really helping. No narcotics. No alcohol. No drugs. No smoking. Live at 4200 ft elevation. Male. 60 years old.
Presume CSA. Tried O2 at night and no difference so I suspect C02 retention.
VPAP set VAuto, max IPAP 10.2, min EPAP 4.0, PS 3.8, Ti Max 4.0, TiMin 0.1, Trigger Very High, Cycle high.
Avg Usage 9.5 hrs, Insp Press 9.8, Exp Press 6.2, Leak 26 L/min, Vt 400 ml, RR 15, MV 6.5 L/min, % Spont T 100.0%, % Spont C 58%, AHI 0.8, central AI 0.0%
Pulmonary Function test shows normal. Sleeping with 2 puffs Ventolin really helps. Without it I can sense crackles in my airway from atelectasis without known cause. No history of asthma. Always been an athlete.
Tried Acetazolamide but big headache. Tried 20mg suldinafil but big headache. Taking Theophylline 400mg ER for a week but don’t notice a difference.
Taking Venlaxafine 150 XR and Lamotrigene 150 for lifelong BPD. These are sedating for sure but the least functional dose on the least sedating medications over the years.
Several sleep studies have not uncovered anything.
Q. Is there anything the group of people as a whole on this forum, might contribute after looking at the VPAP settings? Changing the cycle from very high to high doesn’t seem have made any difference?
I cannot stay awake more than 4 hours without 1 45 min nap. I sleep 9 to 9.5 hours, get up for an hour then have to sleep 1.5 hrs more because it is just too draining to stay awake.
I may have some insulin resistance because I get sleepy if I over eat or eat sugars. My glucose is never more than 140. I started Metformin 200 just to add some sensitivity to insulin. Not really helping. No narcotics. No alcohol. No drugs. No smoking. Live at 4200 ft elevation. Male. 60 years old.
Presume CSA. Tried O2 at night and no difference so I suspect C02 retention.
VPAP set VAuto, max IPAP 10.2, min EPAP 4.0, PS 3.8, Ti Max 4.0, TiMin 0.1, Trigger Very High, Cycle high.
Avg Usage 9.5 hrs, Insp Press 9.8, Exp Press 6.2, Leak 26 L/min, Vt 400 ml, RR 15, MV 6.5 L/min, % Spont T 100.0%, % Spont C 58%, AHI 0.8, central AI 0.0%
Pulmonary Function test shows normal. Sleeping with 2 puffs Ventolin really helps. Without it I can sense crackles in my airway from atelectasis without known cause. No history of asthma. Always been an athlete.
Tried Acetazolamide but big headache. Tried 20mg suldinafil but big headache. Taking Theophylline 400mg ER for a week but don’t notice a difference.
Taking Venlaxafine 150 XR and Lamotrigene 150 for lifelong BPD. These are sedating for sure but the least functional dose on the least sedating medications over the years.
Several sleep studies have not uncovered anything.
Q. Is there anything the group of people as a whole on this forum, might contribute after looking at the VPAP settings? Changing the cycle from very high to high doesn’t seem have made any difference?
