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[Treatment] Feeling much better in the morning but still tired and fatigued
#1
Feeling much better in the morning but still tired and fatigued
So late last year I had an at home sleep study, this showed that I had severe OSA with an AHI of 28. 
It was noticeably worse in the study when sleeping on my back which makes sense to me.
I am a loud snorer and would snore through the night much to my partners annoyance.

I had recently had a 2 week trial with a PR Dreamstation APAP set at 5-15 cmH2O which after the 2 weeks found my 90% pressure to be 10.5 cmH2O.
For the next two weeks on the trial the machine was set to CPAP mode at the 10.5, I think I responded well to this and found it comfortable to sleep with.
When the trial finished I discussed with my doctor and purchased a PR Dreamstation CPAP Pro which has been set at 10.5.

Now for the tricky part. I feel much better in the mornings, my throat doesn't hurt and I don't have a splitting headache. 
However I think I am still just as tired throughout the day as before, I find it very hard to concentrate and have trouble with memory at work.

I have attached a few of my recent nights OSCAR data, would really appreciate any insight into what could be done to improve my experience.


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#2
RE: Feeling much better in the morning but still tired and fatigued
I have just realised I had posted these charts incorrectly, will update tomorrow with the correct information as per the wiki OSCAR Chart Organization
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#3
RE: Feeling much better in the morning but still tired and fatigued
Tiredness is something that typically goes away over time. There are a few lucky individuals (raising my hand) where it substantially goes away overnight, but they are by far the exception. In all likelihood, you have had apnea, undetected, for literally years. It can take time to recover from that.

You have a slight hint of a form of positional apnea that likely results from "chin tucking". In more advanced cases we recommend a soft cervical collar (see the link in my signature) but you just need to be aware of it and perhaps a minor pillow adjustment (2 pillows to one pillow, thinner pillow).

Please provide a few zoomed charts showing random 3-minute segments (duration shows on the top left of the flow rate chart) Simply click repeatedly on the are you choose until the duration shows about 3 minutes. We can then evaluate the waveform to see if it is something more subtle that your machine is not flagging.
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#4
RE: Feeling much better in the morning but still tired and fatigued
Thanks for the reply Gideon, I will look into obtaining a soft collar. 
I have had a few nights where have woken up with a dry mouth. 
I assumed I was opening my mouth during the night, do you think I should look at a chin strap as well?

Attached are three three minute snapshots from the same night.
Thanks again for your help,


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#5
RE: Feeling much better in the morning but still tired and fatigued
Look for a collar that restricts your jaw from dropping. This acts as a 2 for one action, combats both chin tuck and open mouth. One less thing you strap on while trying to fall asleep.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#6
RE: Feeling much better in the morning but still tired and fatigued
The original purpose of the collar was to stop mouth breathing. It was a user that saw that it also significantly reduced their apnea. The gurus here picked up on this over time and now the collars primary purpose is to treat positional apnea.
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#7
RE: Feeling much better in the morning but still tired and fatigued
So I have now been using the collar for a few nights.
I am not sure if i'm really seeing a difference and the last couple of mornings I have woken up with similar feelings to pre-CPAP.
I have attached 3 recent nights using the collar, I have hidden the VS2 snore this time around as they cluttered the flow rate graph.

I will also provide some 3 minute shots in another comment


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#8
RE: Feeling much better in the morning but still tired and fatigued
Here is a few samples of 3 minutes length from the nights above


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#9
RE: Feeling much better in the morning but still tired and fatigued
And how do you feel? I don't know how you felt pre-cpap.

On the details there is a lot of awake breathing see the 2nd and 6th to see the best examples
the 1st and 5th are normal inspiratory breathing then an arousal followed by fairly normal breathing
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#10
RE: Feeling much better in the morning but still tired and fatigued
I think I can see what your mean on the charts but what does awake breathing mean. I don’t really wake up during the night, or at least I don’t remember ever waking durning the night.

In terms of how I feel, pre-CPAP - bad sleep inertia, headaches durning the morning, memory issues and general fatigue. My study showed an AHI of 28. 

While on CPAP the sleep inertia is generally gone however the last few mornings I have noticed it again. 
I do feel much better but I believe it could be improved. I am still tired in the mornings and during the day although it is much less than before.
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