[CPAP] Two years with low AHI and still very tired

[Allessio77]

I have been using CPAP for over 2 years following a sleep study which provided an untreated AHI of 23. Despite full compliance with an average of 7 hours sleep per night I am completely exhausted every day....

My consultant is excellent and is thinking of now diagnosing idiopathic hypersomnia however the treatment would remain the same as I already take Modafanil.

... I continue to be tired, not only sleepy but this impacts on concentration levels etc.

Is the main issue sleepiness or fatigue?  Do you have an daily episodes of an irrepressible need to sleep?

I would say both. Although I do not spontaneously fall asleep, I have heavy eyelids and feel a strong need to sleep...and most often lay down for a 1-2 hour nap in the afternoon. The fatigue manifests in my lack of energy or will to do anything. My day is essentially over by noon. I am in bed at night between 9 and 5. This has been going on for about one year now.

[Walla Walla]

Allessio77,
I believe the question was for Orzabal.

[Allessio77]

Allessio77,
                I believe the question was for Orzabal.

Sorry. I must be very tired today!!

[trish6hundred]

Hi orzabal,
WELCOME! to the forum.!

Good luck as you continue CPAP therapy and hopefully, your doc will be able to help you figure out why you are so tired. Hang in there for more responses to your post.

[AshSF]

I was in a similar situation. I solved it by going to a constant pressure.

According to a study, up to 18% of apnea patients don’t do well on changing pressure. I am one of them.

In your case, you may want to go to a constant pressure equal to your 95% pressure from your readings (or a lower pressure that you can tolerate), and evaluate how you feel after 10 days.

AHI is only one variable in a good sleep. The others (sleep architecture, deep sleep %age etc) can not be evaluated with a xpap machine. You can only go with ‘how do you feel during the day’ to assess that.

[chill]

I also seem to do better with a constant pressure.  It is not universal, but I seem to tolerate the higher pressure better than the changes.

[orzabal]

Good morning, it's hard to tell the difference between fatigue and sleepiness, by way of example yesterday I felt fatigued all day and by late afternoon I was struggling to stay awake............ I took 400 mg of Modafanil and within 10 minutes was so tired that I had an hours sleep!!

I am tired again this morning but again a good AHI of 1.52 although my flow limitation number read 1.24, I do think that my issue may be related to the flow numbers which are consistently about this level.

[orzabal]

Hopefully this screen shot may provide further information

[ardenum]

I was in a similar situation. I solved it by going to a constant pressure.

According to a study, up to 18% of apnea patients don’t do well on changing pressure. I am one of them.

In your case, you may want to go to a constant pressure equal to your 95% pressure from your readings (or a lower pressure that you can tolerate), and evaluate how you feel after 10 days.

AHI is only one variable in a good sleep. The others (sleep architecture, deep sleep %age etc) can not be evaluated with a xpap machine. You can only go with ‘how do you feel during the day’ to assess that.

Actually you can. You said it yourself "sleep architecture, deep sleep %age". For that you need a EEG device. I can't comment if the 'consumer' ones are any good. 

I used Neurobit Optima 4. It cost me around the same as my Aircurve 10 VAuto. With all the hassle: cables, electrodes and gels. It took me a while to get a hang of it.

[Walla Walla]

crowtor,
Welcome to the Board and Thank you for the insight on getting a EEG. For most of us that's not an option. The cost plus not knowing how to use it rules out.