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07-08-2023, 03:54 PM (This post was last modified: 07-08-2023, 04:03 PM by Barios.)
Persistent fatigue
Hello, I am a 29-year-old French individual (sorry if my writing is poor). I have been using a machine for almost 4 months due to severe sleep apnea with an AHI of 35 per hour.
On paper, everything seems fine. My AHI is now at 0 or 1, which is excellent. There are not many leaks or other apnea events recorded. I have an excellent average of 3 hours of deep sleep, and currently, I sleep for an average of 9 to 10 hours per night.
The problem is that I feel even more fatigued since I started using the PPC machine compared to before. There are phases where I literally can't bear my own weight, and I have no strength, in addition to feeling tired throughout the day. I have undergone a full-body scan and multiple blood tests, but no issues were found. I am not on any medication, and I have been sleeping at a fixed time for over a month.
My sleep doctor told me that it couldn't be due to the machine because, according to him, everything is fine. However, I still have doubts.
I am using a Loweinstein Prisma Smart Max machine with the Fisher & Paykel Eson 2 nasal mask. I hope you can help me. Thank you.
Help and advice on this forum is based on the OSCAR reporting software from data obtained from OSCAR comptable CPAP machines, extracted from their SD data cards.
As far as I can tell your Prism is incompatible with OSCAR.
I am not a familiar with this machine or of the style of it's reports, but from your comments, perhaps the following observations may be of some help to you:-
You say you had an AHI of 35/hr. Did you have a "Home sleep test" (Polysomnographie ventilatoire). If so, did your doctor give you a full copy of your report and review with you it's contents?
If not, I think you need to take steps to get this, as it could contain important information showing the underlying causes of your severe sleep apnea, especially the breakdown of the individual elements making up this 35 events per hour.
It is curious that your sleep apnea has been successfully reduced from 35/hr to 0/hr with just 7.5 cms of pressure. Who is doing the titration, and follow up?
You are certainly sleeping a lot, but of a poor quality.
A guess at this stage to explain this, without any benefit of full data, is that it may be caused by either:-
1. Interaction of medicines you may be taking, especially any sleep aids.
2. Problems of SpO2 desaturations.
3. Incorrect machine settings.
4. Sleep hygiene or other change of lifestyle
In the absence of detailed data, it may help to get a pulse oxymètre, and record your Sp02 values to see if any are very low.
Oxygen starvation can cause pretty serious problems. You would need to record several weeks of data, and if necessary show the results to your doctor.
Many people uses oxymètre readings to monitor their therapy. Lots of models are available on Amazon, although fairly expensive. I use a very basic model for €60, which is just sufficient for my own needs.
Better models are available for around €150.
If you wish to eventually post your sleep test on the forum, after redacting your personal identification. It could be helpful. In French is OK.
07-11-2023, 04:29 AM (This post was last modified: 07-11-2023, 04:30 AM by Barios.)
RE: Persistent fatigue
I had a Polysomnography done at a clinic, and yes, I have the results. I will post them for you. In terms of follow-up in France, the machine is provided by a company and prescribed by the sleep doctor. They don't want to make any changes because, according to them, my deep sleep is high enough and I have no AHI, so they consider the machine to be sufficient and don't want to investigate further.
I am not taking any medication. The sleep doctor advised me to have a regular bedtime, and I have been following that for almost 2 months, but there haven't been any changes.
Regarding oxygen deprivation, I just had another Polysomnography done, but this time with my machine. I will find out my levels once I receive the results.
The continuation
What makes you think that I have intermittent hypoxia 24/7?
I had a full-body scan a few weeks ago, and wouldn't any heart or lung issues have been detected at that time?
I smoked for about 10 years, but I quit almost 3 years ago, and I had asthma when I was younger.
(07-11-2023, 07:12 AM)Barios Wrote: What makes you think that I have intermittent hypoxia 24/7?
I had a full-body scan a few weeks ago, and wouldn't any heart or lung issues have been detected at that time?
I smoked for about 10 years, but I quit almost 3 years ago, and I had asthma when I was younger.
In your opinion, is my machine properly adjusted?
You smoked for 10 years and you had asthma.
This is not a sleep problem.
A full body scan - what was scanned?
Was a CT performed? Lung function tests?
You have slipped through the system like many others.
07-11-2023, 08:50 AM (This post was last modified: 07-11-2023, 08:53 AM by Barios.)
RE: Persistent fatigue
I have done a scan and I have the report I am writing to you because it is noted in French.
Thoracoabdominal and pelvic CT examination
On the result it is noted
There are no detectable pleuroparenchymatous abnormalities or abnormal mediastinal masses.
The liver, spleen, pancreas, adrenals and kidneys are normal.
There are no pathological abdominal or pelvic masses.
I'm seeing my doctor on Thursday and I'm going to ask him if I can have an oximeter.
07-11-2023, 10:14 AM (This post was last modified: 07-11-2023, 10:15 AM by Apnea23.)
RE: Persistent fatigue
(07-11-2023, 08:50 AM)Barios Wrote: I have done a scan and I have the report I am writing to you because it is noted in French.
Thoracoabdominal and pelvic CT examination
On the result it is noted
There are no detectable pleuroparenchymatous abnormalities or abnormal mediastinal masses.
The liver, spleen, pancreas, adrenals and kidneys are normal.
There are no pathological abdominal or pelvic masses.
I'm seeing my doctor on Thursday and I'm going to ask him if I can have an oximeter.
You'll need a continous monitoring one, not one they use in the surgery.
Many of us here use the o2ring by Viatom.
It has to be continous to catch the desaturations.
Then you can proceed with a detailed CT lung scan and any other pulmonary tests that may be relevant!
Apnea23, as you may know, hypoxia involves low levels of O2 in the body's tissues; hypoxemia involves low levels of O2 in the blood. An oximeter can detect low levels of O2 in the blood, but it can't directly detect low levels of O2 in the body's tissues.
After you stated that the OP has hypoxia, he volunteered that he had asthma when he was younger and smoked for 10 years but quit 3 years ago. You then declared that he doesn't have a sleep problem but needs continuous O2 monitoring and follow-up pulmonary tests.
There is no evidence in the OP's sleep study pointing to either hypoxia or hypoxemia. His mean O2 sats were at 96%, and he went below 90% for less than one minute. He has an AHI of 35.4, indicating severe sleep apnea.
To the OP: I would caution you that Apnea23's confident statements about your condition are not adequately grounded in evidence. For more general information about hypoxia, you can look at this trusted website:
