[Symptoms] Severe OSA/Brain Fog/Depression/Confusion/Anxiety/Immune Deficiency

[sleepyman67]

I have been treated with CPAP and then BIPAP for the last 19 years. When first diagnosed by AHI was 130. I have had 4 sinus surgeries and UPPP. My current pressures are 22/18 on BIPAP. I sleep an average of 8 hours a night with multiple awakening. I have never has any stage 3 or 4 sleep on any of the 7 sleep studies in the lab. MY REM sleep is limited to an average of 65 minutes if you pool the studies. I wear a chin strap and use a ZEST nasal mask. My average leak is 8L/min which is awesome in my opinion.
My question is why am I so anxious, depressed, brain fogged, fatigued, and severe memory issues. I take Sunosi 150 mg every morning with zero symptom resolution. I am on 4 Blood Pressure medications at the maximum dosages.
What can I do to get better? How do I get more REM sleep and some (STAGE 3/4) sleep and have dreams once again??
Please help me if you can?
Thanks!

[sleepyman67]

I forgot to mention my treated AHI reported by the machine ranges from 0 - 0.8, but the average is 0.2 per hour.

[70sSanO]

19 years is a long time. I've been at CPAP a long time too, but I haven't had the same issues.

The good news is that your numbers are great. The bad news is that your numbers are great and most doctors will only tell you that all their other patients would love to have those numbers.

There are experts here, way beyond me, who can help you with optimizing your BiPAP therapy. You'll need to download OSCAR software (from AB) and have an SD card in your machine to record the detailed data. Without data it is impossible to tell what is going on. For example, there are limitations in air flow that are not in your AHI. They will never be seen in your numbers and your doctor will never have a clue. People get theses flow limitations all night long and their sleep is disturbed and they are wiped out during the day.

I'm not saying that is your issue, but without data it is anyone's guess. But you are on a BiPAP, so there is something going on.

But it also may not even be sleep apnea driven, and your machine can only do so much.

John

[ardenum]

AHI is good, seems like a sleep problem in itself. Being anxious, depressed, brain fogged, fatigued with severe memory issues is most likely a result of no Stage 3/4 sleep, there are pills that induce deep sleep. Best find a great Neurologist that deals with sleep issues, even if you have to wait months or go out of state. One visit with a great doctor can be worth more then trying to find one locally. Take all your sleep studies and specifically ask for a drug that promotes/induces slow wave deep sleep.

If you just wanna ask for something specific here's a list from a study.
https://www.ncbi.nlm.nih.gov/pmc/article...objectonly

The study : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824211/

[sleepyman67]

   

Does this help?

[70sSanO]

It would help to show all the data on the left and the flow limitation graph.

I’m not that familiar with VAUTO, but it looks like you are running it as a straight CPAP With a pressure of 21 and EPAP of 17. Basically a CPAP with an EPR of 4.

John

[Dormeo]

It would help to show all the data on the left and the flow limitation graph.

I’m not that familiar with VAUTO, but it looks like you are running it as a straight CPAP With a pressure of 21 and EPAP of 17.  Basically a CPAP with an EPR of 4.

John

This machine runs as a bilevel CPAP only. But it would be great to see a little more on the chart. 

Sleepyman, could you hide the calendar using the little triangle to the left of today’s date, and the panel on the right?  I cat remember whether your machine data produce a flow limitation graph, but if yes, please squeeze it into the screen shot. You can move the mask pressure chart down out of sight.

[sleepyman67]

           

Here are three screenshots of all the information the machine provides.

The S model does not run in an auto mode.

Any advice on what I should do next?

I never dream.

[70sSanO]

The only thing I can think of is maybe your sleep study has some info that is not apparent from your OSCAR data. If you post it, you need to make sure that you redact/white out any personal information.

You can also zoom in on the Flow Rate graph to show a typical 2/3 minute span. Your breathing shape may show something happening that is not in the data. I haven't eliminated that you might have flow limitations and they are just not recorded. If you have them, I also don't know what to adjust when your choices are IPAP, EPAP, and Trigger; and the Flow Rate graph as your data source.

Your numbers are so darn good, that it is tough to find that needle in the haystack. And there is a possibility that none of this is sleep apnea driven at all.

John

[Dormeo]

Sleepyman, I know you had limited REM during your sleep studies, but that is pretty common as an effect of sleeping in unfamiliar surroundings with lots of stuff attached to your body.

Your current perception is that you never dream. People often do not remember their dreams, especially if they don't wake up right after them. This is not to say that your perception is wrong, but it is to say it's not, in itself, good evidence that you don't dream.

But something is causing you to feel so awful during the day. Maybe your sleep architecture is indeed messed up; what isn't clear is why. It might be something subtle that is respiration-related, but it might instead, or in addition, be depression or some other condition.

Medications can also be unsuspected causes for daytime exhaustion. And there are a wide variety of medical problems that you'd need to sort out with a physician. So I'm seconding crowtor on the importance of additional medical evaluation.