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+--- Thread: [CPAP] Tired all the time despite low AHI and consistent CPAP use (/Thread-CPAP-Tired-all-the-time-despite-low-AHI-and-consistent-CPAP-use)
Tired all the time despite low AHI and consistent CPAP use - ForceUser11 - 09-11-2023
Hi I was wondering if someone could help analyze my OSCAR determine and determine if there would be more optimal settings I should use. I've been using it everyday consistently for a couple years but I'm still always tired. I keep track of blood oxygen as well and it never dips below 90% when I'm using the CPAP.
I'm 30 years old, 5'11" and 190lbs.
RE: Tired all the time despite low AHI and consistent CPAP use - jwest - 09-11-2023
What have you tried so far? Do you notice any patterns in your long-term statistics overview? You could share a readable screenshot here so that I could have a closer look?
How would you describe the difference between CPAP and CPAPless nights?
What was your RDI from your sleep study and when was it?
Have you noticed anything that has made therapy better?
How many times do you wake up in the night?
Does your pulse oximeter monitor your movement too? Are you moving a lot?
RE: Tired all the time despite low AHI and consistent CPAP use - ForceUser11 - 09-11-2023
I've tried doxepin, zolpidem, melatonin, and ambien. The only thing that's done anything is ambien but that's only helped me fall asleep faster.
I'll attach a screenshot of the overview and I'll send a readable one in a moment.
I haven't slept without the CPAP in a long time now but I remember feeling drowsier and less functional without it. The sleep study was two years ago and the RDI was 4/hour.
I haven't really noticed anything that has made it better. I probably wake up once or twice per night. Yeah it monitors movement and I see some spikes a few hours after I've fallen asleep.
RE: Tired all the time despite low AHI and consistent CPAP use - ForceUser11 - 09-12-2023
Uploading more attachments.
RE: Tired all the time despite low AHI and consistent CPAP use - Gfuchs - 09-12-2023
Wild guess --- have you checked your hormonal levels (e.g., testosterone levels)? The reason for your tiredness could be something entirely different. To me (as a user, not expert), your stats look not bad. The leak rates could be lower, but machine can normally compensate for that unless the leaks cause you to arouse in sleep.
RE: Tired all the time despite low AHI and consistent CPAP use - ForceUser11 - 09-12-2023
(09-12-2023, 01:22 AM)Gfuchs Wrote: Wild guess --- have you checked your hormonal levels (e.g., testosterone levels)? The reason for your tiredness could be something entirely different. To me (as a user, not expert), your stats look not bad. The leak rates could be lower, but machine can normally compensate for that unless the leaks cause you to arouse in sleep.
Will get those checked tomorrow and report back. Seems the metabolic panel I got didn't test hormone levels.
RE: Tired all the time despite low AHI and consistent CPAP use - jwest - 09-12-2023
I meant, what have you tried in the context of device settings? What pressures have you tried, pressure support, features, etc?
Hmm interesting. If you firmly believe that you sleep better with CPAP, then you likely do have some degree of SDB. However, RDI of 4 is very very low, but SDB is a spectrum, and it's clear there is variance in response between patients.
Did you wake up more without CPAP? Did you notice any other differences? O2 differences, dream differences, etc?
I'm assuming this sleep study was in-lab. Is it possible to go for another?
Your leak rate over the year average is 26.4 or 21.6 over the past 6 months, which is quite elevated and likely problematic.
You do have some flow limitation, but again, we don't really know where to draw the line for individual patients. Population wide, it's accepted up until about 30% flow limitation during total sleep time that doesn't meet the other event criteria (i.e. RERA, hypopnea, apnea). From someone who's been in the space for a long time, you do have a strong case for seeking out alternative explanations, but your data isn't conclusive. In other words, don't think through our suggestions that this is by default in your head or due to some other health complication; it's merely a strong suggestion to also consider what else may be playing a role here.
RE: Tired all the time despite low AHI and consistent CPAP use - Bonzadog - 09-12-2023
Him
I too have tried various sleeping tablets to no avail. I consulted a doctor who put me on medical Cannabis ( Hindu Kush, Bedrocan and Pink Kush) and that helped. However, I am concerned, since I have heard that REM sleep is not that good when using cannabis.
But still better than staring at the ceiling for a long time. Sleeplessness is a real issue and needs drastic action.
RE: Tired all the time despite low AHI and consistent CPAP use - Dormeo - 09-12-2023
You could try inching your minimum pressure up a little to try to nip a few more OAs in the bud. But aside from that, it's hard to know from the charts what, if anything, can be done to help you sleep better.
I'm guessing you know the basic guidelines for better sleep, but it might be worth taking an honest look at your habits in light of this list.
• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.
It's also worth exploring some other aspects of your health that may bear on your sleep. Check the side-effects for all you medications (prescription and OTC) to see whether they might contribute to your feeling unrested. The suggestion to check testosterone levels is a good one; you might also make sure you're tested for anemia, thyroid conditions, Lyme disease, autoimmune diseases (especially in the connective-tissue-disease family), and deficiencies in vitamins B12 and D.
Finally, your doctor would probably find it useful if you could describe your "tired" feeling more exactly. Is it that you're sleepy during the day (e.g., would like to take a nap)? Or is it that you feel fatigued, as you might be with a cold or the flu? (Low energy, takes an effort of will to do anything.) Do you feel worse after exertion? Better? Are there times of the day or evening when you're OK?