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I'm running into an odd problem. Apparently I've had near-asymptomatic (Every once in a while I'd wake up gasping for air, but that was very infrequent) OSA for years; after a recent diagnosis as a result of work requirements that forced me to get tested, I was diagnosed, and began using a CPAP 10 days ago. Whereas before the CPAP machine I never felt daytime drowsiness, I now feel it daily. I tested at 34 events per hour prior to the CPAP; with the CPAP I'm at around 3.5, so it seems like a success, but about 4 hours after waking up I feel rundown and sleepy and want to take a nap. This never happened before, as I was always bursting with energy. With the CPAP I average 7 hours of sleep a day, exactly as I always have. I have no other symptoms, no dry mouth, dry nasal passages, stomach air, and while wearing the thing itself is awkward and unpleasant, I have no problems breathing with it at all. The only thing I can think of is the unpleasantness of the device is interfering with the quality of my sleep, but it seems to me that compared to 34 apnea events an hour, that would be minor. Has anyone else experienced this, or does anyone have any ideas?
10 days is not a long time to get used to wearing a CPAP. It took me months to get a restful sleep with the mask on. I was diagnosed with an AHI of 37, and did not feel any apparent great burst of energy from using a CPAP. I think some of the benefits get a little overstated. However, I have stopped snoring, and I more often than not sleep through the night without getting up. My target is to get 7-8 hours of quality sleep.
My thoughts would be to stick with it, and it will get better for you. Do you know what your breakdown of AHI events are that make up your current 3.5? If they are mainly obstructive, there may be opportunity to reduce the AHI a little further. My wife was diagnosed around 80 and now can routinely get under 1 for AHI. I however have mostly central apnea for residual and 3.5 is a good score for me. CPAP does not work well in reducing central apnea.
Unfortunately, I have no choice but to stick with it, as I can't work without the doctor signing off on the apnea treatment as successful. I suppose I'll download OSCAR and start digging in to it further, although all the CPAP measurements are based on quality of breathing, not quality of sleep itself, so I don't think it'll be that useful.
One thing about the CPAP is that I had minor asthma, and it's entirely gone away since using the machine. Unlooked for benefits.
OSCAR or SleepyHead will help you understand a lot better what is going on during the night. It will also give you a good idea whether or not your machine is well set up.
SleepDent
+0 points
·
over 5 years
ago
Sleep
Commentator
I think that you make some very valid points. I think that there IS too much reliance on the numbers and trying to quantify things. And when you really dig into the standards that are currently set, you find that, basically, there is still a certain amount of uncertainty as to what constitutes "adequate" treatment, both for CPAP and oral appliances. There really should be more emphasis on quality of life. Let me give you a real life example from my practice. A patient was diagnosed with an AHI of 45. He did not take take my primary recommendation as to the best oral appliance for his severity level and, instead, chose something more comfortable to him. His chief complaint was that his wife did not like his snoring at night. The appliance knocked out his snoring to his wife's satisfaction and reduced his AHI to about 25, which made him feel a lot better. The sleep doctor covering the case was pretty dissatisfied with the results, but the patient and his wife were pleased and he continues to use the appliance. Is that good enough. Maybe, yes. Arthur B. Luisi, Jr., D.M.D., The Naples Center for Dental Sleep Medicine.
I don't mind the numbers so much as I wonder if medicine knows which numbers to stress, or even if they have the right ones. It just strikes me as odd that I'd go from sleeping a solid 7 hours a day, and be able to function with no fatigue at all, to suddenly needing to take naps every day. I think I'm not snoring anymore, which is good, obviously the AHI is way, way down, which I assume is good, and I breathe better overall, which is good. But the drowsiness is quite frustrating, especially since it was what the CPAP is supposed to deal with, even though I wasn't experiencing it: the treatment caused the problem it's designed to mitigate. It's just strange. I'm slowly getting used to the thing, and have even figured out how to sleep on my side some (although the mask pops off a couple of times a night when I do), so I assume it will get better with time. At this point, I suppose I'm just venting.
Having the CPAP interfere with the quality of your sleep is a real issue. The machine and especially the mask did disturb my sleep and as I said, it took months to get used to it. I have made many changes in the setup of my machine and I think I am on mask #6. I have switched pillows, changed the pillow case to a satin pillow protector, used at least 3 different chin straps, and now on method #2 of mouth taping to keep my mouth shut during the night. I have also gone from a wide pressure range in Auto mode to a single pressure in CPAP mode. We have even gone to a king sized bed from a queen size!
The mask, the pressure setting, the ramp method, the mask type, the headgear, the pillowcase, the pillow stuffing, etc... all can be part of the problem or eventually part of the solution.
Sherry
+0 points
·
over 5 years
ago
Sleep
Commentator
So true! I was diagnosed 30 years ago around the age of 28 and I am still struggling with all the pieces to find something that works. I am forever switching up a mask, changing a pillow, trying mouth taping, chin straps, dental devices, and so forth. I know I feel better when I get more hours but yet despite my best efforts, the mask that go to sleep with is elsewhere in the morning.
In my experience what you are experiencing may not be strange at all. The true test of the quality of your sleep is whether you wake refreshed and whether you have energy to carry out your normal daily activities. Being drowsy during the day is a sure sign that your body is not oxygenated. I learned how to control my severe OSA by completely changing how I breathed. The Buteyko method taught me to change from mouth breathing to nasal breathing. I also changed from a chest breathing to breathing with my diaphragm. If you change how you breathe through the day then it is likely to carry over to how you breathe at night. The problem with CPAP is that it provides symptomatic relief as no treatment of your breathing occurs during the day. I also learned to breathe less and this helped my blood oxygen saturation. I underwent 2 sleep studies before and after I learned Buteyko Breathing. It is all detailed in my book Breathless Sleep... no more. I have trained as a breathing re-Educator as I do not want others to suffer as I did. I have been free from OSA for almost 10 years now.
I agree. Mouth taping by itself will not prevent sleep apnoea. But after you have learned to reduce the volume of air you breathe by only breathing through your nose mouth taping is an effective tool to maintain during sleep the reduced volume of air breathed nasally. Also sleeping on either side ( never on your back) and in an elevated position is highly recommended. I discuss my experience over the past decade on my website www.learntosleepwell.com
SleepDent
+0 points
·
over 5 years
ago
Sleep
Commentator
At this moment, I am working on prototypes for a new type of full face mask that I think is going to help huge numbers of people. The mask starts with nasal pillows that are attached to the upper teeth via a tray which eliminates all external straps. This is nothing new. The CPAP Pro and the TapPap have been doing this for years. What IS new is that my device has a very, very soft oval-shaped silicone mouth seal that goes inside the mouth. Very comfortable and feels like nothing. By sealing the mouth from the inside, the air pressure becomes your friend and not your enemy because it actually seals better. Mask will just not leak in any position and with any movement-EVER. Will keep you updated on the progress. Arthur B. Luisi, Jr., D.M.D., The Naples Center For Dental Sleep Medicine.
sleeptech
+0 points
·
over 5 years
ago
Sleep
Enthusiast
Your body doesn't just snap back immediately into a normal sleep pattern as soon as you are treated. It can take a while for your brain to get over years of disrupted sleep and learn how to sleep normally again. This is why so many people suggest that you hang in there. It may take weeks or months for things to really settle down. Not the best news, I know, but better than a heart attack or a stroke. Also, if you were titrated in a lab you have the added comfort of knowing that some one has watched it working and made sure that it was effective.
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