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One week on CPAP, scores good, so tired can barely move

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PoopedInBama +0 points · over 3 years ago Original Poster

I'm a 56 year old male, just started CPAP. My scores was 15.6, which is not that bad, though my oxygen saturation apparently went below 88 for more than two hours. I have now been on CPAP for six nights and while it hasn't been easy, I've done my part -- used it all night, every night and all in all, think I've slept OK. Two nights at 5.6 AHI, but all other nights below 5.

My fatigue, always a problem, hasn't been helped yet, but the past two days it's crushing me. I feel like I've been drugged.

I realize that everyone is different but is this sort of problem normal when starting CPAP?

Also, has anyone used Modafinil for extreme fatigue? Am new on this forum and figured I'd ask that as well.

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SleepDent +0 points · over 3 years ago Sleep Commentator

Hi! I am a dentist working in dental sleep medicine. Unfortunately, it often takes quite a while to get improvement in your fatigue. The OSA has damaged your body over time and that damage must be repaired before the symptoms improve. It can take two weeks, a month, even two or three months or even more to get the payback. So far, you are doing a great job. Be patient and don't get discouraged. The payback over time will be well worth it. Sometimes patients get what I would call rebound fatigue. You are more relaxed and sleeping better, but it kind of brings out your latent fatigue. It can be pretty unpleasant. I would also urge you to work with your DME and/or sleep physician to see if you can get your treatment AHI down even more. Theoretically, anything under 5/hour is considered "normal", but some patients need to be even lower for best symptom resolution. Good luck to you! Arthur B. Luisi, Jr., D.M.D.

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PoopedInBama +0 points · over 3 years ago Original Poster

Thanks Arthur!

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Wynken +0 points · over 3 years ago

Ditto! Began apap therapy on 4/3/18. AHI was 20.4 but I was sleeping through the incidents...waking up tired but getting through the day. With therapy, max AHI has been 2.9 but I have never experienced such fatigue. I suspect that that the changes in air pressure throughout the night are proving to be more disruptive than the incidents themselves. Advice anyone? Thanks.

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gregbrown +0 points · over 3 years ago

This is a bit like how I feel too. I started my therapy mid March and it seems to me that the nights when I have low events per hour I don't feel as well rested as before I started the therapy. My doctor and other health care people have said try it for 28 days so I'm going to follow that advice and see.

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Wynken +0 points · over 3 years ago

Thanks, Greg....I am going to give it a try for a full month too.

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PrettyinPink07960 +0 points · over 3 years ago

I have had the same experience with fatigue and I have been on CPAP since Nov. 1. I now consistently score 92 - 100 with AHIs mostly under 4. AHI was initially 25. I sleep 8 to 8.2 hrs per night waking a couple of times for bathroom. So, you would think I am totally well rested. But I am not! I do notice more energy during the day, but at around 3:00PM I get so exhausted I can barelt keep my eyes open. I am 73 years old, work part time from home so I am able to take a 45min to 1 hr nap. I thought after 4 months I should see more improvement. I have an appointment for a fitting at the end of this month. Hopefully I will get some answers. Will keep you posted.

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Wynken +0 points · over 3 years ago

Thank you for your input. I am now at the four week mark and the fatigue is crushing. My pulmonologist just keeps telling me to give it time. I am also having a problem with sneezing and watery eyes/nose. I was attributing it to allergies though I have never had seasonal allergies before. Online posts suggest that it may be linked to cpap usage. Sadly, I feel worse now than I did before I began the therapy.

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Varmit +0 points · over 3 years ago

Have been using the ResMed 10 Auto since late February and adapted somewhat. The pressure range is 12 to 20, with my AHI quite varied -- over the last 30 days there have been 17 nights over 5, with 3 under 2, 1 @ 19 and 1 over 11. Hours of sleep have been getting longer but the really good ones have been aided by muscle relaxant and aspirin (aches and muscle fatigue from work). For the most part 5+ hours seems frequent if not average. Yes, have been using it every night/all night since after the first weeks. My daytime length of energy appears to be increasing and I'm enjoying this very much. However, over the last week, when we've gotten back to a morning, 2 mile walk (between 37 and 39 minutes), been fighting to keep going (although each day has improved a little). This morning I completed a 10 minute or so round of basic yoga/stretching exercises an hour or so ahead of the walk, then enjoyed a relaxing time before starting out and the 2 miles went better than yesterday's. Ate some of a protein/carb bar with coffee -- Cardiologist keeps harping on keeping blood sugar and blood pressure up.

Been back about an hour and can still feel chest congestion and my physical energy is not up to normal. I expect if I begin moving strongly and quickly, I'll run out of both breath and energy. Is this the sort of exhaustion or fatigue you others are discussing? I really want to know if this a problem with CPAP or ??? Let me add that I'm 73, have a two line pace maker and still experience flutter on the left side. Before starting CPAP, while my daily energy was shorter than I'd like, the activity instigated exhaustion was not a problem as long as I exercised regularly. I'm a potter/sculptor so personal energy is very important to my life.

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jstevie +0 points · about 3 years ago

Good to hear I'm not the only one to experience more fatigue after starting CPAP. I generally hit the sack around 10 and am up by 5:30 - 6:00, so ~7.5 - 8.0 hours sleep. I have two theories on why I feel more fatigue. One is that my wife is a very light sleeper and I am conscious of the slightest hiss that may leak from my nose pillow when I roll over, and wake up to adjust the fit. Therefore I suspect I don't fall into a deep sleep.
Second, I wonder if maybe I am sleeping better and feel more energized by 6AM, lay awake thinking about all the cool stuff I want to do during the day, and get up before I should. Naa, I think it's theory #1. lol. I'm 64, 6'2", 195lbs, and in good condition. Doing CPAP because OSA gave me atrial fib.

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Sierra +0 points · about 3 years ago Sleep Patron

Research shows we really do not need more than 7-8 hours of sleep per night. I think the secret is that we should go to bed needing that sleep. No caffeine after noon, no naps during the day, and then 7-8 hours of real good sleep. If you are getting up too early, then perhaps you are going to sleep to early!

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snuzyQ +0 points · about 3 years ago Sleep Commentator

Hi jstevie and welcome to the forum. It would be a good idea to run all this by your doctor.

There are lots of things that can cause fatigue...OSA being just one of them. A good sleep doctor would want to know why your fatigue is continuing after CPAP treatment. He/she will want to review your machine's data to make sure that the CPAP is actually reducing your AHI to under 5 and that CPAP is effective for you.

You can review your own data, too and a lot of us here on the forum do just that. Sleepyhead is awesome. You can install it for free on your computer. All you need is an SD card and a SD card reader. I found a great deal for both on cpapXchange.com and just now inserted the new SD card into my husband's Airsense 10. He isn't interested in his sleep data, but I am. I keep hearing the leaks he's having from his nasal pillows mask and am wondering just how effective his CPAP treatment really is. He says CPAP hasn't helped him with his fatigue level and that now he feels even worse on CPAP than he was before treatment. He's remembering from 6 years ago when he first began CPAP, so I think his comment is pretty subjective.

His respiratory therapist reviews his sleep data just once per year (they check mainly for compliance because they don't want to pay for CPAP supplies if the patient isn't using the CPAP machine each night, and for AHI, which they want to see under 5 to prove that the treatment is actually accomplishing something. He only sees the doctor if he reports a problem and, so far, he's kept his ongoing fatigue to himself. You can't blame a wife for worrying.

My husband's Airsense 10 didn't come equipped with a SD card. If I discover trouble in his data now, we'll have a "closet talk" and troubleshoot his next move, together. If I don't find trouble, then he'll need to see his doctor anyway to explore causes of his fatigue and my worrying can take a rest.

Keep up the good work. OSA is no minor affliction as you very well know.

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