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Residual Sleepiness/Tiredness despite OSA being treated

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Dana -1 point · over 2 years ago Original Poster

My short question is: why am I still so tired despite my apnea being well treated? I would be very grateful for any thoughts or suggestions! Thank you!!

Here are my details: After many years of having tremendous difficulty treating my sleep apnea, upper airway resistance syndrome and general sleep disordered breathing (trying various cpaps, apaps, at all kinds of pressures and getting severe stomach pains, full face masks, nasal pillows with chin straps, couple of different custom dental appliances, WINX), I now started a new treatment plan about 6 weeks ago using a combination of CPAP while also using a custom made mandibular advancement device and I can only sleep in my side with this setup and have the apnea be effectively treated. The machine is a Resmed Airsense 10 Autoset for her, it's an APAP but I'm using it in CPAP mode and it is set at 6cm with initial ramp up at 4cm; I am using Airfit P10 for Her small nasal pillow mask; and the mandibular advancement devise is one of the Whole You ones (Respire Pink EF, micro, with reduced lingual). I access my machine's numbers each morning and it seems--both according to the data I access and after my meeting with my Dr last week--that my apnea and RERA's are being well treated. I am still very tired though, nothing has changed in that regard. Does anyone out there have any thoughts, suggestions for me about the residual tiredness/sleepiness? According to the ResMed website, I'm getting Total MyAir Scores of usually, 98, 99; each morning when I log onto the ResMed My Air site it gives me my AHI for the previous night (one number), and over the course of the 6 weeks it has ranged mostly from 1.5 to 4.3 (plus a few times with higher numbers, but those seem more like anomalies, one being the very first night which was 5.9; another night where I decided to try a smaller nasal pillows and ended up with AHI of 7.8; and another night at 5), most nights were in the 2's or 3's; although I can't access the RERA data myself, my Dr says my RERA Index during this time has been 0.2. My Dr. talked about possibly me taking a prescription drug of Modafinil or Armodafinil to combat the tiredness. I am very reluctant to use medication. I have another odd body issues, like hypermobility and some Dr's also think I might have fibromyalgia, maybe Ehlers-Danlos syndrome. Although according to my last regular (non titration) in-lab sleep study that I had this past Dec. my untreated AHI is in the "moderate" range, for many years prior, my AHI was in the "mild" range but during those years of "mild" AHI I had very high RERA's and RDI's. (that some Dr's would classify as making the whole thing "severe"). I'm also wondering, is the ResMed data really accurate in terms of my RERA's being well treated? I am also considering seeing other Dr's like a neurologist, maybe someone who deals with hormones in post-menopausal women. Feeling disappointed that I don't feel less tired.

Thanks for listening to my saga!!

I truly appreciate any suggestions.

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