Minimal AHI ... Still DEAD Tired! - 10 years in.
Minimal AHI ... Still DEAD Tired! - 10 years in.
Hi,
I need some guidance from the experts in this board. I was diagnosed with Severe sleep apnea and had an AHI of 45.
For the past 565 days my average AHI is 1.67
I wake up, every single day, dead tired. Like a Zombie. As if a truck has just ran over me.
Last night I slept 7.5 hours (wow) and yet woke up in a pretty bad place -- so much that here I am posting for the first time here.
I have replaced machines and masks, and currently have one with a great mask fit and I use it every single night.
My case is not one of "stick with the therapy". I've been using a machine for over 10 years, getting closer to 15. I comply with the therapy.
It is very disappointing. The minimal AHI suggests that the therapy is working, but if so, why do I feel so bad?
I really dread doing another sleep study, is that the only solution? I will do it I guess, but there's got to be something more here.
I need some guidance from the experts in this board. I was diagnosed with Severe sleep apnea and had an AHI of 45.
For the past 565 days my average AHI is 1.67
I wake up, every single day, dead tired. Like a Zombie. As if a truck has just ran over me.
Last night I slept 7.5 hours (wow) and yet woke up in a pretty bad place -- so much that here I am posting for the first time here.
I have replaced machines and masks, and currently have one with a great mask fit and I use it every single night.
My case is not one of "stick with the therapy". I've been using a machine for over 10 years, getting closer to 15. I comply with the therapy.
It is very disappointing. The minimal AHI suggests that the therapy is working, but if so, why do I feel so bad?
I really dread doing another sleep study, is that the only solution? I will do it I guess, but there's got to be something more here.
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
Have you had a complete physical with blood work ups to rule out other possible causes of your fatigue?
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion) |
Additional Comments: Back up is S9 Autoset...... |
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
Yes, my last two physicals have shown that I am very healthy (lol)... I've even done cortisol levels, iron, vitamin D and B, etc. and all normal.
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
What are your pressure settings?
Do you use SleepyHead (free software DL from the forum) so you can see what's going on?
Do you use SleepyHead (free software DL from the forum) so you can see what's going on?
_________________
Mask: Ultra Mirage™ Full Face CPAP Mask with Headgear |
Humidifier: IntelliPAP Integrated Heated Humidifier |
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
I have an APAP set from 4 to 20; the average pressure (over 560+ days) to get me to 1.67 AHI is 7.5; this is automatically calibrated throughout the night. Yes, I have the software and that's how I've been able to tell all this. I've looked for any other obvious things that can explain why I am so dead tired but nothing jumps at me (I'm an engineer so I'm can make some sense of the data).
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
The first thing I suggest is bumping your low pressure (4) to 7 and see how that goes over a few nights... because your machine's having to work too hard to play catch up when anything happens. 4+20 are the default machine settings, not prescribed ones, and too many MDs are either too ignorant or lazy to prescribe based on your sleep study results, so we have to do things on our own, take control of our therapy and learn as we go.
_________________
Mask: Ultra Mirage™ Full Face CPAP Mask with Headgear |
Humidifier: IntelliPAP Integrated Heated Humidifier |
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
Having a nice low AHI doesn't guarantee that we are going to feel those good numbers. Wish it were that simple because getting a nice low AHI is actually pretty easy to do. Unfortunately that's not the way it is in real life for some people.
Some things to consider when we aren't feeling as good as those numbers seem to say we should feel.
1..Look at sleep quality...and not only hours of sleep but the overall sleep quality as in are those hours of sleep fragmented with multiple wake ups?
2..Look at medications taken along with possible side effects of those medications being a factor.
3..Look at the leak reports as well as the AHI itself...if leaks are a problem it could be masking sub optimal therapy.
4..Look at sleep hygiene in general.
5..Look at other potential health issues and this includes mental as well as physical health issues.
6..Look at maybe trying fixed cpap pressure or a tiny range in apap mode just in case the changing pressure of auto adjusting mode maybe being a factor in overall sleep quality. Some people find they sleep better and feel more rested in cpap mode than in apap mode.
7..Look at bed comfort in general.
8..Insomnia....either sleep onset or sleep maintenance
Lots of things affect how we feel during the day and impact our energy levels during the day...and not everything can be fixed with optimal cpap therapy and having a nice low AHI number. Takes a lot of detective work to sort it out and fix or try to fix.
Some things to consider when we aren't feeling as good as those numbers seem to say we should feel.
1..Look at sleep quality...and not only hours of sleep but the overall sleep quality as in are those hours of sleep fragmented with multiple wake ups?
2..Look at medications taken along with possible side effects of those medications being a factor.
3..Look at the leak reports as well as the AHI itself...if leaks are a problem it could be masking sub optimal therapy.
4..Look at sleep hygiene in general.
5..Look at other potential health issues and this includes mental as well as physical health issues.
6..Look at maybe trying fixed cpap pressure or a tiny range in apap mode just in case the changing pressure of auto adjusting mode maybe being a factor in overall sleep quality. Some people find they sleep better and feel more rested in cpap mode than in apap mode.
7..Look at bed comfort in general.
8..Insomnia....either sleep onset or sleep maintenance
Lots of things affect how we feel during the day and impact our energy levels during the day...and not everything can be fixed with optimal cpap therapy and having a nice low AHI number. Takes a lot of detective work to sort it out and fix or try to fix.
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
That was my first impulse this morning, to bump the low pressure to something higher -- however when I look at my average AHI for such a long time it seemed that the pressure is working for me; otherwise I should have more AHIs, no?
It also seems that the most the machine gets to is 7 or 8 throughout the night.
I can definitely try that and if there's no other option will do that. I am aware that the 4-20 is the default setting and would gladly change it, I'm just wondering if the problem is the pressure, why are my AHIs so low?
It also seems that the most the machine gets to is 7 or 8 throughout the night.
I can definitely try that and if there's no other option will do that. I am aware that the 4-20 is the default setting and would gladly change it, I'm just wondering if the problem is the pressure, why are my AHIs so low?
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
I had your exact problem, 10+ years using CPAP, low AHI, and dead tired. Had a sleep study and discovered I have PLM which was causing 30 arousal's per hour. Medication for PLM has been a big help.
Based on my experience I would suggest having a sleep study done if you haven't had one recently.
Based on my experience I would suggest having a sleep study done if you haven't had one recently.
_________________
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear |
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
Additional Comments: Settings: EPAP 13.6, Max IPAP 18.4, P.S 4 |
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
Here is where I stand on these:
This is pretty bad for me. I have vivid dreams and toss and turn a lot. Naturally is an area where further inspection must be done but I have no idea what else to do (see below).1..Look at sleep quality...and not only hours of sleep but the overall sleep quality as in are those hours of sleep fragmented with multiple wake ups?
I take no medications whatsoever. I would take vitamins (like B6) which would, at times, improve the quality of my vivid dreams. I've tried Niacin and Melatonin and they just make me sleep longer but I still wake up tired.2..Look at medications taken along with possible side effects of those medications being a factor.
This is quite good, very low leaks. I've had some 5 different masks over the years and quite happy with my current one in terms of comfort and leaks. This took me many years to figure out.3..Look at the leak reports as well as the AHI itself...if leaks are a problem it could be masking sub optimal therapy.
This is something I've been improving over the years. I used to sleep only 5.5 hours a night now I am approaching 7. Low light in the room, leave computer behind before, blindfold, etc. --- sure I can do more, and yet very little to no improvement over the past several years. Which is why I was suspecting I would still be experiencing tons of apnea incidents, but I can rule that case out it seems.4..Look at sleep hygiene in general.
For the past 3 months I've been exercising lots and modifying my diet. I've experienced dramatic weight loss and gains over the past, and I wish I could tell you "I felt better when I was 30 pounds lighter", but I can't. So far, for me, weight loss or gain and exercise seem to have very little to no correlation to my sleep quality. In other words, my sleep quality is pretty BAD regardless of what I do. Hence my desperation.5..Look at other potential health issues and this includes mental as well as physical health issues.
This i haven't tried and I guess it's a remaining choice. When I look at the low AHIs I would suspect that I am having no trouble with the therapy but the results are not there.6..Look at maybe trying fixed cpap pressure or a tiny range in apap mode just in case the changing pressure of auto adjusting mode maybe being a factor in overall sleep quality. Some people find they sleep better and feel more rested in cpap mode than in apap mode.
I've improved my mattress and I am really happy with what I have --- tempur with 10+ pillows. I travel a lot and have tried hundreds of beds in 4 and 5 star hotels and can tell you that my bed at home is by far my favourite.7..Look at bed comfort in general.
I now fall asleep way easier, but do wake up a few times a night when I toss and turn so much. Unsure what to do about this based on the above.8..Insomnia....either sleep onset or sleep maintenance
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
My wife reports that I twitch a lot during the night. Can you please elaborate more on what medication have done for you and what you've taken?GTOJim wrote:I had your exact problem, 10+ years using CPAP, low AHI, and dead tired. Had a sleep study and discovered I have PLM which was causing 30 arousal's per hour. Medication for PLM has been a big help.
Based on my experience I would suggest having a sleep study done if you haven't had one recently.
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
Per my wife's description once in a while would shutter while sleeping. It wasn't something she noticed nightly. As for medication I'm taking pramipexole .35mg, and about a year ago started taking Nuvigil 125mg which helped with alertness, clearing the brain fog.
Guest wrote:My wife reports that I twitch a lot during the night. Can you please elaborate more on what medication have done for you and what you've taken?GTOJim wrote:I had your exact problem, 10+ years using CPAP, low AHI, and dead tired. Had a sleep study and discovered I have PLM which was causing 30 arousal's per hour. Medication for PLM has been a big help.
Based on my experience I would suggest having a sleep study done if you haven't had one recently.
_________________
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear |
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
Additional Comments: Settings: EPAP 13.6, Max IPAP 18.4, P.S 4 |
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
what about more medications that you take especially the psychotic ones? Please list them
Nuvigil 125mg
pramipexole .35mg
Nuvigil 125mg
pramipexole .35mg
_________________
Mask: Mirage™ SoftGel Nasal CPAP Mask with Headgear |
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
Additional Comments: S9 Autoset machine; Ruby chinstrap under the mask straps; ResScan 5.6 |
Last edited by avi123 on Sun May 24, 2015 9:36 am, edited 2 times in total.
see my recent set-up and Statistics:
http://i.imgur.com/TewT8G9.png
see my recent ResScan treatment results:
http://i.imgur.com/3oia0EY.png
http://i.imgur.com/QEjvlVY.png
http://i.imgur.com/TewT8G9.png
see my recent ResScan treatment results:
http://i.imgur.com/3oia0EY.png
http://i.imgur.com/QEjvlVY.png
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
I am not taking any medications whatsoever.... have tried for a few days taking some B6 which improves the quality of my dreams but that's about it.avi123 wrote:what about more medications that you take especially the psychotic ones? Please list them
Re: Minimal AHI ... Still DEAD Tired! - 10 years in.
What model machine and software are you using?
_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.
If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.