Still tired after CPAP and 8 hours of sleep

[Perrybucsdad]

I have been using my CPAP for many years now, my event status is nice and low, (under 1 event an hour) and I try and make sure I get more than 8 hours of sleep (normally closer to 9 hours). But on many mornings, I am still tired. Why?

I don't drink alcohol, I do drink coffee but only in the morning, I don't drink any other caffeine. When I look at ResMed dashboard and history, I see I have 3 - 5 on/off mask events to go to the bathroom. Is that the reason why? My body is taking a while to go back to sleep after these? Unfortunately, I'm on a water pill for my BP which I take in the morning, and yes, I do have some water normally with a snack just before bed. Could it be anything else that I should look at?

Thanks

[Pugsy]

Good to see you again. It's been a while.

How old are you now? I forget. Any chance the prostate is maybe compounding the nocturia problem?
Guys can also have a problem with overactive bladder syndrome as well.

If you are getting up to pee 3 to 5 times a night then you certainly aren't getting good quality sleep.
Likely not getting the nice normal cycles of sleep in the needed amounts for the restorative powers of sleep to work their magic.

While it wouldn't be impossible for there to be something else medically to be going on causing the fatigue the first culprit is going to be the multiple awakenings each night.

You probably should be having a chat with your doctor about all this. Maybe get some routine blood work along with hormone and maybe vitamin D levels and for sure thyroid labs.
See if prostate could be a factor or overactive bladder or if there is a different BP med you could take if it ends up that nothing else is a factor.

[Perrybucsdad]

Hi Pugsy, I'm 53m so prostate is a concern at my age. I did take a prostate test recently, and all was good on that end. Being that I am a cardiac patient as well, I get blood tests quite often, and the only thing that was a little out of order last time was my glucose, but I am also a type 2 diabetic... but the A1C was well in control.

Funny thing about the water pill is this is the kinder, gentler one that I am taking compared to what I used to take. I do know that if I stop drinking water about 7pm or earlier, I don't wake up hardly at all. Problem is, I'm thirsty after that time.

Okay, I was hoping there was something that would really jump out or something that I hadn't thought of. It sounds like to me it is the getting up part, so I need to figure out what to do there.

[Pugsy]

Well you may be in bed for 8 to 9 hours but if you are getting up to pee often then you aren't actually sleeping all that time.
So it's fragmented sleep for one thing and the other is you are not asleep for part of the time depending on how long it takes you to go back to sleep each time.

I strongly urge that you have a chat with your doctor.
An enlarged prostate won't necessarily be picked up by a blood test if that is what you had done recently...the PSA test.
Also it could be a by product of the blood glucose levels causing the nocturia.
Thirst is a common symptom of diabetes as well. So maybe the glucose levels aren't stable or something.
Many potential culprits and you need some professional help to sort through them to find the culprit and then try to fix it.
Of course it could be some other medical reason but I would start with the poor sleep quality caused by the fragmented sleep which is caused by the nocturia.
Something has changed somehow....just gotta figure out what it is.

[ozij]

I do know that if I stop drinking water about 7pm or earlier, I don't wake up hardly at all. Problem is, I'm thirsty after that time.

Can you try to drink more water, earlier on?
Could it be that it's a habit, that you may want to break out of gradually?
For example:
In the coming week, drink a quarter glass of water about a half hour earlier, and only 3/4 at your usual time. Actuall pour out the amount from your "before sleep glass" into another one, so you can see you're not drinking less.
The next weeks, gradually make the earlier amount larger, and move it back in time - play it by ear as to how much and when, but aim for a change.
And make the later amount smaller and earlier.
Do it gradually, slowly, consciously - with awareness that you really are hydrating you body.

Leave yourself a few sips for comfort for before you go to bed -- but really just about enough to make your mouth happy, remembering how nice and cool the water was when you drank much of it earlier.

[Perrybucsdad]

I think some of it is just habit. I will normally read for about half an hour, and I have this habit of sometimes having a little popcorn or pretzels while reading and a big full glass of ice water.

I think what might be better is just to go cold turkey with the snack and water two hours before bed. I keep reading that two hours before bed is the magic number it seems. That would mean I have to stop all fluid at 7:30p. If we eat late, which is common in our house, that may be an issue... but let me see what I can do.