Still tired with CPAP treatment?

Still tired with CPAP treatment?

Why are you still tired after using the CPAP treatment?

  • If you're still tired after using the CPAP machine, then you most certainly have CPAP resistant syndrome or True Residual Sleepiness.
  • The science explains that there is a residual sleepiness in some patients with sleep apnea, which takes time to disappear.

What are the causes behind your tiredness?

  • hidden problems that directly affects CPAP therapy,
  • problems that are not connected with CPAP therapy, but affects the quality of sleep
  • No underlying issues - science call this situation true residual sleepiness.

What are the risk factors when using the CPAP method?

  • CPAP Mask Leaks
    Inexperienced CPAP users almost always have this problem.
  • That's why they are the majority who complain about fatigue, headache and sleepiness during the day.
  • If your mask leaks just a little bit, you're accumulating sleep dept.
  • So fixing these leaks usually leads to a better quality of life.
  • Incorrect CPAP Air Pressure
  • Believe it or not, the CPAP titration study (where the CPAP is calibrated to the correct pressure that opens your airway) doesn't always show the accurate settings to get a good sleep.
  • This means you may go home from the sleep study with a wrong setup.
  • It also means it's possible you don't get enough pressure to open your airways.
  • The result: tiredness, headaches, depression during the day.
  • Mask Discomfort
  • Unfortunately, it's not uncommon to take some time to adjust to sleeping with a CPAP mask on your face.
  • It's not easy. If you struggle a lot to adapt to your CPAP mask, you'll get poor sleep.
    Here are some examples of problems caused by sleeping with a CPAP mask:
  • forehead hurts,
  • feeling of claustrophobia and suffocation,
  • sneezing after you put the mask on,
  • dry mouth from sleeping with your mouth open,
  • waking up with nasal congestion,
  • sleeping in strange positions to keep the mask from leaking,
  • the airflow from CPAP feels to dry and unbearable

What causes that are not linked with CPAP, but disrupts your sleep?

  • Central Sleep Apnea
    Central Apnea is a sleep disorder where the brain forgets to command your body to breathe.
  • Your CPAP is useful only if you have obstructive apnea, but is useless for the central apnea.
  • Medications That Can Affect Your Sleep
    The most common drugs that can make you feel sleepy during the day, are:
  • Antidepressants
  • Sedative medication
  • Medication that cause insomnia
  • It's not uncommon for patients with sleep apnea to take drugs for depression.
  • However, these drugs have serious side effects that can affect your quality of sleep.

What is the mystery of True Residual Sleepiness?

  • Only 10% of patients remain sleepy on CPAP, even after you exclude the other causes of sleepiness.
  • Imagine that after you struggled to find the perfect CPAP mask, adjust the CPAP pressure, improve your sleep hygiene, and your sleep data looks perfect, you are still tired during the day.
  • It can be very frustrating.

Can you get Neuron damage from untreated sleep apnea?

  • Scientists found that long-term exposure to low levels of oxygen in mice results in sleepiness during the day that persists at least several weeks after the oxygen levels are restored.
  • This observation prompted the scientists to ask whether the neurons from the sleep control regions of the brain are damaged from long-term hypoxia (low oxygen levels).
  • The longer you had untreated sleep apnea, the more damage your neurons have.

How does depression and obesity affect you?

  • A study showed that sleep apnea patients with depression are still tired even with nightly CPAP usage of 6 hours.
  • The scientists also observed that obese individuals also had residual sleepiness with CPAP.
  • It’s important to lose weight - your sleep will improve.

Can The Residual Sleepiness Be Treated?

  • The good news is that the residual sleepiness will disappear in time.
    However, the sleepiness decreased significantly with longer CPAP use:
  • Only 8.7% patients still had residual sleepiness using the CPAP 6 hours per night.
  • 18.5% patients still had sleepiness after using the CPAP 4 hours or less per night.

How can you treat True Residual Sleepiness?

  • Stimulant drugs that alleviate sleepiness.
  • It may be necessary for the doctor to prescribe Modafinil (Provigil) or Armodafinil (Nuvigil) as a stimulant.
  • These drugs has been proven effective over the years, where the patients experience increase wakefulness and daytime function.
  • The doctor has to be very careful with this prescription.
  • If you don't wear the CPAP every night for 6 hours, with good sleep data, these stimulants can harm you.
  • You need to sleep enough with your CPAP, to get these drugs.