Thought I might jot down my experiences so far with OSA/CPAP. Who knows, it may help somebody. And if anyone has a miracle cure I'll be happy to hear it
I'm a 36yo male and I have always been tired to some extent. I just thought I wasn't a morning person. Had mentioned tiredness to doctors in the past but the most they would do was a blood test which showed nothing out of the ordinary so they said not to worry about it.
Then about February this year rather than just feeling tired, I was now completely physically exhausted all day every day (didn't build up, but came on virtually overnight). Doctor ran the usual blood tests which showed nothing that would cause it, and referred me to the sleep clinic at the local public hospital. Despite my symptoms not being typical the specialist at the sleep clinic thought I had sleep apnea and scheduled me for a sleep study - only a 2 month wait to get it done...
My symptoms were:
- non-refreshing sleep
- severe daytime tiredness/fatigue and physical exhaustion (despite not having done anything)
- poor concentration and extreme irritability
- insomnia (despite being tired and exhausted I couldn't get to sleep)
But I didn't have what are apparently the most common symptoms:
- I didn't snore (but I did breathe 'heavily' through my nose)
- I didn't have daytime 'sleepiness'. I was tired and fatigued but not 'sleepy'. I couldn't get to sleep during the day if my life depended on it. I scored a definitive ZERO on the Epworth scale which is a better result than in most people without a sleeping problem.
After the two month wait for a sleep study, it didn't go too well. First was learning that they will wake me at 5am to send me home as they need to clean the room for day patients (the facility was at a private hospital where the sleep study rooms are used for other purposes during the day). Then they tell me to try and sleep without taking a sleeping tablet. For a light sleeper who can't get to sleep early and had been on daily sleeping tablets for months, sleeping in a strange location with wires and stuff attached, add the pressure of trying to get to sleep so I can have enough sleep for them to analyse it... Not hard to guess that sleep didn't come easy that night. After a couple of hours tossing and turning they decide to offer me a sleeping tablet. They graciously let me sleep till 5.30am rather than 5, and I managed to get a total of one hour of sleep.
Of course the attendant was unable to inform me when sending me home if I got enough sleep for them to analyse. So I spend the next few weeks worrying that I'll have to suffer the long wait of getting another sleep study appointment and do it all again without receiving any treatment.
Amazingly enough the 1 hour of sleep seemed to be enough for the specialist to diagnose "moderate sleep apnea". All he does is book me for another sleep study, this time with titration. So 2 more months without treatment follow while waiting for the 2nd study.
On the night of the 2nd study they were happy for me to take my own sleeping tablet, I wasn't going to argue with them. Being more comfortable with the situation and not having as many wires and probes attached as in the first study (but with the addition of a CPAP mask), I was able to get 4 hours sleep before being sent home at 5am. Thankfully they gave me a prescription for CPAP at the time, so I went that day and hired one.
The pressure they prescribed was 8cm. But after 3 weeks of full-time use it was having absolutely no effect at all. Went back to the specialist who tried telling me I hadn't been using it long enough. I pushed him to ask what else I could do and he decided to increase the pressure to 9cm. He mentioned that even on CPAP my sleep quality wasn't too good, but he didn't seem interested in pursuing it.
Finally some relief! Not too much, but a little. After I think the second night on 9cm, I was able to get out of bed and have a shower straight away, rather than have to sit on the couch for an hour dosing up on caffeine to gather some energy. I was far from feeling good, but it was a slight step up from what I had been feeling for the past 6 months. I was still tired and fatigued all the time but most of the physical exhaustion had gone.
Went for another followup with the specialist who asked me if I wanted to try increasing the pressure again. I said I thought it was worth trying. So he increased it to 10cm.
But 10cm pressure didn't work any better than 9cm did.
I had to go back to my GP to get another prescription for sleeping tablets, and he thought it was time for me to stop taking them. I was actually able to get to sleep without them, but after 3-4 nights without taking one my apnea symptoms worsened considerably - the daytime physical exhaustion returned. Since then my progress (hence the effectiveness of CPAP) has varied from night to night. More chance of feeling better the next day if I take a sleeping tablet, but it isn't guaranteed.
A couple of weeks ago while having a restless night I heard a gush of air and realised that air was leaking out through my mouth (I use a nose mask). Since then I have taped my mouth up each night and the morning headaches (which I experienced most mornings) and dry mouth/throat (every morning) have both gone. But unfortunately it hasn't had any effect at all on the tiredness/fatigue/exhaustion.
My GP doesn't have any explanation for the sleeping tablet interaction and wants me to stop taking them, and I'm not entirely happy with the specialist I have been seeing (not to mention them doing sleep studies where they send you home at 5am), so I'm going next week to a specialist sleep centre - it's going to cost me, but I think I'd gladly sell everything I have if I could buy quality sleep.
Have been using CPAP for nearly 3 months now, but it's effectiveness varies from day to day between slight to none. I don't know if I need to do something different with CPAP, or if there is something in addition to sleep apnea which is affecting me.
Slight nasal congestion may be a contributing factor – specialist dismissed it without even looking into it, while GP has got me to try two different prescription nasal sprays, both of which had no effect.
There are probably other relevant things I have omitted. Yes, I am overweight – 100kg when I should be about 85kg. But the sudden worsening of symptoms earlier this year roughly co-incided with losing a couple of kg rather than gaining weight.
Other medical conditions which may or may not be related:
Blood pressure a little high in recent times. Cholestorol is borderline, but triglyceride levels are quite high.
Irritable bladder (frequent urination) – no infection or other known cause.
Gastro-oesophagal reflux – due to a pre-existing physical condition and under control with acid-reducing medication.
Hope I haven’t rambled on too much!
