Health Update #5 March 14, 2003
Problems, a New CPAP Pressure,
and MSLT Delayed to April
I'm in my third month on CPAP for sleep apnea.
After making some progress in January (see previous update ), in February I started to do a little worse. This was due I believe to allergies, air leaks, "mouth breathing," and sleeping on my back more (something I haven't done much in 15 years). These can comprimise my CPAP treatment and may be why I haven't shown more improvement on CPAP since November. Sleeping on your back for example makes apnea worse and requires a higher air pressure to sleep in that position thanon your side (I didn't sleep on my back during the APAP study when my air pressure of 7 was set). I have even snored at times while sleeping on my back while using CPAP which is a sign I have too low an air pressure. I'm in the process of troubleshooting these problems and experimenting with using chin straps and even taping my lips togther to prevent mouth leaks. I started using Flonase for allergies and nasal stuffiness again but this is causing nose bleeds so I need to try something else for allergies. I have since started to see some improvement again since addressing these problems more aggressively. Hopefully this is a trend back up and not a "sucker rally."
I called my pulmonologist about these problems and my improvements since I last saw him, and he gave me a prescription to increase my CPAP air pressure from 7 to 9. As noted in the previous update, during my APAP home test the air pressure went up to 9 at times, but he prescribed a constant pressure of 7. My MSLT has been reschedualed from February to April. This should give me some more time to tackle my problems. He said I could cancel the MSLT if I felt I was doing better. I'll wait to see how it goes at 9. I'll call back in a month and let him know how it goes.
Hopefully, that will work. If not, it'll be more troubleshooting. The first things to try for my continued ("risidual") fatigue, sleepiness and cognitive problems is continuing to troubleshoot the mouth breathing and sinus inflamation problems if needed. I may need a retitration to see if my new air pressure is enough (especially on my back) and/or may try an APAP again. If I don't get the problems solved with these and regain my enegry and alertness, I may try drugs such as Provigil or maybe try surgery. Another thing to look at is to see if the fatigue and concentration problems are depression either caused by or seperate from the apnea (they tend to go together) that may need treatment in addition to the apnea. This will take a few months more than likely to sort out. Hopefull my magic or "Goldielocks" number is 9 and my troubleshooting will be over (and fatigue, irritibility, fuzzyheadedness,...) :-)
Sorry dealing with apnea is taking up my time, but as you can imagine, it's a little debilitaing and doesn't seem to want to go away (darn!). My relationships are suffering as a result. I don't feel like I'm much a part of my kids' life the past year or two as I don't have much energy at times to do anything. I frequently decline my wife an kids' offer to join them in going somewhere or do something fun - instead I take a nap. It also doesn't help being irritable at times due to the apparent sleep debt. I feel like I'm watching (in a daze) my life and my kids' life go by. Some dad (and husband) I've become. I'm having second thoughts about declining my pulmonologist's offer of a prescription for stimulants to help me keep going. I'm willing to try about anything at this point. Anybody got a Radio Disease Killer or Electronic Radio Biola handy? :-)
I am starting a seperate page for those who are also currently struggling with CPAP treatment:
A Compendium of CPAP Problems and Solutions
Previous health updates:
Update #4 I Finally Got a CPAP! Feb. 8, 2003
Update #3 My Home APAP Test and Sleep Study Results Nov. 15, 2002
Update #2 My sleep study Sept. 10, 2002
Update #1 My Health August 10, 2002