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Monday, April 21, 2014
I have been tested in a sleep center and am now using a CPAP. I typically go to sleep at 10:30pm - 11:00pm, awake at 6:00am to feed the dog, return to sleep at 6:30 - 6:45am without the CPAP, and get up between 10:00 - 11:00 am. I am still capable of sleeping, but try to get up.
I am 67 and taking a number of medications. I try to exercise by walking for 45 to 60 minutes 4 or 5 times a week.
I am concerned about the excessive sleepiness and hope it might be related to a medication I am taking. My doctors don`t seem to be able to help.
Thank you using NetWellness. It is always difficult to determine the exact nature and extent of a patient's problem when responding to an internet question as we are often lacking vital information needed to provide the appropriate advice. However, I will answer your question with the information available and advise you to seek additional help.
We frequently see patients such as you in the Sleep Clinic who have been on CPAP therapy and have persistent sleepiness. The list of possible contributors is quite lengthy and a careful history, examination and interpretation of the CPAP compliance data (smart card in the CPAP machine that provides a report of the nightly use of CPAP) are required. The most common causes of persistent sleepiness include ineffective CPAP therapy, lack of sufficient sleep hours, depression, medication side effects, and additional sleep disorders (for example narcolepsy, restless leg syndrome and periodic limb movement disorder). There is also a subset of sleep apnea patients who have persistent daytime sleepiness despite optimal therapy. These individuals often require additional therapy with a non-amphetamine stimulant called Provigil (Modafinil).
In your case, without knowing further information, I cannot say for sure what the cause of your sleepiness may be. Aside from the above mentioned possibilities, part of your problem may be that you are not using CPAP for your entire sleep period. I encourage you to keep your CPAP on for the entire time you are sleeping. Studies have shown that the longer you use your CPAP, the more benefit you will gain from it.
In order to determine how best to help you, you will need a full re-evaluation, including additional history, a review of sleep study, CPAP usage, and all your. If you are not satisfied with your current care, I suggest you ask your primary care physician for a referral to another sleep center, perhaps to a local academic center or university. Some cases can be complex and difficult to evaluate. Physicians at academic centers may be able to provide a more extensive evaluation that will lead to resolution of your problem.
Once again thank you for using NetWellness.
Steven Kadiev, MBBCh
College of Medicine
The Ohio State University