Sleep Centers of Middle Tennessee

I’m On Auto-PAP But Still Have Excessive Daytime Sleepiness.  Is There Any Help?

Posted on 15 Aug 2012 - 12:00 PM

Listener Question
SD,
I have fatigue and really low energy. I have been on autopap for years. I
just had a new study, and had my settings reviewed; I am breathing and
sleeping properly for 8 hrs a night. The problem is that I also sleep 8 hrs
a day too….

I am looking for something in addition to the apnea that would give me
similar symptoms.

I am 39, about 20 lbs overweight, and I hardly ever drink. I have never done
recreational drugs or smoked, but I am willing to start if you think it will
help.
How do I tell my doctor what I think is how he should do his job? How do I tell my doctor
that I am running out of money and insurance?

The Sleep Doctors Answer
Dear anonymous,

Thanks for your question. Your questions are indeed valid, and good ones. There are many things that can cause a person to feel excessively sleepy during the day. Medical conditions, medications, and psychological disorders are the most common things that can cause a person to feel sleepy during the day despite effective treatment of OSA with CPAP, and despite an adequate amount of sleep each night.
I would first consider whether or not your auto PAP machine is adequately treating you. It is not uncommon for us to see patients on auto PAP who are having miniature “arousals” from sleep throughout the night, due to changes in pressure inherent to auto PAP. Having a PAP titration in the laboratory, determining your pressure needs, and setting your machine to one pressure setting may be more beneficial than you think. We would be glad to see you and walk you through this process, if you need help. Alternatively, we can steer you towards someone who is competent at assessing, diagnosing, and treating your daytime sleepiness.

On a final note, sometimes we see patients with excessive daytime sleepiness, despite adequate treatment of OSA. For these patients, there are alertness or stimulating medications for use during the day that are of great benefit, if you are interested in this as an option.

Best of luck to you, and please feel free to let us know if we can be of assistance. Thanks for listening to the Sleep Doctors! Best, Brian Wind