I am so, so tired

[Bertha Venation]

Long ago I took this complaint to my doctor, who ordered a sleep study. CPAP was prescribed and for a couple of years it seemed to work well.

For the last several months, I have awakened tired, driven to work drowsy, sometimes nodding off,* and have nodded off at my desk. Daily. On the weekends, I take naps. In fact, I'll get up and enjoy my ritual -- have coffee and sit in my chair or outside in good weather and read. Well, I don't read anymore, although I try. I fall asleep.

I had another sleep study a couple of weeks ago. Since my doc is on vacation, I don't have the results yet. Perhaps the CPAP is set at the wrong pressure, or I need a different mask; the sleep study tech made these suggestions. My wife wonders if I might be anemic.

I am so very tired of being tired. I hate dragging myself through the mornings. I can't concentrate. I make notes on tasks throughout the day; sometimes I can't read my writing, and have to go back to the boss to find out what the task was. This is embarrassing.

I am SO very tired of being tired.

Until I see my doc -- any practical suggestions? Not looking for medical advice.

* I have found a way to keep from nodding off while driving to work. I eat celery.

[woodsprite]

1. I hope they find that it's just a needed CPAP adjustment

My brother had the 'nodding off' while driving issue. He found an earpiece that looks a lot like a blue tooth earpiece, but an alarm sounds if his head tips forward. I have the issue with nodding off at work, but I'm a notorious night owl. I barely get 4-5 hrs of sleep a night on most nights. Last night I couldn't sleep past 4am, but it's due to a stressful situation at work.

I did have a problem with anemia a few years ago. My levels were really low and I needed to bring them up before some surgery. I was sitting at an 8.5 but had to get to a 13+ in order for them to do surgery. I managed to bring it up that much through diet over about 3 wks. The tip off wasn't how tired I was (like dozing off), but was how short of breath I was and the lining of my eyelids were very white. I had never been short of breath before, and that's what got me to the doc.

The nurse who tested my blood said to try to increase my red meat, spinach and dark leafy salads (eaten WITH oj, citrus, or strawberries - they help with iron absorption - important with any non-animal higher-iron food), prunes, beets, dishes with kidney or black beans, and least 1x day take a couple of tbls of black strap molasses. By the time I went back for surgical admission, I was at a 13.4. Just enough that they didn't have to postpone surgery.

Also, if you do find you're anemic and need to take a supplement, you may have better luck with a liquid supplement rather than the pills. All the pill supplements that I tried seemed to 'stop up the works' and the liquid didn't seem to have as much of an issue with that.

[Bertha Venation]

4. thanks for telling me about the bluetooth-like device

I'd never heard of it.

I know the doc will test my blood for all kinds of things.

Thanks, woodsprite.

[woodsprite]

7. If you google or search on Amazon for "doze alert", you'll come up with lots

of versions of the device. I'd check into the reviews to see if some are better than others.

I hope you find a solution to your sleep issues.

[mopinko]

2. no advice really, just

i feel ya.

but, when was the last time you replaced your mask? and what does your machine say?

[Bertha Venation]

5. Hi, mopinko

thank you

Replace the mask about four months ago. My CPAP is kinda basic; has no display.

[mopinko]

8. there are other sleep tools out there these days.

my daughter has one of these and it also monitors sleep-
http://www.fitbit.com/flex


not that expensive, good for a lot of other fitness help.
i hear there are iphone apps, too.

feel better.

[NYC_SKP]

19. I won a fitbit flex and have been using it since December 5th. Love it!

And syncs to iPhon, pad, etc.

Merry Christmas!

[KC]

3. Have you

had your blood sugar tested?

[Bertha Venation]

6. Hi, KC

I am diabetic. Someone on another board reminded me of diabetes, and it was a huge "duh" moment for me. I haven't checked my sugar in years. I start again, in about 40 minutes, to test my postprandial sugar.

Thanks.

[KC]

9. Let us

know!

[Bertha Venation]

10. Well

I've tested my blood consistently since Friday, and find that my sugar is running high, sometimes very high. It's averaging about 80 whatevers above what it's supposed to be.

I expect to hear from my doctor today about my sleep study, and she'll want to see me. Obviously I'll bring this up.

Thanks, KC

[KC]

11. You're welcome

I want to have a sleep study done at some
point. My lack of sleep is bound to be
adding to my already high stress level.

[SlimJimmy]

12. The answer is pretty simple based on what you've said. Get your blood sugar under control and

many of your other symptoms will go away or greatly dissipate . And don't just test once postprandial, check first thing in the morning, after every meal, and before bedtime. Get on a suitable medication for control, exercise regularly, and/or use insulin to make fine adjustments.

Your health can't be left to chance. Diabetes control can't be left to chance. I've lost two relatives due to poor blood sugar control issues. Don't fall into that trap.

[Bertha Venation]

13. Hi, SlimJimmy

Thanks for this. I see my doc tomorrow morning, and I expect she'll put me on meds. I have to get my eating under control. When I was first diagnosed in '05, I counted carbs religiously and lost 38 pounds. Of course it's all back, has been for a long time, and I'm testing for the first time in I don't know how long. I know I'll do better if I can get my eating under control.

I'm sorry that you've lost people to this disease. I take it as a cautionary tale.

Thanks again.

PS I test upon waking and two hours after each meal. I'll add bedtime.

[SlimJimmy]

14. Good, glad to hear that you are taking it seriously. All the best to you.

[MrMickeysMom]

15. BV... How are you doing?

We don't talk much, but since my expertise includes sleep medicine, I thought I'd ask about your last sleep study results.

I know there are other issues to gain control over, but sometimes the chemicals that want your brain to stay alert beg a person to keep eating! Vicious cycle!

Best,

MMM

[Bertha Venation]

16. Hi, MMM

Well. My internist read the sleep study and referred me to a pulmonary specialist because at one point my oxygen was 83 (?). I saw a specialist last Friday and he was the worst doctor I have ever seen. (I don't have time to give details but if you want to know, I'll follow up at another time.) I wouldn't trust him with a dead dog. So I have to make an appointment to see a different pulmonologist. My internist said they might want a new sleep study. Terrific. I wish I knew how to read the damned thing myself.

It is a vicious cycle! And I'm trapped in it. I need serious relief on so many fronts. I am so very tired.

Thanks, MMM. I appreciate your kindness.

Edit - PS Being in sleep medicine, do you know anything about this new dental appliance for sleep apnea?

[MrMickeysMom]

17. Hmm....

I can't say that I have respect for every pulmonary specialist I've worked with (as a respiratory therapist), so I hope (maybe word of mouth?) will get you a better one. Regardless of who you get, why in the world would you need another sleep study? That tells me that they didn't get enough information (couldn't get you to sleep 4 hours or more) or couldn't apply positive pressure to the inside of your airway through the mask such that it resulted in showing what final pressure you needed to get quality sleep.

Oxygen saturation read through the fingernail should be higher than 88%. You may have needed oxygen titrated, which means that in addition to the pressure from the machine, you needed to have some flow of supplemental oxygen mixed into the CPAP or BiPAP pressures (BiPAP refers to a higher pressure during the "inhaling" phase.) The newer CPAP or BiPAPs also can self adjust (some nights you may need to have a little extra pressure and believe it or not, little tests during the operations will result in the adjustments you need for that particular night when maybe you're super somnolent.

Regarding dental appliances for sleep apnea, some devices are good, depending what kind of distance there is between the chin and the jaw (which is roughly the center of your airway). Some mandible advancer mouth pieces can achieve a more open airway, but they are NOT as effective as CPAP or BiPAP.
Here's a link worth a look: http://www.sleep-apnea-guide.com/mandibular-advancement-device.html

Just think.. with a good pulmonary doc, you'll have an explanation of this, and real quality sleep will lead to quality wakefulness!

[Bertha Venation]

18. "Just think.. "

Your whole last sentence -- + 1,000. Your lips to Bob's ears, MMM.

[mopinko]

20. i got the program that reads my chip.

it has a lot of info, and would probably really help you track down what helps and what doesn't.
the price was a rip-off at the time, and it didn't run on my mac. but these days you can probably get one that reports to your phone.
but i am feeling better finally after getting the data into my own hands. helped to titrate the meds, so i can sleep without being in a coma. (a good AD finally also helping. like cymbalta.)