I have been on CPAP therapy for 9 years, have done numerous sleep studies, one just last year and still can't sleep a full 4 or 5 hours a night. Is there anything that can be done? I experience severe daytime sleepiness.
Doctors Answers (2)
If you are unable to wear or tolerate a C-Pap for your obstructive sleep apnea then consider an oral appliance for it. Before further treatment is done you need to maintain good sleep hygiene. This means:
- • Maintain a regular sleep schedule, even on days off and weekends
- • Go to bed only when sleepy
- • If you are unable to fall asleep after 20-30 minutes, get up and do something quietly in another room. When you become sleepy again, return to bed.
- • Avoid falling asleep anywhere other than your bed.
- • Develop healthy habits while preparing for bed such as a warm shower, reading or a light snack.
Your question regarding your CPAP not working suggests that you are having difficulty tolerating CPAP therapy. The CPAP machine is presumably not broken? Many patients are prescribed CPAP machines with "fixed" pressures. Let's assume your CPAP pressure is set at 10 cm H2O. If you are in a stage of sleep or a body position which may require a CPAP pressure of only 6 cm. of water pressure you will get 10. If you require a pressure of 12, you only get a pressure of 10. This may not be your problem but is a common issue. This is corrected by changing to auto- titrating CPAP which adjusts to your needs. Having used CPAP for 9 years you should have adjusted to many of the common irritations. It is difficult to understand why you have had so many sleep studies. The auto titrating units often obviate the need for multiple sleep studies. Other issues, however, may be the reason. Central sleep apnea, for example, can complicate treatment and Bi-level units may be more effective. A sleep aide may be indicated for a period while you adjust to CPAP. About 15% of sleep apnea patients remain sleepy after successful CPAP therapy. (If your treatment is truly therapeutic). A stimulant to promote wakefulness is suggested (for quality of life and for your safety and the safety of others). You may need to seek another opinion.