104: Don’t just look at the CPAP numbers!

Getting the diagnosis of sleep apnea can be a relief– FINALLY, there is an explanation for why you are so tired during the day!  

Now that you’ve been using your CPAP machine, it’s time for reassessment.  

• Is your sleep apnea fixed?  Are you able to use CPAP nightly, and throughout your sleep period?
• Does your sleep quality seem fixed?  
• During the day, do you feel awake?  Alert?  Energized?  

If the answer to any of these questions is no . . .  you’re probably wondering if CPAP is worth it.  

I can’t tell you how many times I’ve sat across from someone like you in my clinic.  And when you say “I’m using CPAP but I’m still tired” I believe you.  And I know you are feeling discouraged.  

But I’m not.  My mind is busy with all the possibilities.  What discourages me is that solving “tired” is often too much to review in a short medical appointment.  

One of the MOST COMMON reasons that you can still be tired despite using your CPAP machine is this:  your sleep apnea is UNDER treated.  

If you’re only using CPAP for part of the night, you are most likely getting low-quality sleep when it’s off.  Don’t be satisfied with 4 hours of CPAP use!  The machine can only report what’s happening when you are using it. 

Slow-wave (deep) sleep happens in the first half of the night.  REM (dream) sleep is more dominant in the second half of the night.  You don’t want to let your sleep apnea get in the way of either of these important sleep stages.  

Not using CPAP in the second part of the sleep period is more common–if you take off your mask in the middle of the night, you leave your REM sleep vulnerable to untreated sleep apnea.  The majority of your REM sleep is interrupted by airway blockage and drops in your oxygen levels.  

Without high-quality REM sleep, you will feel tired.  And your sleep quality is DEFINITELY not as good as it could be.  

Bottom line:  Your sleep apnea is active when you are sleeping without CPAP.  For maximum benefit, use CPAP throughout the night.  If you’re having trouble with this, I’ll invite you to consider my Ultimate CPAP Mask Course.