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What Causes Chronic Fatigue When Diagnosed With Sleep Apnea?

Posted on Wed, 14 Jun 2017

Question: I have been having chronic fatigue for sometime, at least 3 years. I was diagnosed with sleep apnea. Even when I use the mask on a regular basis, I never feel refreshed. In the morning I feel like I haven't slept even though I have, no refreshing feeling. I am currently being tapered off very gradually narcotic pain meds and benzodiazepines. When I walk up a good flight of stairs my legs burn, and I am breathing heavy. This has been getting worse in the last month. I can cut the grass and go for good walks, which always feels good even though I have to push myself to do these things. But this fatigue is getting crippling and slows me down from most activities I enjoy. So not sure what's going on. Ps. I was diagnosed with Fibromyalgia as well as PTSD due to childhood sexual abuse and I am seeing a psychologist for CBT. I hope you can give me some insight to what may be going on. I have no chest pains or heart issues in the past. Thank you for your time. I am 58 male 6'4" and generally healthy.

Answered by Dr. Alexander H. Sheppe (14 minutes later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

I have a couple thoughts. First, sleep apnea is the most likely cause here, and the most likely problem is that the mask you are using does not have an adequate seal when you are asleep. This is a common problem. Visit a doctor to get re-fitted for a mask of the appropriate size and shape. Second, you may be depressed or fibromyalgia may be getting out of control and either would benefit from using an SNRI medication such as Cymbalta. Talk to your doctor about trying it.

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In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Alexander H. Sheppe (1 hour later)

Thanks. The mask issue has been addressed, and is not currently a problem. As to depression i forgot to mention i was on escitlopram. Although i have not been using my mask much in the last week the two weeks preceding it i used it nightly, and no effective results. My sleep studies show that it does signifigantly lower the apnea, which with both types. The specialist said as I tapered off the pain meds i would feel better and have much less apneas. However i am three weeks past the last narcotic and benzo decrease, so the withdrawl symptoms have come back to baseline. I was on very high doses of fentanyl patch and hydromorphone. Now i only take 4 4mg hydromorphone per day. Knowing this does it change your diagnosis?

Answered by Dr. Alexander H. Sheppe (1 hour later)

Brief Answer:
Followup

Detailed Answer:
This is useful information, but I still feel the sleep apnea is the largest issue. You say you have not been using your mask much in the last week -- it takes several weeks of continuous use for the best results. I would clarify with a doctor if the mask actually forms an adequate seal, as oftentimes they do not even when they appear to.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

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Above answer was peer-reviewed by : Dr. Prasad