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Suggest remedy for sleeplessness caused by sleep apnea

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Posted on Tue, 24 Nov 2015
Question: I do have sleep apnea and use a CPAP every night and have for many years. Still having problems getting restful sleep, wake up frequently, My wife says I toss and turn all night. Wake up tired. A second issue...not sure if related or not, is the fact that during the day while awake I have what appear to be involuntary deep breaths. Its almost as though my breathing is shallow and I need to catch up every once in a while. Not causing discomfort...just strange. Can you advise what this might be, as well as the apnea related issue (could my setting be wrong on CPAP)?
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Answered by Dr. Alexander H. Sheppe (37 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Thanks very much for your question.

There are a few things that could be going wrong here. First, it may be that your mask does not actually fit as well as it could. This could lead to leaking, which could make the CPAP work less efficiently. Second, it may be (as you suggest) the pressure settings on your CPAP are not adequate. You may need a higher positive pressure applied. Third, it may be that you can central, rather than obstructive, sleep apnea. Central sleep apnea is rarer, but this could explain why CPAP is not working, and why you are having the sensation of needing to take deep breaths during the day. Alternatives to CPAP include BIPAP, the medication Diamox, or a surgical intervention by an ENT. I would get another polysomnogram (sleep study), even if you have had one within the last few years, to get further diagnostic and treatment clarity.

My name is Dr. Sheppe, and I am an XXXXXXX psychiatrist working in New York City. For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2242 Questions

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Suggest remedy for sleeplessness caused by sleep apnea

Brief Answer: Consultation Detailed Answer: Thanks very much for your question. There are a few things that could be going wrong here. First, it may be that your mask does not actually fit as well as it could. This could lead to leaking, which could make the CPAP work less efficiently. Second, it may be (as you suggest) the pressure settings on your CPAP are not adequate. You may need a higher positive pressure applied. Third, it may be that you can central, rather than obstructive, sleep apnea. Central sleep apnea is rarer, but this could explain why CPAP is not working, and why you are having the sensation of needing to take deep breaths during the day. Alternatives to CPAP include BIPAP, the medication Diamox, or a surgical intervention by an ENT. I would get another polysomnogram (sleep study), even if you have had one within the last few years, to get further diagnostic and treatment clarity. My name is Dr. Sheppe, and I am an XXXXXXX psychiatrist working in New York City. For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers