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Ask The Sleep Doctor – Not improving on CPAP & Dying without sleep?

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Dear Dr. Rosenberg,

I have severe sleep apnea and have been on CPAP for three months. I don’t feel any better now than I did before. What do you think?

ANSWER:

First, you need to be sure that your machine is working effectively. Most machines come with a down-loadable smart card. Your physician should be able to review it and tell if your sleep apnea is being successfully treated. Second, not all people placed on CPAP will "feel better.” Up to 10% of those treated may continue to feel sleepy and fatigued. However, they are still getting the same benefit in terms of stroke and heart attack reduction that the other 90% get. So make sure it is working effectively and stick with it.

Dear Dr. Rosenberg:

Is it true that if you go for days without sleep you will die? I saw an episode of a television program where the sleep doctor said if you do not sleep for ten days "you die.”

ANSWER:

That is not true. In fact, in 1964, as part of an experiment, a man went 264 hours without sleep. He was fully recovered after 14 hours of sleep. This is another medical myth that has been perpetuated by poorly researched television programs. It is understood that most people would feel miserable with so little sleep. However, they are not going to suddenly slump forward and die.

Dear Dr. Rosenberg,

My husband has early dementia. He has trouble with his memory and organizing his thoughts and is becoming more and more frustrated with his condition. We saw a neurologist who ordered an MRI and he said it showed "white matter changes”. He said sleep apnea could be causing this and suggested a sleep study. What do you think?

ANSWER:

I think he might be on to something. White matter changes indicate damage to the part of the nerve involved in the transmission of impulses from one nerve to the next. Recent studies have shown that the incidence of these changes to be twice as frequent in patients with moderate to severe sleep apnea. These findings on MRIs have been correlated with an increased risk of stroke and dementia. Therefore, I would agree that a sleep study is a good idea. If your husband has sleep apnea and it is treated, then there is a good chance he could improve or avoid further deterioration.

Dear Dr. Rosenberg,

My husband likes to keep the room on the warm side. I feel that one of the problems I have with sleep is caused by the high room temperature. He says it’s all in my head. What do you think?

ANSWER:

Actually, room temperature in the bedroom has a lot to do with sleep and higher temperatures tend to elevate the core body temperature. This can make it very difficult to sleep for many people. It is the drop in core body temperature that is a major signal to fall asleep. Most people sleep best with room temperatures between 65 and 70 degrees. Surely, armed with this information you two can work out some type of compromise.


Robert S. Rosenberg, DO, FCCP, is the medical director of the Sleep Disorders Center of Prescott Valley, Arizona and sleep medicine consultant for Mountain Heart Health Services in Flagstaff, Arizona. Dr. Rosenberg is Board Certified in Sleep Medicine, Pulmonary Medicine, and Internal Medicine. His book Sleep Soundly Every Night, Feel Fantastic Every Day  is a best seller. Dr Rosenberg’s latest book is The Doctor’s Guide to Sleep Solutions for Stress & Anxiety. Visit Dr Rosenberg’s website www.AnswersForSleep.com which offers a wealth of information on sleep topics.

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2 comments on “Ask The Sleep Doctor – Not improving on CPAP & Dying without sleep?”

  1. I have been using cpap for more than a year, with mixed results, ahi ranging from 5 to 45. I have aortic valve regurgitation, EF 60, and right shoulder arthroscopic surgery with likely future replacement, making it difficult to sleep on either side, and have central apneas sleeping on my back.
    My last sleep study tried asv, and I had the worst night of my life, sleeping a total of 14 minutes (I think that was one second at a time.) It seemed that every time I fell asleep, I was instantaneously blasted with a hurricane and woke up. The technician tried various different settings with no success, and I finally gave up and went home. I have been reluctant to try the asv machine at home after such a horrendous experience. Ij'd appreciate your input on asv in my case.

  2. I have been being treated for severe sleep apnea with a BiPap for 14 months now and my ahi is still above 5. The average is about 7, but there are nights with ahi as high as 20. My doctor has made many adjustments in the pressure settings over the last 14 months, with little improvement.
    It also seems as if the Central apneas are becoming more prevalent. For the last 10 days, I have had substantially more centrals apneas than obstructive apneas.
    Are there cases that cannot be solved? If so, what do I do? and if not - what should I do?

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