Sleep Medicine Specialist Questions BiPAP machine

always tired

I have been using bipap for about 5 years, and even though it never made me want to jump through hoops like some people said it did for them, it did help. But now I use it EVERYTIME, I sleep but now I am exhausted for much of my life.

I go to sleep tired and wake up the same, my doc says there is not much that can be done. I have a regular high setting now and any higher than that, my mask leaks. He says I have one the best masks around, so I'm just looking for another opinion, I guess. He also says I am not a candidate for surgery. He says that won't help me, something about the back of my tongue and nothing can be done about that

Male | 63 years old
Complaint duration: 2 years
Medications: high blood, heart meds
Conditions: a/f heart- high b/p

2 Answers

Option 1: Repeat the sleep study and titration.
Option 2: A week trial of Auto-bipap to determine the pressure requirements. Mask leaks are a problem, this needs to be addressed as a priority.
The first thing to do here is to be sure you're getting enough sleep. For some people that's a full 8 hours. Assuming there is enough sleep, the next thing to do is to look at the data recording from the BiPAP machine. Virtually all modern machines are able to track whether apnea is suppressed. If apnea is not suppressed a formal laboratory study would probably be appropriate. If it is suppressed and there is no shortage of sleep time, about 10% of sleep apnea patients will remain sleepy. There are FDA approved medicines for this.