Hi, I was diagnosed with OSA ~10 years ago and have been using a CPAP ever since. (I recently got a new one; it’s a Resmed Airsense 10). I don’t really recall my earliest sleep test results, but I just remember I was having multiple interruptions a minute which went down to ~0 once I had a CPAP. My current AHI data look good (.7) and my partner reports no gasping or snoring. By all accounts, my CPAP therapy is just working like gangbusters.

I have also had a serious fatigue problem which is getting worse and worse. I have to nap (or try to nap) every day, my energy levels are very low, and I have trouble concentrating. This is becoming debilitating.

I do NOT have the chronic pain that would be associated with fibromyagia or chronic fatigue syndrome. Blood tests reveal no vitamin deficiencies. I don’t really have any other symptoms. I haven’t noticed any other obvious sleep disorders, like restless legs.

I currently take Effexor for anxiety, and I am very happy with its effectiveness and would strongly prefer not to go off it.

My most recent sleep test was to get the new Resmed, and the results were somewhat odd. I spent some time in REM, but no time at all in Stage 4 sleep. I would not necessarily assume this is typical (the sleep study was obviously under odd conditions, and at a strange time of night) but it is noteworthy.

My doctor assures me that the only real therapeutic option is wake-up pills, and he’s prescribed modafinil, and now sunosi. Neither has helped my fatigue in any noticeable way. My doctor actually says this is a thing: a certain percentage of OSA patients get their OSA treated, but the fatigue never goes away. Looking him up, he’s actually pretty esteemed in the sleep science community, but his attitude here surprises me.

Does anyone have any thoughts they think might help?

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