Fatigue and sleepiness are common symptoms of OSA. Elimination of these symptoms usually begins as soon as CPAP is started. Studies have suggested that the maximum effect is achieved in about 2 weeks. For unclear reasons, some patients have persistent sleepiness despite good adherence to CPAP. Stimulant medications may be appropriate for some of these patients. Consult with a sleep medicine expert if you suspect this. However, remember that CPAP will not make up for insufficient sleep.
If you have been using CPAP for several months and are still struggling with becoming comfortable with it, do not feel discouraged. I see many such patients. You are not alone. Here are several suggestions to consider:
* Make sure the mask is comfortable and the humidifier is working;
* Treat nasal congestion with heated humidification or nasal medications (consult your doctor about this);
* Emphasize the positives you have noted about your sleep since starting CPAP; patients who struggle with therapy often lose track of some of the good things they have noted since starting this therapy;
* If mask claustrophobia is interfering with your becoming comfortable with CPAP, try desensitization training. The goal of this is to get you so accustomed to the CPAP mask and pressure, that you forget it’s on your face. Start with short periods of time while awake and doing something that is distracting – such as watching television. Gradually increase the time you wear CPAP. Continue using CPAP while sleeping while you desensitize to it while awake. Start with 10 minutes and build up from there.
* Set goals for yourself. Just as you would train for an athletic event, train yourself to use CPAP. Start with 2 hours per night. Add another 30 minutes per week until you are sleeping with it all night long.
Finally, if these tips do not help, consult your physician. He or she may have other ideas to consider.