You Just Started Treatment
The amount of time it takes for CPAP therapy to work differs from one person to another. If sleep apnea is severe prior to treatment, the improvement may be more obvious. On the other hand, when the symptoms are mild, it may take longer to notice any changes.
Keep in mind that it can take several weeks before you feel the impact of CPAP therapy. Perseverance, support, and regular contact with your healthcare provider will help you cope with the transition. In time, you may not only feel the benefits of CPAP but see the benefits on your AHI report and with improved blood pressure readings.
If you are not noticing any improvement, speak with your sleep specialist about ways to adjust your therapy to work better for you.
Mild Sleep Apnea
Excessive daytime sleepiness is a common symptom of untreated sleep apnea. However, not everyone has this symptom, and many wonder why they should go through the hassle of CPAP if they don’t feel any difference. This is especially true for people with mild sleep apnea (defined as having between five and 14 breathing interruptions per night). At this level, many people have little, if any, daytime sleepiness and score low on the Epworth sleepiness scale – meaning they don’t need treatment for daytime sleepiness.
CPAP Benefits for Mild Sleep Apnea
Even with mild sleep apnea, CPAP can benefit people. It may not be as noticeable, but it can still improve vitality scores and overall health. A 2020 study in Lancet Respiratory Medicine found that people treated with CPAP had better vitality scores than those who were not treated. At the end of the three-month trial period, those treated with CPAP had a vitality score of 7.5 out of a possible 10 compared to 1.5 for those who were not treated.
You’re Not Using It Long Enough Each Night
It can be hard to adjust to CPAP therapy. You may want to remove your mask, especially as it gets closer to the morning. The problem with this is that sleep apnea often gets worse as morning approaches.
Ramp Feature
If you still find that breathing against the air pressure is difficult, ask about CPAP machines with a "ramp" feature. This allows you to start at low air pressure and gradually increase as you fall asleep.
You’re Gaining Weight
In the past, CPAP was thought to lead to weight loss. Recent studies suggest that may not be the case, and people often gain weight, particularly around the midsection. Many people call this "CPAP belly." There are some theories as to why this occurs. It is thought by some that when you have sleep apnea, your body burns up a lot of energy as you struggle to breathe. When your breathing improves with CPAP, you burn fewer resting calories and can start to gain weight.
When to See Your Sleep Specialist
If you continue to feel tired when using a CPAP machine, see your healthcare provider or sleep specialist. Your machine may need an adjustment, or you may have an unrelated condition. Other health conditions can occur alongside sleep apnea and cause insomnia, including restless leg syndrome, anxiety, or depression.
Alternatives to CPAP
Other ways to manage sleep apnea may include:
- Weight loss
- An oral appliance or other type of device to help with breathing
- Experimenting with different sleep positions
- Medication
- Surgery to remove enlarged tonsils (tonsillectomy) or to fix an elongated palate or enlarged uvula (uvulopalatopharyngoplasty)
Summary
If you are using CPAP therapy but still feel tired, there could be several reasons why. It’s possible that you haven’t been doing the therapy for long enough, you are removing your mask during the night, your pressure needs to be adjusted, or your symptoms are mild. It may take several weeks of proper and continuous usage before you feel the results of CPAP therapy. If you haven’t noticed any changes, be sure to speak with your healthcare provider. There is a chance they may diagnose you with another underlying medical condition or complex sleep apnea. In these cases, other treatment methods may be used.
