British Snoring & Sleep Apnoea Association

Since I've had my CPAP machine (January 2012) I'm more tired and sleepy during the day than I was before. I've even started to have naps during the day - which I very rarely did before. I've spent my Easter holiday dozing all day everyday.

I can't say I'm sleeping better, although my husband said I look more restful when asleep. It took me a few weeks to build up to 6 - 7 hours of sleep - often with a wake up where I have to take off my mask and put it on again because of leakage. I used to have 8 - 9 but that was likely due to the tablets (below)

I wasn't like this before - I was tired but a lot of that had do with taking amtriptayline tablet at night and I have had to stop taking them with the apnea.

I also find that occasionally during the day I sort of stop breathing then I get a slight jolt across my chest and it reminds me to breath.

Is this all part of having sleep apnea? I am so tired and sleepy all the time.



Jegs

Did you come off the amitripyline gradually?

Hi Jeg, as Mountain said, did you slowly come of the Amitryptiline because a sudden stop in taking that type of medication can make you feel bad. From what I have heard, you shouldn't feel more sleepy when using CPAP, maybe you should get your settings double checked or see if the machine is faulty at all?

Hi,
You need the pressure on the machine to be higher ,you should not be sleepy in the day with cpap therapy if its working correctly.

You mention leakage on the mask that could be a number of reasons - poor fit ,straps too tight or too lose , mask seal not clean . Perhaps try adjusting the straps see if that works better or try another mask if possible .

In theory they say that everytime you sleep you should use your cpap machine even if its just for a quick nap.

Regards,

You haven't answered the question as to how you tapered your amytriptiline ... slowly and safely I hope. If not, seek advice on whether the way you have come off this medication has triggered unwanted side effects.

If your mask is leaking, turn your machine off, lie down, put the mask on and pull the straps gently and symmetically so that it is just sitting on your face gently and not hard against it. Then turn the machine on and see if the mask is more comfy. You don't have to have a rigid seal, just let the mask stay in contact with your face rather like the skirt of a hovercraft on water.

If it seems that you need to have the pressure increased DON'T DO IT YOURSELF. Go back to the sleep clinic, and get them to check your requirements again ... and perhaps suggest a better type of mask.

What's wrong with amitriptyline? I'm using it just now with cpap cos severe headaches ......?

Nothing .... as long as you are being treated at a correct dosage by a qualified doctor who knows your state of health, possible side effects, and who can support you when you are coming off this antidepressant, by being informed (hopefully also experienced) and having enough time available to see you regularly during your taper.

Oh right we'll they've never said anything like that. I've just to take it for 6months and apparently these headaches will disappear . It's 25g. Tablet each night .

I noted at my appointment that one of the questions is about morning headaches. I don't have them but this could be because I take 50mg amitriptyline evry night for pain. Maybe it is doing something after all.

OUCH ladies. Now I'm a bit worried about you ....



See the full article at http://en.wikipedia.org/wiki/Amitriptyline

It is fine that you are being given Amitriptyline for your headaches, BUT, and it's a BIG BUT from someone who was on antidepressant medication for 9 years and who had to taper for a year to come off it (so I think I have the right to voice my concern)

Whilst this medication can help with headaches, that's only a beneficial 'extra' from a medication designed to treat depression. Are either of you suffering from diagnosed clinical depression? Check with your doc!!

Also, you must be very careful coming off any antidepressant medication as it cannot be stopped abruptly without risking symptoms such as rebound depression and other most unpleasant physical and mental symptoms. This typ of drug can stay in your system for some time - a half life - and when the body doesn't get its daily 'fix'/dose, it can complain loudly and annoyingly until it gets used to the lack of it.

Speaking VERY generally, the longer you take an antidepressant, the more necessary it is to taper off gradually when it is time to stop taking the med. Not all docs are aware of this (not that they can be reasonably expected to know everything about everything they prescribe). Certainly - from my experience in the past -various manufacturers only base the information they give to their sales reps on a sample who took the drug for a MAXIMUM of 12 weeks, thus claiming no problems for the patient once the medicine is no longer being taken. Maybe now they have investigated the effects of stopping the drug on folk who have taken it over a longer period, but I would certainly be aware that after 6 months on amytriptyline, you could have some strange feelings when you stop it. Please discuss this with your doc ahead of time.

I'm not wanting to frighten anyone. But I had to find out by the school of hard knocks what happens when you take antidepressants ... I certainly needed them at first, but eventually found that I was strong enough to think about coping without them, and had to come off them very gradually to avoid problems en route.

Incidentally antidepressants CAN make you feel sleepier during the daytime too. At my worst, I was sleeping 18 hours a day. What a waste of time, but I was incapable of doing anything else!!

I have now been off antidepressants for 5 years. I needed them. They served me well. I 'got better', and now no longer need them - or at least at present!

PLEASE TAKE CARE .... and be proactive in your own health care.

Thanks for that. No, the doctor never spoke about any of that or coming off the tablets gradually. He says that my headaches may be caused by stress at work (going through various corporate restructures, and i'm having to do them all...!) but, to be honest i've had more stressfull situations than this in life and never had a headache. he said that these pills will prevent the headaches , and they do, i dont get them, but yeah - more sleepy during the day, but whatever i can deal with that if it means no headaches. dont like the idea of taking anti depressants when i'm not depressed though..................

Thank you for the info Alsa. I am still taking mine for FM pain, supposed to be at bedtime but I take them earlier so I am not groggy from them in the morning. I was briefly on a higher dose and had to cut down very gradually.

I am not depressed either.

Perhaps you should ask your doc why s/he's put you on Amitriptyline which is primarily an effective tricyclic antidepressant even though headaches can be treated with this medication. Perhaps there is something more suitable that could be prescribed JUST for your headaches. And your headaches should lift once you are diagnosed with OSA and compliant on CPAP therapy at the right machine pressure.

However, the Amitriptyline may be:-

AGGRAVATING your daytime sleepiness problems
ACCUMULATING in your body chemistry to the point where the brain needs its 'fix' to work to remove your headaches
TEMPORARILY relieving your headaches, that might be being caused by untreated OSA.

It may be worth pushing for a change in medication if you are feeling strong enough to deal with the changes, because you MAY need to taper slowly from the Amitriptyline if it has become a regular and necessary part of your body chemistry.

If you are not clinically depressed, why are you being treated with antidepressant medication?