cpap helping severe apnea but still daytie fatigue

[shelly62]

I have been having chronic fatigue for a couple of years. Past year got so bad I almost had several MVA's. Finally went in and was tested. Severe sleep apnea and PLM's (alot of them). Cpap at 10cm helped daytime fatigue and I am sleeping better but still aytime fatigue. Provagil helps but not with driving. Ritalin, adderal not helping with that yet. Still testing for Hypersomnia vs Narcolepsy. Repeat sleep study showed very little Apnea but still some PLM's. I also have some neurological symtoms going on for past few years some new ones have shown up. How often or can Sleep Apnea and PLM's be caused by MS. My concintration has gotten worse as well as my ability to multi task at work. Just can't seem to organize and actually got frustrated for the first time. Trouble with words eith getting them out or thinking of the word. I am wondering if there is a bigger picture here we should be looking more into. Can you  help with this question?

[Steven Y Park, MD]

You're in a difficult situation. It's the chicken or the egg question. Does sleep apnea cause MS or vice versa? Assuming that your CPAP numbers look good (compliance, leaks and AHI), then there may be something else going on. But before you look for other explanations, make sure that your CPAP therapy is optimal. If your machine doesn't have these reports, then consider asking for a model that has these features. An auto-adjusting machine is another option (that usually has all these reporting features).

[shelly62]

Thank you for your help. My numbers are great and the machine  and mask are all working fine. My machine is a new one that you can down load all the info onto the computer. No leaks and numbers where they should be. Pravogil and Adderall 20 mg twice a day helping the daytime fatigue but again not with driving and not with the consentration. Just testing the Adderall right now to find what works. 30mg didn't make any difference. Takes me three times to read something and then still cant remember what I read. Had to drop out of RN school with just 2 semesters left due to the problem with staying awake on the road and got too difficult to stay focused and  comprehend what I read. Any other things we should look for?