Pre/post CPAP performance

I have just been diagnosed with severe sleep apnoea and, to be honest, I’m pretty stoked about it. I had to act cool and contain myself when the Doc read the study results to me.

I’m stoked because my recovery and performance will (hopefully) get better with a CPAP machine, and because it explains so much about my need for 9-10 hours of sleep just to stay ontop of things.

I’m wondering if there’s anyone else who has gone through this and can share some insight into how/if their performance changed after using a CPAP machine.

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I also have sleep apnea and insomnia. When I sleep well (which is rare due to the insomnia and waking up frequently) I’m a completely different person. I’m able to hammer out the workouts and tough rides and feel great afterwards. CPAP will help with the apnea but insomnia is another matter altogether. The best bet is to try to keep as consistent sleep schedule, avoid caffeine within 6-8hrs of bed time, limit electronic device use before bed time, etc. There are tons of useful resources online but its sometime hard to sort through the crap to find the good stuff. Several TR podcasts have gone into sleep but I can’t remember which ones. I agree though, its pretty liberating to figure out why you always feel like crap!

I have absolutely no problem getting to sleep or getting enough hours. My sleep hygiene is pretty nailed. It’s the obstructive sleep apnoea that’s the problem.

I’m just interested if anyone has before and after fitness changes when they’ve been able to recover more efficiently.

I don’t have sleep apnea but it does seem logical that you would have better recovery. Probably also a greater feeling of wellness.

That’s really cool I hope you do a follow up post. I’d be interested to see how the HRV works for you. I’ve been thinking about it myself but haven’t pulled the trigger yet

@comicdans.ms I ’d be interested to know your state of physical fitness. I was diagnosed after my deployment from Afghanistan in 2015. We inhaled some nasty stuff over there, and after taking 86 rockets on our compound in 6.5 months, we didn’t sleep much either. I’m in great physical shape, and I thought this was a “fat man’s” diagnosis.
Here are the benefits of my CPAP:

  1. I can stay awake and keep active
  2. I don’t snore anymore
  3. Not exhausted anymore. No matter how much sleep I got, I was absolutely exhausted

Here are the downfalls

  1. I can get bloated. The farts are phenomenally awesome. I can wake up sometimes with a stomach pooched out that literally makes me look pregnant. This isn’t a daily thing, but sometimes it can be painful
  2. Red marks around my face (this goes away after being awake)
  3. See number 1, but the diet can help with this. If I eat beans, or eat like crap, I will most definitely wake up with a painful bloated stomach

I can get away with not wearing my mask every night. Matter of fact, didn’t wear it last night, and did a TR brick workout today. I think with a good fitness base, comes the ability to not use it nightly.

The best thing about being treated: my blood pressure was 195/105 prior to treatment. I am 37-years-old, and on a higher dose of bp pills than my folks are on. The CPAP allows me to not take my pills (my blood pressure is now 115/65 with a pulse of 70 give or take). This is serious shit.

The mask will be on the ground when you wake up for the first few weeks to a month or so. This will go away, to where it won’t bother you. Trust me on this. EDIT: the CPAP also “cured” my restless leg syndrome. I’d make up in the am feeling like I did 1000 body weight squats

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I’ll post up the before and after HRV data. I use an Emfit QS under my mattress which tracks it throughout the night so will be good to see. It’s never been as high as other trained athletes in studies I’ve read. It might just be down to personal values, but maybe it is the OSA.

Thanks for your post! Super enlightening. I’ve always had pretty ok responses to training. Have used trainer road for 4 years and last season I was around 325w/4.7wpkg. This year I’ve made mistakes with over reaching and then a period of undereating and being too concerned with weight. I’ve moved past that but have put myself in a hole that I’m trying to dig myself out of (which is hard with the race series starting in 3 weeks). Recovery times are pretty bad. I’m still way fatigued on Tuesday after a typical Sunday workout, and struggling to finish VO2 workouts. And I’m having trouble with anymore than two weeks of proper training. I’m putting this state I’m in down to the mistakes I made, exacerbated by the sleep apnoea. I’ve started to listen to my body, not train if I don’t feel like it and stop the workout once I can’t hold the numbers.

Currently around 300w when I was 320w or so this time last year. I want to get a cpap machine sorted asap to hopefully get myself ok for at least the last half of the race series that goes for a couple of months.

@comicdans.ms this cpap is a game changer, let me tell you. You will be pleasantly surprised

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@comicdans.ms what are your numbers from your sleep study? What does your blood pressure look like?

Arousal index was 25 times per hour.
AHI was 30.2 events per hour.
Oxygen saturation went down to 87%.

I don’t know my blood pressure numbers. It’s always good though when the Doc takes it for whatever reason. I want to get bloods and endocrine levels taken before I start on the CPAP and then again a few months later. Will post all of whatever I get done.

I have sleep apnea (RDI some place in the high teens) and have been using a CPAP since 2010. While I have been cycling for almost 20 years, I don’t have pre-CPAP data for comparison. However, I can tell you anecdotally, that there is a HUGE difference of getting high quality sleep vs. not, even on substantially fewer hours. And beyond performance, there are major health reasons (i.e. getting oxygen to your brain) for getting your sleep apnea issue addressed. You did not mention your age, but regardless of age, with an AHI of 30, even with 9-10 hours, that isn’t a restful sleep. And thus, you have a good reason to be elated about the findings.

The CPAP I am using is the Philips Respironics. I previously used the ResMed (the other popular brand), but I like the Philips for the online app it provides (and a few other features). Below is a sample screenshot of AHI over a 60 day period. The “DreamMapper app” also provides screens for usage (#hours of sleep) and mask fit (%). As you can see from the screenshot, you can get single day, 14, 30, 60, and 90 day views. And if you are deeply analytical, since CPAPs require a prescription, the CPAP provider for Philips can provide you with a full detailed report showing each apnea and hypopnea event (I got that report when I first started using it, but don’t bother anymore). Bottom line, getting your sleep apnea issue addressed is a game changer, not just for performance, but your health.

Feel free to PM me if you want to discuss further.

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Ah cool! I like analytics so that’ll weigh in on what I buy.

I’m 33, 6’1, 67kg/147.7lb

I don’t have any pre-CPAP data either, but can tell you that it made me feel like a new person. I started dreaming regularly for the first time ever and woke up feeling refreshed, rather than dragging. The biggest difference for me is in energy levels and motivation. Prior to the CPAP, it was hard to get motivated to do anything, because you’re always so tired. No I have the energy to ride regularly, which breeds fitness, which gives you more energy - it’s a virtuous circle.

My one piece of advice is that there are a variety of types of masks. If you don’t do well with one type, get another and keep experimenting until you find one you like.

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Great thread and appreciate the discussion.

FWIW - Married to a sleep physician and pulmonologist. Obstructive sleep apnea impacts about 30+% of the population and risk increases with age (and yes BMI but not solely a disease of obesity). It not only affects sleep quality and recovery but also contributes to weight gain, cortisol, mood, cognitive function, male impotence and risk of atrial fibrillation, stroke and MI.

Diagnosis is easier than it used to be, some can even arrange home tests pre/post- device and optimize settings. I figure If I am willing to drink beet juice, pomegranate extract, do ice baths and sauna for marginal gains, then this is a clear win.

Great discussion.

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@comicdans.ms they are pretty much all the same. Mine is a Resmed Airsense 10 autoset. Mine has the same type analytics with an app to track it all. Point is, one is not any better than the other these days. Technology has come a very long way. Mine, as I’m sure is true with others, will give me more (or less) air depending upon my needs as I sleep. I haven’t used my CPAP in two nights, and I’m feeling it today. My lower back and hips are nagging at me, because I slept crazy last night. I need to stop this nonsense and wear it nightly…

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@comicdans.ms you need to get with @Schmedlapp before you buy. His wife is a subject matter expert on this. Note: I’m not being a jerk here…I’m being serious. It’s hard to see body language and tone via text

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Diagnosed with sleep apnea last September. I started CPAP use following a septoplasty/turbinate reduction surgery in November. It took me about two months to adapt and find a mask that worked for me… I slept well for about three weeks, then my daughter was born and I stopped using the CPAP for about a month. Once I got back into the swing of things, I noted a marked uptick in restful sleep.

I’ll say this: it makes a difference, for certain. I don’t have in-depth analytics, but anecdotally, I can tell you that my ability to comply with sustained power workouts is improved when I get good sleep vs. when I don’t. I had two consecutive nights of poor sleep Thursday and Friday nights, and Saturday’s Palisade was “failed”. I experienced similar failures during Sustained Power Build after my daughter was born.

So, I think you can expect that your ability to comply with your training plan is going to improve, due to improved recovery. That said, I wouldn’t go into your training expecting to be able to train at a higher FTP immediately because you’re sleeping better. The effect of the improved sleep will pay off in improving your training process… but it’s still a process. It’ll allow you to push higher than before with reduced mental fatigue and improved recovery, but the tangible payoff is going to take a period of weeks or months.

I have the ResMed Airsense 10. It also offers the online sleep tracking and analytics. I’ve been very happy with the combination of that CPAP with the dreamware nasal pillows. I don’t see a need to tape my mouth shut, personally… I just hold a pillow and support my lower jaw with it, no issues.

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YMMV but she offered the following:
No one device has been shown to be consistently better than another. The most important factor is compliance (kinda like a training plan). Ramp rate can make it more tolerable as you get used to it. Humidification chamber can make it more comfortable, nasal pillows may be more comfortable than a full face mask (provided you don’t get a leak through open mouth). Nasal mask if pillows don’t don’t seal (but still caveat for open mouth leaks). Oral devices have defined role for mild/moderate OSA, but it should be specifically fitted and confirmed to resolve obstruction based on follow up study. Not all are the same and they are not one size fits all. Surgical intervention (UPPP uvulopaletatoplasty) not shown to improve the disease and complicates CPAP tolerance for future care.
Good luck. Get a good sleep doctor. Your body and health a well worth it.

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Such good replies here. Thanks all for all the posts!

I’m so keen to meet with the specialist and get a trial unit sorted ASAP. In Australia we are given a 3 month trial covered by Medicare.

Hoping I can get my fitness to where it will be useful for at least the last part of a team series starting in a few weeks.