Could daytime sleepiness be caused by sleep apnea?

Question

Hi doctor,

I am wondering about the connection between my excessive fatigue, sleep issues, and potential cardiac insufficiency. I experience excessive sleepiness due to mild sleep apnea, but I feel a strange disconnect when it comes to exertion. Even light anaerobic activity causes shortness of breath, and it takes time for my respiration rate to return to normal. When using an elliptical machine, I struggle to get my heart rate up to 110 beats per minute. However, when I take Lisdexamfetamine, I can easily reach a heart rate of 125 beats per minute and recover immediately after stopping. My blood pressure is 130/88 mmHg. Currently, I am taking Enalapril, Hydrochlorothiazide, Amlodipine, Levothyroxine, and Fluoxetine. These issues preceded my daily alcohol consumption and occasional cannabis use.

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Yes, daytime sleepiness occurs due to sleep apnea. If present in its severe obstructive form, it can lead to a range of cardiac conditions, such as atrial fibrillation, coronary artery disease, and heart failure. Exercise intolerance may initially develop as a consequence of early heart failure. Additionally, at your age, you may be experiencing chronotropic incompetence, which is the inability to increase heart rate with exercise. Regular graded exercise can help improve this. It is also important to avoid alcohol and cannabis.

I hope this helps you.

Thank you.