New to this and need advice

[davjan4]

A short history first.
47 year old male
6'0''
178 lbs
Regestered Nurse by profession.
Diagnosed with Epilepsy at the age of 16, take Depakote for that. Seizure free for 20 years.
I had what the docs called anxiety attacks a few years ago. They manifested themselves as waking EXACTLY on hour after I went to sleep. I would be sweaty and it felt like I wsa outside of my own body. An unspeakable terror I would not wish on anyone and there are no words to explain the abject terror one feels. The last time I had one of these was 3-4 years ago. I'm on no meds for that.
A couple of years ago I started having what appeared to be apnea (awakening out of breath, taking deep breaths). I went to the sleep doc and he told me "sounds like you have central sleep apnea. Needless to say that scared the crap out of me. I had a sleep study done. The results were very mild (index of 10-12) obstructive apnea. He told me at that level of mildness I did not really have to do anything unless Iwanted to. He refered me to an ENT. The ENT decided I had reflux, and long story short, I probably do, so I just got back on meds for that. I tried a dental device (Somomed). The dentist told me that he had done 60 of those with 100% success. I was his first failure in that my index went from 10-12 to 32!. Insurance did not pay, but he felt so bad for me he gave me my money back.
Anyway I went back to the sleep doc and he looked at the sleep study results from the dentest and pronounced them "disturbing". Only one year had passed and I went from the 12 to the 32 index. I am going to borrow an autopap thi s friday 8-11-07 to try for three days, then he is going to download what it is doing and then talk with me to see what I need to do.
My symptoms are strange in that I stop breathing seconds after I go to sleep. I them awake gasping. It seems that when I finally get to sleep, that if I awake at night, like at 3:00AM, I can get right back to sleep and not be aware of any episodes like this. I have to take Sonota to get me past these episodes when first going to sleep so I can sleep at all. My wife tell me I gasp in my sleep. I do not snore much, but recently have been know to some, especially early in the AM (when I seem to sleep the best).
Have any of you experienced anything like this. It's really quite depressing, and I don't know what I'll do if the autopap does not work.

[Guest]

Welcome to the forum!

There's a wealth of information here and a few folks who also have issues with Central Apneas......thankfully, I'm NOT one of them.

You might look into some of the specialized BiPAPs that are designed to help treat Centrals. ResMed came out with a new one last year and Respironics introduced one this year. Respironics had previously had a model called the BiPAP ST.

Since an Auto CPAP can't recognize the difference between Obstructive and Centrals, they aren't necessarily a good choice for treating those. They tend to keep raising the pressures (depending on how they're configured)......which can exacerbate centrals at certain pressure levels.

Best wishes,

Den

[Guest]

Let me be clear that I have NOT been diagnosed with central apnea as of yet. The doctor supected it, but really should not have brought it up without any diagnostic data. The sleep study indicated at that time obstructive.
I hope that raising the head of my bed will help, but I doo't think it will. I have this happen even if I'm sitting up sleeping. I will post how it's going with autopap when I get it on 8-7-07. So you all should be hearing from me saturday.

[ozij]

Davjan,
Nothing is strange about your symptoms. Jerking awake just when you're falling asleep is one of the symptoms of obstructive sleep apnea. Some of us gasp and don't snore, and many of us woke up in anxiety, caused by the simple fact that they were being choked while they slept, and that is very frightening.

Your doc is wise to give an APAP (Auto PAP) study. Three days may be too little, don't let that make you give up.

For good treatment you have to have a comfortable mask - it takes a while for some of us to find that.

You have to sleep without leaking air - neither from the mask seal nor from your mouth.

And you have to find the correct pressure.

That's possible for some to achieve in 3 days - but it took longer for many of us.

Don't worry - you're on the right path, and eventually it will work out.

Welcome to the forum, and keep us posted.

O.

[Guest]

You mentioned you had reflux. (or the ENT did)
GERD can raise Hell with sleep and apneas, too.

Raising the head of the bed (as you mentioned) has been known to help with that, too. Others have relied on various medications for it.

Den

[TXKajun]

If/when you get your autopap, make sure the lower setting is at about 6 cm or so. Most folks report that if the setting is 4 (which most APAPs are set at), then it feels like they suffocate in the beginning....can't get enough air.

Good luck and welcome to the forum. Study here as much as you can to prepare yourself and you'll do just fine!

Kajun

[echo]

During my second sleep study (titatration with AutoPAP), the doc said I had two central apnea events - and I knew when they happened, because twice I was right about to fall asleep and I jerked awake (no terrors, but still very bizarre feeling; like anxiety) - I looked at the clock both times, and it matched with the doctor's identification of the central events.

Strange thing is that she didn't notice any centrals in the initial PSG study a few months prior - but she went back and looked again and there were a few there as well (also in the time period of when I was falling asleep)!!

She said it's possible that the central turns into an obstructive (I think this is a newly recognized form of apnea - Complex apnea, formerly called Mixed apnea?) - and perhaps the AutoPAP exacerbated it? After the first few days on CPAP, however, I haven't noticed any more central events while falling asleep. I don't have an explanation for this mechanism, just reporting my experience.

I don't know too much about mixed/central apnea, but found this online: http://www.medpagetoday.com/Pulmonary/S ... rs/tb/4034

I also sleep better in the morning hours (pre-PAP), and used to have reflux (solved by diet).

Perhaps others more knowledgable than myself will have better info for you on central / mixed / complex apnea.