New, Severe, Really Concerned

[Jaso411]

I would also ask about GERD/Heartburn. Have you been diagnosed with this? I have had some similar issues of the waking up and gasping for air especially when I first fall asleep. Over the 7 years of being on a CPAP I started to put together it was actually food coming up that was causing a lot of my RERAs and AHI events. It did not matter what time of night it was, it would start most of the time right when I would go back to sleep. Even if it was not food coming up it could be caused from gas pressure and or Bile.

It in no way explains the entire list of things you have going on in this thread but I did notice a lot of similarities and thought it worth mentioning.

[NewToSleepApnea]

Thank you for all the help. Everyone. Especially you pugsy,you are going above and beyond.

Jaso411 - dont really have heartburn. I was intermittent fasting when this all started. So I didn’t eat after 8pm and went to bed around midnight everyday for a month or so when symptoms started. Dr thought it was that at first too. Gave me Omeprazole but it didn’t work so we stopped it.

Only medication I currently take is Vistaril (Hydroxyzine) 25 mg before bed to get drowsy and calm anxiety. Never had anxiety before and now it’s extreme. Was/is a cannabis user at night but haven’t since the episodes started. Been reading (and Drs said) mixed results with that and sleep apnea. Some say it could be great for it, others poor. Nervous to try it out again. Maybe using it most days the past months previous to this hid the symptoms? I take fish oil, B12, and a Magnesium pill in the morning as well. Lost 25lbs in two months (245 now) and you would think it would help!

Pugsy I will figure out how to compress the SD card and send it tomorrow. Thank you again for your help!

[NewToSleepApnea]

1st Half of Last night - Didnt feel like I ever fell fully asleep. Like Pugsy mentioned, I feel as if I was getting awakened before being full under.
The 2nd Half (starting around 2:35pm) I put in headphones and know I actually fell asleep for most of the sessions the rest of the night. Looks and Felt like a big Difference.

Graph of the whole Night

5-13-20.png (123.34 KiB) Viewed 6547 times

Graph of just the 2nd Half

5-13-20 - Actually Slept.png (120.73 KiB) Viewed 6547 times

[Pugsy]

Obviously once more soundly asleep things calm down considerably.

I am thinking just work on sleep quality itself and trust me....I know that's easier said than done. Been there and done that myself.
It's a war that I only win a few battles in and never totally win the whole war.

Take a hard look at anything and everything that might be a factor in your sleep quality.
Sleep hygiene habits...good and bad...external factors like comfort.
Remember the machine only knows to record and respond to air flow irregularities and our awake breathing really does cause the machine to flag and do things to those irregularities but in terms of OSA therapy....awake stuff just doesn't count.
CPAP machines can only fix bad sleep when the bad sleep is caused by real OSA issues.

I suggest just giving yourself time to work on sleeping more soundly. I am fairly confident if I saw your flow rate up close what I would see is a lot of just crappy sleep quality preceding the flagged events and that would mean they aren't real asleep events.

[Pugsy]

I have the SD card contents in my OSCAR software. It is pretty much exactly as I expected which is both good and bad I suppose.
I have included a few snapshots below so you can learn what I was looking at and why I feel the way I do about things.

You never really went to any sort of sleep status until way late in the night...all the stuff prior to 01:45 (I didn't know your time zone so your times might be off...I just picked CST in USA) is all arousal/awake related SWJ...sleep/wake/junk...not real asleep flagged events and thus other than pointing to crappy sleep for some reason...we ignore it.

All the flagged events prior to 01:45....not real asleep.

Probably at least 90% of the flagged events after 01:45 aren't real asleep events. You had a LOT of arousal/awake breathing going on even once you finally went to sleep. Now why your sleep quality is in the toilet...I have no way to know but I just don't see it being OSA related or sleep disordered breathing related. Nothing real OSA related happened prior to any SWJ stuff to blame the arousal on a real apnea event of some sort.

If this were my report....I would be looking to add some sort of OTC sleep aid as first thing to try to see if I could improve on the staying asleep part of things. You have both sleep onset insomnia as well as sleep maintenance insomnia going on.


This is what asleep breathing looks like. Nice and regular and rhythmic.

chrisasleep1.JPG

The flow rate after the area circled in red is all arousal/awake related breathing...anything flagged during the irregular breathing isn't a real asleep flagged event....let's just call it SWJ

chrisarousals.JPG

This one below...same thing...anything flagged after the red circled asleep breathing is SWJ

chrisasleep.JPG

This one below is all arousal/awake breathing related. You may or may not remember being awake but you for sure weren't asleep.

chrisawake.JPG

[Pugsy]

I see no reason to go changing any of the settings at this time.
We can't fix bad sleep with more pressure if the bad sleep isn't related to an apnea event and yours just don't point to real apnea events causing the bad sleep.

I really didn't see any real apnea events of any kind on the report from last night and I went through the entire night's flow rate zoomed in up close. Might have been a couple of maybes or iffy ones but they weren't clear cut and a couple wouldn't cause all this mess.

[NewToSleepApnea]

Man, this is both encouraging and discouraging.
I've tried to tell Drs from the start that this has not been the same symptoms that other people I've spoke with have. (That have sleep apnea.)

So based on this, it doesn't look like sleep apnea at all? But some type of waking arousal issue?


*I know that this problem definitely feels as if I stop breathing and my heart skips a beat. Thats all i know from symptoms. But that is the thing that came out of nowhere and killing my sleep/life.

[Pugsy]

Refresh my memory....have you ever had some sort of diagnostic sleep study either at home or in a lab?

[NewToSleepApnea]

At home sleep study. Said only mid 20's AHI.

But my first two nights on the machine with Easy Start on, had me around 45 AHI.

Its always been the only thing that bothered me was the Sudden Gasping for air Arrousals and the drop in O2 during sleep.

[Cardsfan]

For your peace of mind, you could get a KARDIA heart monitor. When you wake up in distress, use it to test you EKG. It records and stores the info. so you can show it to your dr. I believe the company is called Alive Corp. My cardiologist recommended it. www.alivecor.com.

[NewToSleepApnea]

I may do that. I wore a 24 hour heart rate monitor and it came back with nothing abnormal.

I sometimes wear a pulse oximeter to bed recently. When I have these episodes, my O2 level drops between 75-88. Supposedly that means it isnt Hypnic jerks or anything.

[Pugsy]

I sometimes wear a pulse oximeter to bed recently. When I have these episodes, my O2 level drops between 75-88. Supposedly that means it isnt Hypnic jerks or anything.

If you do wear the pulse ox again and see those drops again...look closely at the drop and consider loss of contact artifacts as a cause.

I didn't see any prolonged reductions (asleep or awake) in respiration on your flow rate that would even remotely cause any drop in O2 levels much less a drop of that magnitude.

[NewToSleepApnea]

Sorry this was before the CPAP machine! Now with the CPAP I think Ive only been down to low 90's. I havent worn the pulse oximeter much since getting the CPAP.

[Pugsy]

Sorry this was before the CPAP machine! Now with the CPAP I think Ive only been down to low 90's. I havent worn the pulse oximeter much since getting the CPAP.

Ahhh...okay....that makes sense then. Real drops pre cpap but should be fixed with cpap. My O2 went to 73% pre cpap but other than normal minor drops during sleep I never had another drop.
It is normal to see a 3 to 4% drop during sleep from the baseline average. It's simply normal because we just don't breathe as deep or as often when we are asleep. So a little bit of a drop is no big deal.

It takes a lot of no breathing to cause the O2 to drop...either a whole bunch of short lived real apnea events or a few massively long events. Random real events won't cause a change in O2 levels in normal lung healthy people. I have tested it...I tried holding my breath as long as I could wearing the pulse ox and at nearly a minute there wasn't a change while awake in the O2 levels.
Now if I did that 45 second holding my breath once a minute for 10 minutes...then it probably would have changed.

[NewToSleepApnea]

So I can’t fall asleep tonight. Every time I try I get this weird feeling in my whole body that I’m not breathing. That’s when I look at my pulse oximeter and it says between 92 and 89. How is that possible wearing a CPAP?

If that is possible - is this okay? It’s freaking me out a bit because I haven’t read anywhere that being below 90 is okay to go to sleep.