Unusual Sleep Arousal

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
starbuck
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Unusual Sleep Arousal

Post by starbuck » Mon Nov 30, 2015 12:39 pm

I have been an APAP user for about 3 years now. I download and analyse my data in Sleepyhead on a regular basis, and I have a CMS50E Oximeter to record and monitor oxygen and pulse level. By and large, my data looks good. AHI always under 2, leak and respiratory data looks good. I have a full face mask and I usually have no trouble sleeping 7-8 hours. But recently I started having some unusual sleep arousal issues. These arousals do not appear to be connected to an apnea event. I check respiratory, pulse, and oxygen levels, even BP, and everything seems normal for me. I sense the arousal in my head, not in the heart or breathing area. It is as if I get startled awake and my head is throbbing. It is hard to fall back asleep when it happens, and at times not being able to get back to sleep at all.

Has anyone else experienced some like this?

Any suggestions to find out what the problem might be?

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Wulfman...
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Re: Unusual Sleep Arousal

Post by Wulfman... » Mon Nov 30, 2015 12:54 pm

starbuck wrote:I have been an APAP user for about 3 years now. I download and analyse my data in Sleepyhead on a regular basis, and I have a CMS50E Oximeter to record and monitor oxygen and pulse level. By and large, my data looks good. AHI always under 2, leak and respiratory data looks good. I have a full face mask and I usually have no trouble sleeping 7-8 hours. But recently I started having some unusual sleep arousal issues. These arousals do not appear to be connected to an apnea event. I check respiratory, pulse, and oxygen levels, even BP, and everything seems normal for me. I sense the arousal in my head, not in the heart or breathing area. It is as if I get startled awake and my head is throbbing. It is hard to fall back asleep when it happens, and at times not being able to get back to sleep at all.

Has anyone else experienced some like this?

Any suggestions to find out what the problem might be?
You don't have your equipment or settings in your profile, but since you state you're using an APAP, maybe it's the pressure changes if you're using a pressure range. The pressure typically won't increase on an apnea, but definitely will increase on snores or flow limitations.


Den

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Julie
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Re: Unusual Sleep Arousal

Post by Julie » Mon Nov 30, 2015 12:54 pm

Yes, see a neurologist, pref. one with some knowledge of apnea, but regardless of that, see one soon.

HoseCrusher
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Re: Unusual Sleep Arousal

Post by HoseCrusher » Mon Nov 30, 2015 5:44 pm

You may want to check out your property and surroundings. You may wake up in response to cat fights in the alley or some other outside activity.

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Ricochet
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Re: Unusual Sleep Arousal

Post by Ricochet » Mon Nov 30, 2015 7:56 pm

Is the arousal the central kind or does it not show up on the report?
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BIGsherm7272
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Re: Unusual Sleep Arousal

Post by BIGsherm7272 » Tue Dec 01, 2015 12:24 am

starbuck wrote:I have been an APAP user for about 3 years now. I download and analyse my data in Sleepyhead on a regular basis, and I have a CMS50E Oximeter to record and monitor oxygen and pulse level. By and large, my data looks good. AHI always under 2, leak and respiratory data looks good. I have a full face mask and I usually have no trouble sleeping 7-8 hours. But recently I started having some unusual sleep arousal issues. These arousals do not appear to be connected to an apnea event. I check respiratory, pulse, and oxygen levels, even BP, and everything seems normal for me. I sense the arousal in my head, not in the heart or breathing area. It is as if I get startled awake and my head is throbbing. It is hard to fall back asleep when it happens, and at times not being able to get back to sleep at all.

Has anyone else experienced some like this?

Any suggestions to find out what the problem might be?
I have experienced the same exact thing. When I first started Cpap I had no issues sleeping for 8-12 hours at a time, and I maybe would only wake up once, but quickly fall back asleep. But over the last month, I have been waking up about 2-3 hours after falling asleep, and I usually am in a vivid dream when it happens (I dream every night and have for many years), and I'll look over at the clock to see what time it is, and most of the time I can fall back asleep nearly right away. But I remember about a week ago, I was in the middle of a very strange dream, and it was just as you described, I could feel it in my dream as if I knew I was about to awaken. I remember feeling this weird sensation in my head, and after waking up my heart was racing and my pulse was strong. I didn't really have a headache, but I wasn't able to fall back asleep. I only got about 3-4 hours that night.

Whatever caused it, I will never know. I unfortunately don't have a oximeter to track my vitals, but when I had my sleep study, even though my AHI was only 34 (which is still considered severe), over 85% of my arousals were due to hypopneas. I also had desats all the way down to 69% at one point, but my average saturation was ~90%, which is not good by any means, but not life threatening. I have been using Cpap for 4 months and still have yet to feel much better. Hopefully one day either my body finally gives in and accepts the benefits of Cpap, or I find the right equipment and settings to get it working right.

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JDS74
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Re: Unusual Sleep Arousal

Post by JDS74 » Tue Dec 01, 2015 6:48 am

Do you have any other symptoms beyond getting instantly awake and having a headache? How long does the headache last? Are you having any blood pressure issues?

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starbuck
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Re: Unusual Sleep Arousal

Post by starbuck » Tue Dec 01, 2015 10:01 am

Thanks for the responses everyone! To reply to some of the questions: The arousal is not from environmental noise. We live in a small gated community with very little or no traffic noise or noise from dogs/cats etc. We have lived here for a little over a year, and it is the quietest place I have ever lived.

I am treating a hypertension problem. Last May at the annual Dr. visit it was 142/90, and she prescribed Losartin 25 mg and a referral to a cardiologist. I have been monitoring my own BP for about 3 yrs and it was rarely much over 145/95, but usually under 140/90. The cardiologist did a EKG, nuclear stress test, sonogram, 48 hr monitor, etc and no problems were determined, and was sent home with a prescription for 50 mg of Losartin with instructions to take as mush as was needed up to the 50 mg a day to get the BP under 140/90. I took the Losartin for about three months and it did not lower the BP and I really did not like the side effects. One of the listed side effects was sleep disturbance. About a month ago I quit the Losartin and started a regimen of of diet, exercise, life style change, weight loss, with some natural supplements. Now the BP is averaging about 137/87 and seems to be trending down and I am generally feeling better except for this sleep problem. I have checked my BP after these arousal events, and find nothing unusual. I do not experience any symptoms or the sensation during the day time, only after the sleep arousal events.

Last night was the second night in a row with 2-3 hours of sleep and woke up with some tingling sensations in the body, so made an appointment with the GP today to see where to go from here. Hoping she will refer me to a neurologist as was suggested. We are new to this area so we have to find new doctors for everything. I don't look forward to this whole process--to say the least, the medical profession does not impress me at all. Will keep you posted on developments.

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JDS74
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Re: Unusual Sleep Arousal

Post by JDS74 » Tue Dec 01, 2015 12:09 pm

Check your PM box.

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starbuck
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Re: Unusual Sleep Arousal

Post by starbuck » Wed Dec 02, 2015 4:00 pm

So here is what the Dr wants to do. Keep in mind we are new to the area where we now live, and I don't have access to the regular doctors that where part of the original apnea diagnosis. Being such, I have to go to the GP to get a referral to specialist. So the GP doesn't seem too worried about the symptoms, and wants to go through an elimination process. Since this doesn't appear to be an apnea related issue she want to see if it is some other sleep disorder. I was sent home with a prescription for trazodone and instructions to monitor and record any sleep interruptions under medication, and come back in a week for further eval.

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Wulfman...
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Re: Unusual Sleep Arousal

Post by Wulfman... » Wed Dec 02, 2015 4:05 pm

We still don't know what your specific machine and settings are.
Could you please put them in your profile?


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starbuck
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Re: Unusual Sleep Arousal

Post by starbuck » Thu Dec 03, 2015 8:18 am

[quote][/quote]We still don't know what your specific machine and settings are.
Could you please put them in your profile?

For now: Pressure Min 11.0, Pressure Max 14.0, A-flex 1

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SGearhart
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Re: Unusual Sleep Arousal

Post by SGearhart » Thu Dec 03, 2015 9:33 am

You might wish to add the 20% and 50% flow restriction option to your SleepyHead reports. These 2 parameters can show activity that is below the normal event threshold but affect our sleep quality. Here is how you activate it:
  1. File->Preferences->CPAP tab.
  2. Check the Custom CPAP User Event Flagging box (lower left).
  3. Go to the EVENTS tab.
  4. Make sure that the 1st and 2nd events under "CPAP Events" are selected for reporting.
    1. Optional recommendation: Change the default"UF1" & "UF2" labels to something like; "FloRsct20" and "FloRsct50".
      (This will allow you remember what the events are when reviewing your data)
Good Luck!

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starbuck
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Re: Unusual Sleep Arousal

Post by starbuck » Thu Dec 03, 2015 9:42 am

You might wish to add the 20% and 50% flow restriction option to your SleepyHead reports. These 2 parameters can show activity that is below the normal event threshold but affect our sleep quality. Here is how you activate it:
I will try this, Thanks for the suggestion.

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starbuck
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Re: Unusual Sleep Arousal

Post by starbuck » Fri Dec 04, 2015 10:32 am

So here is what the Dr wants to do. Keep in mind we are new to the area where we now live, and I don't have access to the regular doctors that where part of the original apnea diagnosis. Being such, I have to go to the GP to get a referral to specialist. So the GP doesn't seem too worried about the symptoms, and wants to go through an elimination process. Since this doesn't appear to be an apnea related issue she want to see if it is some other sleep disorder. I was sent home with a prescription for trazodone and instructions to monitor and record any sleep interruptions under medication, and come back in a week for further eval.
After three nights I can report that the the trazodone is not working either. There goes that theory.

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