New cpap user and Night Terrors

Hello all. I am a new cpap user for 5 days now and I've just experienced the most terrifying experience I've ever had. Last night, at 2am, I had mask’s leaks and I had a lot of problems solving the issue. So I decided to remove the mask. I felt asleep almost immediately. In fact I was not sleeping deeply since I heard my wife get up and going to bathroom. The problem is that I was snoring unusually and my wife decided to wake me up. She talked to me and immediately I sited up abruptly in bed and began screaming and crying. I was realizing what was happening but was unable to stop screaming for several long seconds. Afterward I experienced racing heartbeat and was in really bad mood for the rest of the night. I never had such experience before. I am a 36 male by the way.

I want to know: does a similar freaking experience ever happen to anyone else? I am asking myself if it may be because that was the first time in five nights I’ve slept without my cpap? All other nights were very good.

When I was a kid, I had night terrors that were caused by hypoglycemia (basically, my body overreacts to sugar, and if I had a bunch of sugar right prior to bed, my blood sugar would drop and I would have a nightmare and just wouldn't wake up.) I remember that during that time I would sort-of know what was going on just couldn't stop the absolute FEAR coursing through me. And that was ~25 years ago.

My guess is with you that you were sleeping "deeply" and for whatever reason your body didn't want to fully wake up. Usually this only takes a second or so in a normal person. Anything longer than that and in your semi-awake state your brain in actually in two different states at the same time and you can easily confuse reality and imagination.

You'll have to look at your routine and figure out if you did anything else differently. If you didn't except for CPAP, it's possible that you just slept deeply (you can think you are not sleeping deeply even if you are, as my sleep study showed explicitly) for the first time w/ the CPAP and your sleep deprived body just didn't want to relinquish that "state". If it reoccurs you might want to go to the DR to check blood sugar, especially if you have diabetes or other potential causes for hypoglycemia in your family history.

You didn't list which mask you're using or mention how your machine was configured, but two possibilities came to mind.

If you use a nasal mask, you're mouth-leaking and negating your therapy.

If your machine is improperly configured and/or if the bottom/minimum pressure it too low, that will also allow too many events to take place and would be delivering inadequate therapy.

In other words, your "night terrors" would probably be an indicator of poor therapy.

Den

EDIT:
Somehow, I happened to miss this sentence when I read the post initially. So, it would logically make sense that the time without the mask on would be depriving the brain of oxygen from apneas and thus causing the situation described.

mccdan wrote:So I decided to remove the mask.

Den

As I understand your story, you took off your mask and fell asleep.

Your night terror resulted from being suffocated in your sleep by your apnea. There is no stronger signal to the body than the lack of oxygen--and all heck breaks loose, including shunting off blood from the body in favor of the brain, the relase of tremendous amounts of panic hormones, and the sense that you are on the verge of death--because, quite literally, you are dying.

These feelings of panic and night terror are quite common among OSA victims who are not using their equipment or for whatever reason their therapy is not working.

Thank you all for your quick response. In fact SleepGuy, your hypothesis seems very logical. I’m quite convinced that the night terror episode is directly related to the fact that I took off the mask and suffocated in my sleep apnea. I will definitively work on finding the best mask for me and solve the leak problem.

A similar thing happened to me the other night when I took off my mask in my sleep and woke up with a start, heart racing, mask off, at 2:30 am. Thankfully, it's a rare occurrence for me and how grateful I am that I live now and not one or two generations back in time.

See I don't know what I have experienced, but it has been before my CPAP treatment.

Basically in the middle of the night, I would be dreaming about something, maybe seeing something in my room, or feeling something. It was definitely around me. I am very arachnaphobic, so a lot of the times it was me dreaming about me being away seeing a spider crawl somewhere near me, so I would wake up, freak out, and look around for a while. Basically it was a vivid nightmare dream sort of thing.

I don't know if that classifies as a night terror but they have stopped since I started treatment.

I have (hopefully had, past tense, with continued therapy) bad dreams. The culmination of the dream is me lunging at what ever boogie it happens to be, and yelling to frighten it away. I have come to believe that the bad dream is my body/brain "forcing" me to wake up from an apneic event and begin respiration. The "yelling at the boogie" is my gasping for air. This is one of the main factors that motivated me to seek therapy...this and the fact that my wife is not fond of my yelling out in the middle of the night.

mccdan wrote:Thank you all for your quick response. In fact SleepGuy, your hypothesis seems very logical. I’m quite convinced that the night terror episode is directly related to the fact that I took off the mask and suffocated in my sleep apnea. I will definitively work on finding the best mask for me and solve the leak problem.

This would make sense, as if the brain is not getting the "tools" it needs, it will likely malfunction, whether it be levels of blood sugar, oxygen, or other critical needs. Severe apnea will likely have similar effects if you wake up DURING an apneatic event that has dropped your O2 levels. While you are trying to wake up your body would go into panic mode to get the brain what it needs.

I would say the good news is there is a fix, effective apnea therapy. (like there was for me as a child, which was NO large amounts of sugar just prior to bed... which, BTW, most healthy people that have a large amount of sugar prior to bed (say a sugared soda) without eating some other type of "fuel" show some drop of blood sugar during the night. With most people, it's not a problem... worst case for them is waking up feeling a little crappy in the morning until you eat something. However, I'm sure if someone is at risk for apneatic episodes it would be advised they do not contribute to the sleep problems by such things as large sugar intake prior to sleeping.)

One of my main complaints before diagnosis was Insomnia.

Insomnia for me was:
Waking up sweaty
Nightmares
Waking up with numb hands or arms

One of the weirdest things that happened at night was it seemed like I woke up suddenly in the middle of a scene where my dream was projected on the wall. Bizarre.

Your body sure doesn't appreciate being flooded with high Cortisol levels all night long. Makes you feel like you're losing your mind.

Good luck,

-Bev