"night terrors" and CPAP therapy

[mrcrayola]

This is a personal reflection on a recent "incident" as I near my one-year anniversary of being a CPAPper, so please skip reading this if it's not of interest.

One of the reasons I agreed to begin using a CPAP machine was my experience with what I'll call "night terrors," i.e., very traumatic dreams that ultimately awaken me, accompanied by a feeling of dread. Mind you, the dreams are entertaining when recalled after the fact - they feel like being confronted by evil and winning - but it became clear to me that I was experiencing oxygen deprivation while asleep, and these nightmares were at least in part my brain's way of trying to snap me out of it.

A bit of research led me to believe that these incidents, which occurred primarily while sleeping on my back, i.e., in the supine position, were attributed to sleep apnea. Accordingly, this time I did not resist recommendations to submit to CPAP therapy, hoping that this would resolve the issue of oxygen deprivation. Alas, it has not, or at least not completely.

About a week ago, I had another one of those dreams. It was traumatic - literally life and death - and not the first time I have experienced one while using my CPAP machine. I awoke as if coming out of a fog. Consciousness is not instantaneous. It is literally as if you have been hyperventilating and are slowly "coming to," as we used to say (confession: as a kid, I stupidly engaged in "play" where we would intentionally hyperventilate, often while under the influence of one chemical or another). In this recent instance, once I became fully conscious, I found myself on my back, CPAP machine and mask still connected and functional. Even so, I felt the telltale tingling in my hands and feet, and literally an aching in my heart.

It is incredibly frustrating to realize that, at least thus far, CPAP therapy has not prevented such episodes. I am not even sure I can say it has minimized them. I had hoped that using a CPAP machine would enable me to comfortably and safely sleep on my back, to spare my injured shoulders the burden of having to bear the weight of supine avoidance. Alas, that has not been the case.

I am not giving up on CPAP. My AHI reading pre-therapy was 19 - granted, a one-night measurement - and my near-one year average is 7.36. Certainly not "treated," as SleepyHead would say, but certainly better than 19. I am still determined to be a "supine man." The adventure continues...

Thanks for letting me vent. All the best to all of us!

MC

[Gryphon]

What kind of machine are you using??? Make and model?
Is it a auto machine?
Do you know your current settings?
Is there more room to raise your pressures?
Can you post some of your sleepyhead graphs here for us to look at?

Restwell,

Gryphon

[mrcrayola]

Hi Gryphon. Thanks for the questions. I'm already at 13.5 on a Dreamstation. I've attempted higher pressure settings, but they just keep me awake. Seems that the key is to avoid rolling onto my back, and there are ways to try to minimize that but, alas, they only work marginally.

Cheers,

MC

[Julie]

You need to ask either a cardiologist and/or a neurologist who specializes in sleep some of the questions... because your GP may just not know enough about night terrors, Cpap, apnea or how oxygen and the brain work to have proper answers. Night terrors may not just go away on Cpap because the cause may not just be a low 02 count, but possibly e.g. a cardiac problem set off by neurological problems - I'm just speculating - so you should find out more about both before giving up on Cpap.

[Gryphon]

But is it an auto adjusting dream station? Ie. Do you have it set to 13.5 all the time or is 13.5 the ceiling that your machine is set so it won't go any higher?

My machine starts at around 11 but can go as high as 25 but... for me usualy never goes above 23. I average around 18 or 19 pressure most of the time.

If your working on a set pressure this pressure may not be accurate to treat your condition all the time..

Lately for me I have been sleeping on my side and so my machine has not been climbing up as high on the pressure.

Are you able to post some sleepy head info ?

[zoocrewphoto]

Can you post some graphs of a typical night and/or the night with the night terrors? It certainly sounds like sleep apnea events, and your treated ahi of 7 is still way too high. We can help you get it treated better. Ideally, less than 2.

I used to have bad dreams where I was being chased. It was my brain trying to explain why my breathing and heart rate were so bad. In the last 6 years, I have only awakened with one bad dream with cpap. It was more of a worry dream, not being chased.

[laprof]

Oh, those nightmares! I, too, had them for about 3 years. Some were so strange that I talked to a friend (who's a cardiologist) about them. He had to write them down b/c they had so many levels. Great. Anyhow, I started CPAP b/c I have SVT and was hoping that it would end with CPAP therapy. (Looks like mine is positional... and only happens at night!) So, to the relative present. When I began CPAP, I still had a few nightmares or dreams that would startle me awake - prior to using the machine for more than 4 hours per night. Now that I'm up to however many hours I can sleep - or stay asleep unless insomnia kicks in, the nightmares/bad dreams have virtually disappeared. In fact, I haven't had a nightmare since mid-June! I use a nasal mask w/ liners to keep the seal as good as possible. Most of my nights hover around 1.8-3.0 now, with the occasional 4-5 if I've dealt with bad insomnia while wearing the mask. So, perhaps you should consider another mask or machine? I use an ResMed 10 (auto) with a ResMed nasal mask. I feel your frustration and fear - having felt them personally for 3 years. But, I am now doing very well regarding nightmares and hope you can, too!

[nicholasjh1]

Ha, I had a dream that I was traveling around in a hot air balloon yesterday night, and the balloon kept deflating, I had to keep on breathing into the balloon to keep it inflated and eventually it crashed. this is when I woke up to find myself breathing out of my mouth trying to "blow up" the balloon... The funny thing is that I tape, so there was plenty of counter pressure trying to breathe out through the tiny opening I had created in the taping. No sure if I was actually having apneas, mouth leak... or simply having a crazy dream about what it was like to have had apneas, but my treated AHI was unusually high for me (.4), so I'm guessing there was a cluster right around the dream time, or I got false Apnea readings because I was attempting to use my mouth even though I have a nasal only interface.