I have been a member of this forum for a long time and have been using ASV therapy since I turned 30, which was exactly 10 years ago.
Initially, I started experiencing episodes of waking up and gasping, which prompted me to undergo a sleep study.
The results of the study showed that I have mixed apnea, but predominantly idiopathic central apnea (meaning there is no known cause).
My AHI during the study was around 35, with oxygen levels dropping to the low 80% range.
Since starting the therapy, my treated AHI has consistently been less than 1.
I monitor my pulse and oxygen levels at night, and on average, my oxygen saturation is around 95%, with occasional dips to 89% for less than a minute. Most nights, it doesn't go below 90%.
Now, here's the problem I'm facing:
I continue to experience an issue, typically 1 or 2 nights a week, where I wake up within the first hour or two of sleep, feeling an intense need for oxygen.
My wife describes it as if I were someone who had been struggling to breathe underwater and finally surfaced.
During these episodes, my heart races due to an adrenaline rush, and I find myself hyperventilating.
To calm myself down, I usually sit up for several minutes before going back to bed.
Many nights, if it happens once, it tends to occur 2 or 3 more times shortly after falling asleep.
What's puzzling is that I don't usually notice any specific event triggering these episodes, and my oxygen reading remains normal.
I have attached a screenshot from last night when this happened. You'll see that I removed my mask for a few minutes afterward to regain control of my breathing. I checked my oximeter during that time and found no oxygen desaturation prior to the event.
I'm at a loss as to what could be causing these episodes. One hypothesis I have is that there may be some issue with carbon dioxide, or it could be related to being in a transitional state of sleep where the pressure from the machine is causing me to wake up in a panic. I'm unsure of what steps to take, and I'm concerned that the stress from these events could potentially lead to cardiac arrest.
My settings: Dreamstation ASV
Max pressure: 25
Min Epap: 8
Max Epap: 20
Min PS: 4
Max PS: 17
Bi Flex: 2
Breathe Rate: Auto
![Image](https://imgur.com/IO21H2y.jpg)
I would greatly appreciate any insights or hypotheses from the forum members regarding what might be happening, and if you have any recommendations for changes or actions I could consider. Thank you.