Does anyone have these symptoms?

[SnoreNoMore2005]

I'm a newbie and have had the following symptoms since starting CPAP a couple of weeks ago: I'm wondering if it's normal or if it means trouble.

Symptom #1 - Sometimes I wake up in the morning and I have a dull ache in my chest. It lasts for a couple of hours and then goes away.

Symptom #2 - During the night I wake up suddenly and my heart is pounding fast. this lasts for a minute or so and then slows down... but by them I'm wide awake. This was happening before I started using CPAP, too.

Symptom #3 - Sometimes in the early morning hours I feel like I'm not getting enough air. My setting is at 14cm with cflex 3 but I feel like I'm getting about 5cm during early morning hours.

Symptom #4 - I wake up exhausted but when I start moving around I realise I feel more energetic than when I was not using the CPAP.

Symptom #5 - My nose gets clogged up during the night.

Is this normal?

SnoreNoMore2005

[Janelle]

I think the chest pain is a common complaint when you are starting out and have what is a relatively high pressure. The heart racing is tachycardia. I would let your doctor know about this, because I wouldn't think on CPAP you'd still be having that. May need a pressure adjustment.

Clogging up could be due to not enough humidity. Are you using a heated humidifier? Are you using ANY humidifier.

I think a lot of people have their highest pressure requirements in the early morning hours. I know with my APAP that is when I often wake up to high pressures. So, again, 14 may just not be your correct pressure. Or you may need different pressures during the night. Are you sleeping in a different position in the morning than you are most of the night. The position can affect your pressure requirements, too.

[TXKajun]

I'm a newbie and have had the following symptoms since starting CPAP a couple of weeks ago: I'm wondering if it's normal or if it means trouble.

"snip"

Symptom #3 - Sometimes in the early morning hours I feel like I'm not getting enough air. My setting is at 14cm with cflex 3 but I feel like I'm getting about 5cm during early morning hours.

Symptom #4 - I wake up exhausted but when I start moving around I realise I feel more energetic than when I was not using the CPAP.

Symptom #5 - My nose gets clogged up during the night.

Is this normal?

SnoreNoMore2005

Hi, SnoreNoMore and welcome to cpaptalk. I've been on my APAP for almost 5.5 months now (PB 420E, HH, Ultramirage FF mask) and yep, when I got started, I definitely noticed your last 3 symptoms. For #3, I think what happens is that after a night's sleep, your lungs get used to the pressure and it feels like it's lower. It is the same as when you got to bed and started the unit, but your body's adjusting to it overnight. For #4, same here. I noticed for the first 3 months or so that I was still feeling tired, but also feeling rested (does that make sense???). I put that down to sleep debt getting paid off. After about 4 months, energy levels rose dramatically. And for #5, I still get a tad congested, even with my full face mask. I've tried saline solution spray at night, OTC nasal sprays and decongestants. They all work to some degree, but for me, the solution has been (since day 1) a full face mask.

Stick with it! This therapy WORKS!

[SnoreNoMore2005]

I do use a humidifier. People on this forum told me to turn it hotter which I did and it definitely helps some.

I have a nasal mask and a full face mask. The full face mask makes it easier for me to breathe, but I get plenty of leaks at 14cm and I would prefer to use a nose mask if I can make do.

Thank you for the encouragement.

SnoreNoMore2005

[dsm]

I can related to all these symptoms except #2.

In the case of #4 I have woken up & then stayed in bed a bit longer than I used to but as you have found, can state quite clearly that I am more alert & rested during the day.

The most exciting thing I am experiencing is the feeling of greater alertness at work and thus far, none of the sleepiness (which was almost a daily occurence before). This has happened after just a few days on CPAP so I have been hoping that it is not a temporary flash-in-the-pan effect. (I am sure it insn't, but the improvement has been so quick).

The chest pain is less now than it was in the 1st 2 nights. I am sure it will go completely.

I too am on #14 cms.

DSM

[lostone]

Symptom #1 - Sometimes I wake up in the morning and I have a dull ache in my chest. It lasts for a couple of hours and then goes away.

I have had this symptom a few times after I started c-pap I think it is because of the high pressure, mine is 20, I think it was my lungs getting use to so much air.

Symptom #2 - During the night I wake up suddenly and my heart is pounding fast. this lasts for a minute or so and then slows down... but by them I'm wide awake. This was happening before I started using CPAP, too

. I had the heart racing before I was diagnosed and started using c-pap and for a little bit after. It has gone away now. I have heard that it can be caused by the fact that one stops breathing so often that it is hard on the heart, the heart has to work harder

Symptom #3 - Sometimes in the early morning hours I feel like I'm not getting enough air. My setting is at 14cm with cflex 3 but I feel like I'm getting about 5cm during early morning hours.

I go through the same thing. I start out feeling the high pressure but as I sleep at night my body adjust to it and I wake up feeling like it is not high enough.

Symptom #4 - I wake up exhausted but when I start moving around I realise I feel more energetic than when I was not using the CPAP.

I was just thinking about that today! I have a bi-level because of the high pressure and it mal functioned and I was 2 days without a machine. I have a really nice one now. But for those two days I was so tired and sleepy I could barely keep my eyes open. Well I used the new on last nite and even though I woke up exhaused I actually feel more energetic and am having no trouble keeping my eyes open.

Symptom #5 - My nose gets clogged up during the night.

I had that too and went to a full face mask with a heated humidifer and do not get clogged up anymore. Knock on wood! lol

Well I just wanted to let you know that I have been there too. Good Luck!

[lindas88]

I also used to wake up with the heart pounding in the night....but not anymore since starting this.

I didn't have an ache in my chest with my pressure at 10 but now I had it changed to 11 and seem to get a weird feeling in my chest...do you think that just one number higher could make that much difference? Maybe I should go back to 10 but I do seem to sleep better at 11.

I also feel less air pressure by morning and sometimes during the night if I wake up I'll lift the mask to see if it is still working...it always is.

My nose doesn't get clogged but when I first get up in the morning and for about an hour or so my nose runs a bit. Why do you think that is?

[WillSucceed]

SnoreNoMore2005

The chest pain could be from the air pressure; you might try reducing the pressure some and then building back up to 14 over several weeks. Personally, I think it is criminal that doctors start people on a relatively high pressure; starting on a lower pressure, 9 for example, and increasing by 1 point per week would be easier for folk to comply with as it would give the patient's body time to acclimatize to treatment.

The racing heart could be several things so you should talk to your doctor about it. The person with OSA who is not receiving CPAP/APAP/Bi-level treatment will have tachycardia as their heart tries to deal with the increased CO2 that they are not blowing off when hypopneas and apneas occur. However, once treatment commences, and if it is being complied with without significant mask leak, the tachycardia should relent.

Have you noticed that your breathing seems rapid, almost as though you are panting, when you wake with the racing heart? If so, try turning C-FLEX off. Despite the benefit that many get from C-FLEX, there are lots of patients who experience breath-stacking. The short explanation of this is that not everyone breathes in sync with the C-FLEX equipped machine. A bi-level machine has lots of sensors in it that help it to match the patient's breathing cycle so that the machine's change in pressure, higher pressure when patient inhales and lower pressure when patient exhales, is in sync with the way the patient breathes naturally. A bi-level machine will wait until the patient fully finishes exhaling and starts to inhale before it increases pressure.

C-FLEX equipped machines, by design, do not have the same sensitivity to the patient's breathing cycle. C-FLEX increases the air pressure just slightly before the patient has finished exhaling and while this method works for many, it does not work for all. For those whom it does not work, breath-stacking, (not fully exhaling before starting to inhale -->CO2 builds up) can occur, breathes become shorter, like panting, and the heart races. This tachycardia can wake you from sleep. Try turning the C-FLEX off for a few nights use and see if the tachycardia goes away.

Having said all of this, I would encourage you to tell your doc. and equipment provider how you are feeling. You might want to ask them about turning C-Flex off. You can turn the C-Flex from 3 to 2 or 1, which will give you LESS pressure relief, but will NOT prevent the pressure from increasing BEFORE you have finished exhaling. This is why I have suggested turning C-FLEX off all together for a few nights trial.

[lindas88]

WillSucceed...Since you answered SnoreNoMore2005 questions, and did such a good job I may add....can you answer my two maybe not so important questions....please....

[SnoreNoMore2005]

Just curious if you think waking with the pounding heart could be from panic attacks. My sleep doc said it was possible.

Sometimes I'm sleeping and having a pleasant dream or maybe no dream and I wake up with my heart pounding so I'm not thinking I'm having a panic attack. I seem to remember gasping for breath many times, but not always.

I don't have panic attacks during the day. Is it possible to have them only at night while sleeping?

Thanks again for all your advice.

SnoreNoMore2005

[ozij]

I heartily agree with Will - for many of us, getting used to breathing against higher pressure is a question of physical training - and that works like any other kind of training regime - whether in running, walking, weight lifting, biking, whatever - you start with a little, and build up gradually. This custom of setting up the "right" pressure on one night, and then sending the patient home with it is probably a carryover from the days of tracheotomies.... Before they used CPAPs, the only solution for sleep apnea was cutting a hole in your throat, beneath the obstructing area. It worked dramatically, and immediately.

Assuming that you're talking about a kind of waking up that didn't necessarily start with xPAP treatment, it could be a panic attack.

However, that said, I would also say that it very natural for anyone who gets choked while they sleep to wake up in a panic - and being literally, physically, concretely choked in your sleep is what sleep apnea is about. I'm pretty sure that if you look at this video Understanding sleep apnea things will seem very familiar to you, including what happens to the heatbeat.

I used to wake up like that, jolted from sleep, heart banging, terrified. I used to jolt in the process of falling asleep too. I no longer do.

Give the treatment time, give your brain and mind time to discover that sleep is no longer a life threatening process.

O.

[lindas88]

ozij...That was a great video...Good for my family to watch to help them understand what is really going on with their Mom.

[WillSucceed]

I don't have panic attacks during the day. Is it possible to have them only at night while sleeping?

I worked on a crisis team in an emerge department (4 different hospitals) for about 10 years. This work involved assessing people who showed in the ER with anything that was other than clearly physical in nature. Team was made up of psychiatrists, social worker (moi) and nurses. I dug out a test so that I would get the wording right about panic attack; here's what I can tell you:

While anything is possible, panic attacks that ONLY happen at night are unlikely. A panic attack refers to a discrete period of intense fear or discomfort, in which at least four of the folliwing symptoms developed abruptly and reached a peak within 10 minutes.
It is panic attack ONLY if these symptoms CANNOT be explained by the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

1) ...feel your heart reacing, pounding, fluttering or skipping beats?
2) ...sweat?
3) ...tremble or shake?
4) ...have trouble catching your breath, or feel like you were being smothered?
5) ...feel like you were choking?
6) ...have chest pain, pressure, tightness, or other discomfort?
7) ...feel nauseated, sick to your stomach, or like you might have diarrhea?
...feel dizzy, light-headed, unsteady, or like you might faint?
9) ...feel like things around you were unreal, like you were in a dream, like parts of your body were unreal or detached from you, or like you were outside of yourself, watching?
10) ...fear you were going crazy or might lose control?
11) ...fear you might die?
12) ...feel numb or tingling in your fingers or feet?
13) ...have hot flashes or chills?

So, if you don't have panic attacks during the day, the 'attack' that you are experiencing at night is unlikey to be panic. I'd be very suspicious of OSA related racing heart as your body tries to deal with hypopnea / apnea.

Not withstanding all that I've yakked about, I'd still talk to my Dr. about this stuff; I'd also still turn off C-FLEX for several days and see how I feel.

[WillSucceed]

lindas88 wrote:

I didn't have an ache in my chest with my pressure at 10 but now I had it changed to 11 and seem to get a weird feeling in my chest...do you think that just one number higher could make that much difference? Maybe I should go back to 10 but I do seem to sleep better at 11.

I wish I had a good answer for you... In my opinion, a change of 1 cm could make a difference -->I could tell the difference between 10 and 11 and I would wake with some chest pain. This, however, was in the early days when I first started CPAP. Dr. prescribed 15 and the chest pain that I felt damn near did me in. I whined enough to get him to agree to a decrease to 9, and it took a couple of weeks until I could tolerate having the pressure increased. During that time, I was keenly sensitive to pressure change and could tell the difference between 9 and 10. Then I did the smart thing and listened to Rested Gal (I keep saying it and it is still true: Rested Gal is 'da bomb!) and got an APAP. Problem solved.

So, yes, I do think that 1 cm of change could be felt. The good news is that I think you will get used to it and be ok. Consider an auto machine. And, if you are going to consider getting an auto machine, do yourself a huge favour and trial veral different machines, even if you have to cough up some coin in rental, BEFORE you buy. The machines have different algorithms driving them and it is important to get the machine that works best for you.

My nose doesn't get clogged but when I first get up in the morning and for about an hour or so my nose runs a bit. Why do you think that is

I don't have a good answer for this. Is it possible that you are breathing filtered air all night (do you have a disposible filter AND the washable foam filter in your machine?) and then in the morning, your nose gets the pleasure of unfiltered air and reactes accordingly?

I used to be stuffed up all the time, worse at night when I would lay down. With the filtered air that I am breathing, things are much improved.

I work in a hospital and am able to get the filter material that the RT's use with the patient ventilators. They get this stuff from the company that make the vents as well as from other providers like Respironics. This material is HEPA-grade and blocks bacteria and allergans. I just cut a piece that is the same size as the small foam filter that came with my 420E and put it in place on the air inlet. I then put the foam filter over it to keep it in place. Beautiful filtered air all night with no bugs, bacteria, allergans, etc.

Send me a private tellling me what machine you have and your address; I'll mail you a piece.

[lindas88]

Thanks for the reply WillSucceed...I guess my whining got your attention. ...last night I turned up my humidifier to almost 5 and my throat feels better ( it was so dry in the morning I couldn't hardly stand it ) and my nose didn't run this morning but because I turned it up I had a lot of water laying in my mask this morning...so I guess it will be to just keep trying to get the right number for me. I bought the machine I have..shown below...and have had it since June 6th I believe and I have never even looked at the filter so maybe I should check that out and see if it should be replaced. I think my machine was one that adjusted my pressure all night but it was set to a fixed pressure because I get better sleep with that. Anyway, thanks for your help and maybe someday I'll be a pro at this like you and a few others seem to be.

ps...I see you guys are having a heat wave up there....down here right now it is only 13c...a bit different then you guys up there.