Stopping breathing while awake

[KittyMom22]

Do other people experience this? Sometimes I have to remind myself to breathe.

[rick blaine]

Hi KittyMom 22,

There are two or three ways this can happen.

One is being in 'reverie' – ie, a kind of momentary meditation or waking dream state. With most people, and esp those without meditation training, it doesn't last very long. My guess is, this is what you have. It's usually harmless.

A second is that some people are habitual breath-holders. This can be for pragmatic reasons – some people hold their breath to increase visual acuity. Other people hold their breath to steady motor activity which needs fine control – eg, threading a needle.

This variation is also usually harmless, but if the breath-holding becomes a habit and causes HVS symptoms, then the exercises assigned to hyper-ventilation syndrome patients are worth doing, in the sense that they normalize both over- and under- breathing.

A third way or context is if you are very fit, with excellent heart-lung conditioning, and you are in a state of stillness or very low activity. And this changes when you become active again.

Now, in case you are worried: a quick and costless test of heart-lung health which you can use to decide what your next step is:

Can you walk up two flights of stairs (each of at least 16 steps) and still hold a normal conversation at the top of them?

If you can do that, then fine, you're fit enough for ordinary life. If you can't, then see a cardiologist.

[KittyMom22]

No, I'm not fit. I think sometimes I just get tired of the effort of breathing with asthma. Like my body is just tired of the struggle. I really wonder if I have apnea or if the home sleep test picked up nighttime asthma.

[rick blaine]

The thing you describe – "tired of the effort" – suggests your asthma isn't under control. You don't say what age you are, but I'm guessing 60+. And I think your doctor should be seeing you about your asthma at least once a year.

And he or she should be giving you an 8 x 11 sheet of paper called your 'asthma plan" with a few what-to-do-ifs on it.

First item: what's your maximum on a peak flow meter? And is it the same as shown on the age-height-gender chart, or is it less?

Most likely second item: if on home version of peak flow meter, and if your flow is less than 80 per cent of your personal max, then increase the number of puffs.

Your puffs can be 50 mcg or 100 mcg or 200 mcg.*

If on two puffs twice a day, move to three such puffs twice a day. After three days, is that any better?

If not, then four puffs twice a day. And evaluate three days of doing that.

Outside of your plan, it may be you need to be switched to a different inhaler. For instance, one that is both salbutamol (blue) and steroid (brown) which usually comes in a purple coloured inhaler.

Or stick with your current steroid inhaler, but alongside it, a 12-hour salbutamol inhaler.

It's best to treat daytime breathing difficulties with the gold standard for daytime, and to treat sleep apnea with the gold standard for sleep apnea, and not expect one to fix or affect the other.

PS. At * I have corrected my momentary brain fart that had me typing 'ml' instead of 'mcg'.

[KittyMom22]

Wow that is a lot of assumptions. You're a pulmonologist?

[lynninnj]

Wow that is a lot of assumptions. You're a pulmonologist?

You should take what helps and leave the rest.

I know I might be offended if someone thought I was 60+.

It appears this poster is involved in healthcare in the UK and likely has a lot to offer.

Yanno, if all you want is a credentialed individual to answer all your questions you might try writing them down and making an appointment with your pulmonologist. I mean, this not breathing thing sounds like something you maybe should* talk to your pulmonologist about.

But if you want help with managing your CPAP usage there is a wealth of info available here offered up by non-medical professionals who have been there done that.

Some of these folks have been here nearly 2 decades and see the medical professionals who never wore a mask a day in their lives managing care for those who do. They have seen that care seriously lacking, myself included.

[dataq1]

But if you want help with managing your CPAP usage there is a wealth of info available here offered up by non-medical professionals who have been there done that.

[Rubicon]

Your puffs can be 50ml or 100ml or 200ml.

All I gotta say is that's a pretty hefty puff.

IDK what inhaler he's referring to, but inhalational steroids are in mcg.

200 ml would be a few cases of inhalers.

[lazarus]

For the first six months or so of my PAP-therapy journey, I would occasionally have the new sensation of forgetting to breath during the day. Because my sleep breathing had been so bad for so long in my case, I chalked the sensation up to some healing and "resetting" going on that was related to my sleep-breathing system getting "reset" but that was also affecting my wake-breathing system a bit too. It eventually went away for me.

I believe that it's a fairly common temporary sensation for those with severe OSA early on in the process of being treated with PAP but that it is rarer with mild-to-moderate.

That is nothing more than my impression from reading posts on forums mentioning the sensation, though, and I have zero insight medically. If I had a history of asthma or other lung-related issues, I might have taken it a lot more seriously than I did when I experienced it.

[KittyMom22]

Wow that is a lot of assumptions. You're a pulmonologist?

You should take what helps and leave the rest.

I know I might be offended if someone thought I was 60+.

It appears this poster is involved in healthcare in the UK and likely has a lot to offer.

Yanno, if all you want is a credentialed individual to answer all your questions you might try writing them down and making an appointment with your pulmonologist. I mean, this not breathing thing sounds like something you maybe should* talk to your pulmonologist about.

But if you want help with managing your CPAP usage there is a wealth of info available here offered up by non-medical professionals who have been there done that.

Some of these folks have been here nearly 2 decades and see the medical professionals who never wore a mask a day in their lives managing care for those who do. They have seen that care seriously lacking, myself included.

I was genuinely curious if this person is a pulm because they're basically trying to create a treatment plan.

I don't want or expect credentialed advice from a patient forum. Obviously I didn't phrase my question accurately enough.

[colomom]

No, I'm not fit. I think sometimes I just get tired of the effort of breathing with asthma. Like my body is just tired of the struggle. I really wonder if I have apnea or if the home sleep test picked up nighttime asthma.

Not a pulmonologist, but I do have personal experience with both OSA and asthma. Your description of your daytime breathing sounds like asthma that isn’t very well controlled or treated. Hope your pulmonologist can find something that does a better job of controlling your asthma.

There can be a correlation between asthma and OSA, asthmatics are more likely to have OSA than the general population.
Untreated OSA can worsen asthma because it can cause increased inflammation in the airways.
An interesting experiment could be to use a peak flow meter first thing in the morning after using your CPAP to see if you are able to see improvements from using your CPAP.

[Rubicon]

An interesting experiment could be to use a peak flow meter first thing in the morning after using your CPAP to see if you are able to see improvements from using your CPAP.

Yeah, no.

[Rubicon]

An interesting experiment could be to use a peak flow meter first thing in the morning after using your CPAP to see if you are able to see improvements from using your CPAP.

Yeah, no.

And anyway, you of all people should have jumped in and said "Of course, you can have wake central apneas!"

[KittyMom22]

I guess I'm a little sensitive because all of these health issues I'm experiencing are coming as something of a shock. Two years ago I was riding my bike for 10-20 miles a day and really enjoying working from home. My son was away at college on a scholarship and I felt I finally could live my life for myself a bit. I was happy to be turning 50.

Then son had some health issues, mom had some health issues, and I was flying back and forth between NJ and FL every few months. Then I got long Covid, which totally messed me up and exacerbated my breathing issues. Throw menopause, weight gain and a few more problems in there and I feel about 90.

This is very humiliating, all of it. I'm a divorced Mom who has worked really hard to hold things together. My health has generally been good until a few years ago. Now I'm having multiple surgical procedures, battling chronic pain, struggling to breathe, and my weight has blown up. I look like a Stay-Puff woman, and was totally dismayed trying to find something in my closet to wear to a client meeting today. Plus I need to clear out my whole house to make room for mom, downsize to the tiny guest room, organize construction of a small bathroom addition, and deal with acclimating a tiny medically fragile rescue kitten (long story, I didn't plan to keep her) to the house and my existing cat. Plus I'm still learning a new job because I had such bad brain fog from Covid I had to switch roles. It was awful and I nearly got fired.

So I really don't like being patronized. I know people are trying to help. I really do. It just is all a bit hard to take right now.

I sincerely apologize for being touchy.

[KittyMom22]

I forgot to mention that my wonderful pulmonologist left the practice to become a hospitalist, so I'm starting over with a new doc.