Scary Symptom..

[BrandyMB]

I have been having a scary thing that happens to me. I am on cpap but have been trying different masks and have not had good luck sofar. Nasal pillows dont work as I am a mouth breather. I am using a F&P 431 right now at 8.0 pressure. Also use the Remzzzs. Lately as I have been going to sleep, as my mind just starts to wander and I am falling asleep. I will stop breathing. Feels like only for a little bit, then I will come to and get a head rush and breathe. I have not been feeling well as my therapy is not working for me. Now this. I had been taking a .5mg Xanax and melatonin/valerian to get to sleep and last two nights I have cut that to half a xanax so I can get off of it. I just changed my cpap machine over to my bipap to see if anything good happens tonight. Anyone out there have this? It scares the heck outta me and makes me very anxious etc..

[onesight1]

request for another titration

sounds like you may have had a shitty titration. It happens.

[Demeter_Soul]

I am sorry you are having such problems, Brandy.
I can't really comment on what might be causing this to happen or help you in that area...but I did want to warn you about mixing Xanax and Melatonin/Valerian Root...or Kava together.
Several years ago there was a special episode on one of the news magazines about mixing such drugs and herbs/supplements/hormones and the main story was about a man who did so and wound up in a coma.
Be very careful with mixing anything with Xanax. It's a potent drug and it can also make OSA symptoms worse/can cause them.

[DoriC]

Ditto. Definitely Google Xanax and you will see all the side effects. Herbs and supplements are not harmless. Hope some of the experts here might recognize the symptoms you describe.

[FinceMgr]

Hmmm.... Male on BiPAP @ 8 cm h20. I am a novice but does anyone else think this pressure may be on the low side. My present pressure is not that titrated in the overnight PSG, because after an initial acclimation period my pressure needs rose a couple of cm h2o.

[BrandyMB]

I went from my cpap to my old bipap tonite to try. My titration 2 months ago came back with 8-10 as my pressure which gave me 4 hours of real sleep when the gal got the mask (full face) to quit leaking. I had a beard at the time, but have since went to a long mustache. I am off the Xanax and will be using only Altrein which has melatonin, GABA and valerian in it. No mixing. One ot the other posters sent me a PM with a link that I read which basically states I have what's called "sleep onset central apneas" which are pretty much normal. That calms me a bit. I have a lot of other medical problems and I strongly feel a lot of it was caused by the apnea, and I am bound and determined to beta this. I feel like a zombie, no energy, fluey feeling and PVC's. I am trying to beat the anxiety. Oh what a trip im in...

[rested gal]

I sent the PM, and I was just taking a guess that sleep-onset centrals might be what you're describing as happening to you. I don't know for sure if that's it.

For other readers, here's a link I sent Brandy:

viewtopic.php?t=18117
page 2, from a post by StillAnotherGuest:

Assuming that the obstructive events are properly managed, then the likelihood of these being sleep-onset centrals is fairly high (you'd need PSG to be 100%) and those things are pretty much a normal event.

[BrandyMB]

It made a lot of logical sense to me. We shall see what tonite holds.

Thanks, RestedGal.

[BrandyMB]

Last night was from hell. I went to bet at 9 and laid there till 3AM trying to use my bpap machine. Every time I would start drifting off, I would stop breathing and come back to with the head rush. I would grab something and read for a while then try again. Wife gave up and went into the living room and crashed on the couch. During all this the anxiety kicks in which starts a vicious circle. I had taken some herbal sleep aids which did me zero. At 3 I went in the LR and then decided to take half an Ambien. I curled up on the love seat half upright and in I'd say 5 minutes I was out. Slept like that till 6:33. so I got 3.5 hrs there. Wife said I was sleeping sound and breathing normally. Then got up, got some water and went on the couch and laid down. Went thru some more of the sleep onset apneas but apparently fell back asleep for another hour as I remember dreaming. Sorry for the long one, but that’s what im going thru. My bed is like a battleground its getting to be. We're gonna go look at recliners after church today and Im gonna set up in the corner of the LR, maybe if I sleep half upright ill do better. I had a sleep study in October so I know what pressures on my machine work. However finding a mask that does is another animal. I have full face ones which drive me nuts, I have nasal pillow ones which are more comfy but I breath thru my mouth so... Bottom line is I'm in a war. If I could somehow kick the anxiety, I may win. But don’t want more pills.
Mark

[DreamOn]

When I read what you described, Mark, I also thought of sleep-onset centrals. I have them too, and it seems like they've been more numerous the past few nights as I catch myself not breathing often. My machine is recording more apneas these nights, and night before last was my WORST since starting CPAP, with a very high rate of hypopneas and more apneas than I've ever had since starting CPAP. I'm not sure what may be going on, or if it is even a lasting trend, but I'm keeping good records so I know it'll get worked through.

I found this explanation of the sleep-onset centrals in the book "Sleep Apnea: The Phantom of the Night" by T. Scott Johnson, M.D, et al., to be helpful:

"Small numbers of central apneas are seen in virtually every normal and abnormal patient that is studied in the sleep lab and are usually a normal part of the transition to sleep.
....
"We have an automatic breathing control system that maintains the carbon dioxide in our blood at a stable level. This system helps to control the rate at which we breathe....During the day when we are constantly overriding our automatic breathing, most people maintain their carbon dioxide level at a fairly low level. With the onset of sleep, however, the sensor mechanism that detects levels of carbon dioxide in the blood becomes slightly less sensitive and accepts higher levels of carbon dioxide....This change in sensitivity occurs quite suddenly as we drop off to sleep from a normal awake breathing state, and we suddenly do not have enough carbon dioxide in our blood to drive regular breathing during sleep. For this reason, at sleep onset and after arousals there is often a pause in the effort to breathe that may last as long as 10 to 15 seconds. These events may be normal."

You mentioned that your nasal pillows are comfy, but that you mouth-breathe. Have you tried using a chin strap, with or without tape to see if that helps? That solved my problem, but I can't say that I was actually breathing through my mouth as much as the chin dropping down during REM, allowing therapy air to escape.

I'm going to sleep with my oximeter tonight and see what that shows. Anxiety can feed on itself, and I know how frustrating that can be. I hope you're feeling better soon.

~ DreamOn

[BrandyMB]

Thanks, DreamOn, for your reply. I live in the good old San Joaquin Valley and its been lousy weather for a month.. and thats about how long I have been sick. That very well may be part of the issue with me. You brought up a good point, which I forgot to mention. I have an oximeter and I put it on my finger and waited for a event. When i came out of it I looked and one time my O2 was down to 88% and another time my heart rate had falln to 46. My normal heart rate when Im in bed is about 52-54. I am on a low dose of beta-blockers also. I do think part of my issue too is im a very much Type A dude and have a hard time relaxing. Also, The anxiety I have been under has as I said turned into a vicious circle for me. Also I MUST get used to the machine and its noises... Arggggh!

Oh almost forgot.. yes I have a chin strap and it doesnt help. Aside from making my head very uncomfy, air escapes thru my lips if my jaw is closed.

[SuperGeeky]

Interesting... Before my last titration, I was taking naps during the day. Same experience, doze off, mind would wonder off into dream-like state and then wake up with feeling of choking. Not head rush though...

Sleep study should eight 'centrals' in first hour. Though, change in pressure stopped all events.

I think overall it was complex mixture of:

1. Light sleep 'nap' easily awakened to Apnea - Drinking lot's of caffeine

2. REM Deprivation - falling into REM quickly during nap and immediately having APNEA

3. Pressure induced 'Centrals' , now corrected after titration

I really believe that Naps are far different from regular nightly sleep. Medication can tamper and create 'Nap' type circumstances at night.

Just purely speculating though,


SG

[rested gal]

Oh almost forgot.. yes I have a chin strap and it doesnt help. Aside from making my head very uncomfy, air escapes thru my lips if my jaw is closed.

That's why I use tape over my mouth, so I can wear the most comfortable mask for me. Otherwise, I'd have to wear a FF mask. (Been there, tried many of them, didn't like any of them.)

LINKS to: Mouth leaks - Air Leaks - Tape - DIY Guard
viewtopic.php?t=8011

[Muse-Inc]

...nasal pillow ones which are more comfy but I breath thru my mouth so...

Try the Hybrid, covers mouth & has nasal pillows that can be adjusted to 2 heights, does not cover the nose or touch the forehead. I hadda give up my beloved OptiLife pillow mask 'cause I was losing therapy air and taping was too scary with my history of allergies-chronic sinusitis-vasomotor rhinitis-congestion.

[BlackSpinner]

I used to have this falling asleep - wake up freaking out too - especially before cpap. I thought I was getting anxiety attacks over all the issues in my life (sick parents, work, money, kid in college, memories of the fire). When I started cpap and learned more about apneas I realized it was "just an apnea" I found I could relax an just ignore the whole thing. It was not an anxiety attack, my life though fraught with issues was not keeping awake, I didn't have to get up, eat or read a book - it was just a sign I was falling asleep! The machine is there to keep me breathing - and it does.