New to BiPap-Trying to Adjust/Reduce AHIs/Anxiety Issues

Hi - I have been using the Aircurve 10 VAuto for about 2 weeks. I used a ResMed S9 Autoset for a few years before that. I guess I am sleeping a little better - don't feel as restless at night. But...(and this may be unrelated to changing to a BiPap because of concern about other health issues), I have developed raging all day Anxiety that is there as soon as I open my eyes. I literally have to take a Xanax the moment I wake up because I feel like I am going to go crazy with fear and doom. I have had occasional panic attacks for years, but never anything like this - it is all day uncontrollable anxiety, and I just shake and cry and feel like I'm losing my mind. No change in medications. Xanax is letting me barely hold myself together, but I just can't feel like this every day, and it has never happened before.

Based on advice from Pugsy and others, I have adjusted my settings from the original prescription of EPAP-9/IPAP-20/PS-5 to mostly 11-20 with a PS of 2. Last night I raised the PS to 3, and results were worse, so I need a 2 or less,

Is the range OK? I have read in other posts where it was recommended to tighten the range - The machine does bump up against the 20 a couple of times and I don't know if I should raise the IPAP and maybe even the EPAP a bit?

I set up an infrared camera and recorded Saturday night to check for mouth breathing - I couldn't really see any but the camera is mainly catching the side I sleep on most of the time and I really couldn't see well when I was on my back. Other than turning and a few foot wiggles, there was not the extreme leg movements that showed during the sleep studies, so that is progress.

I have attached 2 days of graphs - the one from Saturday night with a PS of 2 and the one from Sunday night with a PS of 3.

Questions:

1) Any idea what could be causing the raging anxiety to start when I started using BiPaP when the "numbers" are not horrible.
2) I know I should go back to a PS of 2 - should I also try a 1?
3) Should I adjust the EPAP/IPAP range?
3) On Saturday, even though the AHI is 4.56, there was a lot of the night when it was much higher, and this has always been the case. I really thought the BiPap could be my "answer", and the AHI averages are a little better, but I'm still having much higher incidents throughout the night.
Even on a night with average AHIs of 3ish, the actual occurrences throughout the night are much higher.
4) Has anyone else experienced a long "getting adjusted to" period when switching from Auto to BiPap?

First Graph is Sunday night with 11-20 and PS of 3



Second Graph is Saturday night with 11-20 and PS of 2


Thank you for your help with this.

Hi Dallas, regarding your statement, " I have developed raging all day Anxiety that is there as soon as I open my eyes. I literally have to take a Xanax the moment I wake up because I feel like I am going to go crazy with fear and doom. I have had occasional panic attacks for years, but never anything like this - it is all day uncontrollable anxiety, and I just shake and cry and feel like I'm losing my mind. No change in medications. Xanax is letting me barely hold myself together, but I just can't feel like this every day, and it has never happened before."


I sooo feel for you: been there done that. There was a time in my life when the very same thing happened to me. Xanax was just keeping it down enough to be able to function. I was becoming suicidal because of it. There were some negative things that started it off, bad thinking, and a move I did not want, some unrest in the family. Anyway the only thing that stopped it was when I was told to eat a LCHF diet, and for me it worked. The hi carb diet I was in was keeping my blood sugar going up and down making my mood unstable. Don't know if this will work for you, but just food for thought, pun intended, lol...best of luck...anxiety is NO FUN

I suggest you see your doctor and get referred for some short term therapy, probably CBT, because you shouldn't have to feel like that, but at this point I think it's beyond your control and you really should not be having to use Xanax. Don't wait til it gets worse or you become too addicted to Xanax (in increasing doses) plus your Cpap therapy is going to suffer. Good luck and let us know how things go. Optimizing your Cpap experience is good, but I think right now you need to concentrate on the other or it won't go very well anyhow.

Not sure what to tell you except that there is a lot of hormonal and energy metabolism disfunction regarding apnea. For instance experiments show that coristol levels are raised in apnea suffers, as well as creatine levels (especially creatine at night), which Creatine is involved with the ATP metabolism for cell energy.. meaning your body is setting up to have more energy at night. While you have the apnea untreated this isn't necessarily noticible because your body uses up that energy. Now I didn't have a lot of extra anxiety after CPAP therapy, but I did have unusual energy levels at first (sometimes good, sometimes bad, sometimes over energized) as well as wierd burst of adrenaline (that I didn't have before) I think my adrenal fatigue might have been correcting. Suffice it to say, there is a lot of healing your body has to go through with apnea... It's not just sleeping vs. not sleeping. Many doctors will try to convince you to use the mask by saying "it will make you sleep better". I consider this a mistake. It will definitely make your sleep more productive (since you're not dieing or getting brain damaged from hypoxia/suffocation), but many wake up (or at least remember waking up) more with the mask. This is due to the hormones rebalancing... increased energy at night... and not blacking out (at least for severe sufferers).

long story short TLDR, apnea is far more than a sleep issue, so there may be metobolic changes that happen that cause wierd things. best advice I can give is treat your body right, try to eat well, eat plenty of omega 3's, and take magnesium (apnea sufferers are notoriously low on magnesium due to the heart struggling every night)

Your post brought back some memories for me forty years ago when no one talked about it. My severe anxiety was part of a major depressive illness caused by a chemical imbalance in my brain that was at that time called "endogenous depression". I couldn't eat or sleep at night and the only thing keeping me barely functioning was Valium 4 times a day until the antidepressants kicked in. When the depression lifted the anxiety went away with it. I had no idea they were connected.

I never want to feel like that again. It's truly a horrible feeling. Get medical and/or psychological help sooner rather than later. I will be keeping you in my thoughts.

Thanks for the replies. I am taking Pristiq, and seeing a counselor (they are as baffled as I am), and the only time I was using Xanax was occasionally for a panic attack - maybe 6 times a year for only a day. This is Way different, and I've been having increasing anxiety since starting Bipap even though it feels fairly comfortable. That's why I was wondering if the Bipap had something to do with it.

This is really crazy lose your mind and sanity anxiety and lasts pretty much 24/7 in the sense that I am also having weird dreams/nightmares. Wish I know what was going on-hope the answer comes soon. Plus I am eating healthier than I ever have - maybe I should eat some cake.

If anyone has any suggestions based on the graphs about settings I might want to adjust, please let me know. Thanks again.

Do you know if you've had your 02 tested for desaturations and what results were?

I can attest that untreated anxiety can lead to severe depression. If you're just taking one medicine for it, I would suggest you find a psychiatrist (an MD) who is more versed in prescribing more than one med. I haven't had a problem in 8 years, but I take more than one prescription too. By the way, I started BiPAP two weeks ago and my mood is stable if not improving.