What's wrong with me?

I took an in home sleep apnea test and results came back with moderate sleep apnea. The reason I decided to take test is because I've had several episodes over last 6 months where I would wake up suddenly and not be able to breathe. On one occasion I woke up not able to breathe or swallow. This last Saturday I woke up not able to breathe and once I caught my breathe, I went to the kitchen to get something to drink and all of a sudden I felt as if I was about to fall asleep standing up. Also felt as if I was still dreaming. Very scary. Anyway I got my cpap on Friday. It's the resnick auto sense CPAP. I have three nose pillow mask. It's set to 4-20. First night I used the machine, within an hour I woke up as if I was suffocating. Happened again 1 more time later that night. I raised the pressure to 6 with no ramp the next night. Same thing happened, wake up suffocating. I've barely slept this weekend because I'm afraid to go back to sleep. I thought the cpap was supposed to help?

Well, it sounds like you have the Resmed Airsense Autoset--a great machine.
But it has not been "set" at all.
It is on factory default--wide open, guaranteed to make you miserable
until you find the correct range FOR YOU.
Hang around, this is not difficult with the help our experts give here.
Consider getting Oscar, the free, user-developed software for cpap analysis.
You may find yourself geeking out with the best of them.

May I ask what country you had the test in? Sounds a bit unusual

United states. Doctor ordered an in home sleep study. They sent me the test and after I completed it, sent it back. Showed moderate sleep apnea with 19.8 events per hour.

Im also under alot of stress lately and have gained weight over last year. Im 6'1" 260 pounds.

Any possibility of it being anxiety? This sounds like me when I was untreated (effects probably moderated through cortisol), although it resolved pretty quickly once I got my AHI under control.

If an anxiolytic relieves the symptoms, that would probably confirm it.

Fetou wrote: ↑

Sun Dec 01, 2019 8:41 pm

Any possibility of it being anxiety? This sounds like me when I was untreated (effects probably moderated through cortisol), although it resolved pretty quickly once I got my AHI under control.

If an anxiolytic relieves the symptoms, that would probably confirm it.

Could be I guess. I take prescribed xanax nightly for sleep.

Fetou wrote: ↑

Sun Dec 01, 2019 8:41 pm

Any possibility of it being anxiety? This sounds like me when I was untreated (effects probably moderated through cortisol), although it resolved pretty quickly once I got my AHI under control.

If an anxiolytic relieves the symptoms, that would probably confirm it.

My sleep issues went undiagnosed for over a year because they were written off as anxiety.

I have only been on treatment for a couple weeks and already noticed improvement.

Sleep apnea is an obvious cause of anxiety. It leaves your body in a fatigued state making life difficult to deal with. When apnea occurs it can cause desaturation which can lead to the body waking you up in fight or flight mode. I often used to wake up early in the morning with my mind racing about the stupidest things and I had no idea what was causing it. I tried all sorts of counselling, self help books etc and it never made sense. Then I had my sleep study that showed severe desaturation at roughly that same time in the morning... Bingo...

In short I agree with you part of this might be related to anxiety BUT I would highly recommend the OP works on treating the sleep apnea before trying any other anxiety related medication.

Increasing pressure to 6 and turning off ramp was a good idea. What is your EPR set at? I would recommend setting it at 3 if it is not already at that setting. EPR will help you breath out more comfortably.


OSCAR data will help us understand what the machine is trying to do to see if any improvements can be made on the settings. You can download the software at this link.

https://www.sleepfiles.com/OSCAR/

There are some installation details here if you need help working through the process.

http://www.apneaboard.com/wiki/index.ph ... stallation

This link can help you set up your profile and figure out how to use OSCAR.

http://www.apneaboard.com/wiki/index.ph ... first_time

Once you have data imported you can organize it by dragging the individual graphs so that from top to bottom it goes Event Flags, Flow Rate, Pressure, Leak Rate, Flow Limit. Under file, preferences, appearance click the box beside "Show event breakdown pie chart" so that the pie chart disappears. Then click view, take screenshot. Upload your image to this thread and someone will help you interpret it.

andrenym00 wrote: ↑

Sun Dec 01, 2019 8:53 pm

Fetou wrote: ↑

Sun Dec 01, 2019 8:41 pm

Any possibility of it being anxiety? This sounds like me when I was untreated (effects probably moderated through cortisol), although it resolved pretty quickly once I got my AHI under control.

If an anxiolytic relieves the symptoms, that would probably confirm it.

Could be I guess. I take prescribed xanax nightly for sleep.

From personal experience, Xanax's extremely short half-life and duration of effect can cause significant rebound anxiety in short periods of time similar to drinking alcohol and then starting to sober up. Perhaps try to coax your medical provider into giving you a longer acting sedative to see if it resolves your intra-night issues? Something like Valium, Klonopin etc.

I sympathize with being afraid to go to sleep. That's what caused me to finally deal with my sleep apnea. I was a claustrophobic, scatter brained mess at the time that I first got my machine. I was struggling with basic tasks like being in a vehicle because of the physical stress.

Geer1 wrote: ↑

Sun Dec 01, 2019 9:03 pm

My sleep issues went undiagnosed for over a year because they were written off as anxiety.

I have only been on treatment for a couple weeks and already noticed improvement.

Sleep apnea is an obvious cause of anxiety. It leaves your body in a fatigued state making life difficult to deal with. When apnea occurs it can cause desaturation which can lead to the body waking you up in fight or flight mode. I often used to wake up early in the morning with my mind racing about the stupidest things and I had no idea what was causing it. I tried all sorts of counselling, self help books etc and it never made sense. Then I had my sleep study that showed severe desaturation at roughly that same time in the morning... Bingo...

In short I agree with you part of this might be related to anxiety BUT I would highly recommend the OP works on treating the sleep apnea before trying any other anxiety related medication.

I got the drastic improvement after the first night like a soothing balm on a wound. My sleep apnea was pretty severe it seems as I was morbidly obese at the time that I started (have lost 100 lbs since). I agree that it can actually be the primary cause of symptoms, and was only suggesting the anxiolytic as a means of ruling out other "physical" conditions that may be causing OP's symptoms, rather than as the solution for them.

Given that the OP is now confirmed to already be using alprazolam, my gut reaction is that this is actually the symptoms of physical dependence on the drug. Nasty stuff in my experience, hardest thing I ever had to deal with.

What is your AHI after a night of sleep? It should show on the screen.

Fetou wrote: ↑

Sun Dec 01, 2019 9:12 pm

Given that the OP is now confirmed to already be using alprazolam, my gut reaction is that this is actually the symptoms of physical dependence on the drug. Nasty stuff in my experience, hardest thing I ever had to deal with.

He has untreated moderate sleep apnea and his explanation of symptoms fits sleep apnea. I think you are jumping the gun by recommending a change in medication at this time.

Klonopin might be a better option especially when he is ready to transition off benzos but if the Xanax is helping right now I wouldn't recommend a change, not until the sleep apnea treatment has started to take effect. Changing medication just muddies the water and will make it harder for him to realize how well the sleep apnea treatment is helping.

Geer1 wrote: ↑

Sun Dec 01, 2019 9:54 pm

Fetou wrote: ↑

Sun Dec 01, 2019 9:12 pm

Given that the OP is now confirmed to already be using alprazolam, my gut reaction is that this is actually the symptoms of physical dependence on the drug. Nasty stuff in my experience, hardest thing I ever had to deal with.

He has untreated moderate sleep apnea and his explanation of symptoms fits sleep apnea. I think you are jumping the gun by recommending a change in medication at this time.

Klonopin might be a better option especially when he is ready to transition off benzos but if the Xanax is helping right now I wouldn't recommend a change, not until the sleep apnea treatment has started to take effect. Changing medication just muddies the water and will make it harder for him to realize how well the sleep apnea treatment is helping.

The symptoms fit anxiety much better than sleep apnea, whether sleep apnea is the underlying driver of the anxiety or not. It's worth discussing with a doctor, based only on my experience. I am not qualified to dispense medical advice as it relates to switching prescriptions, and am just making a suggestion of something to explore with a doctor as a possible short term solution. Please note that Klonopin is a benzodiazepine and does not represent a transition off of benzos.

Of course, a doctor who prescribes Xanax as a sleep aid might not be worth exploring anything with, tbh, unless it was only for a short duration.

Andre, Geer1's post that includes Oscar information is a really good one, and I hope you'll do as he suggests. That will help the experts help you. Once they can see exactly what is going on, they may be able to help you change your settings to increase your comfort.

The experience of trying to sleep with the mask on your face and the machine generating pressure is for many of us initially unsettling. You might help your body acclimate itself if you use the mask and machine during the day while you read or watch TV -- something you enjoy that can distract you some.

Fetou wrote: ↑

Sun Dec 01, 2019 10:05 pm

The symptoms fit anxiety much better than sleep apnea, whether sleep apnea is the underlying driver of the anxiety or not.

Anxiety gets blamed for everything these days. Benzos, antidepressants etc aren't cures, they are bandaids being applied to gushing wounds. You need to stop the source of bleeding to get better.

Anyone struggling with anxiety should read Edmund Bourne's book, The Anxiety and Phobia Workbook. Anxiety is just a physical response to stress (mental or physical), in order to reduce anxiety you need to treat what is eliciting this response. If the OP doesn't know what is causing his anxiety then sleep apnea is probably as likely as anything else.

Waking up gasping for air and a sleep study indicating AHI of 20 strongly supports untreated sleep apnea... Lets figure out how to treat it and see how much of a difference that makes.