Do you do this?

I too sometimes just stop breathing while distracted. I have really noticed it lately since I got my new apap. I work a couple of days at 1AM in the morning. While trying to settle down to sleep, and wearing my mask I have noticed the apap pulsing to get me to breath. I may be reading or thinking about something, definitely conscious, not dozing off. I believe these episodes mainly score as central apneas for me, and raises my AHI on the days I have the apap on for 1/2 to 1 hour before sleeping.

Are we talking about 2 different things, or am I making nothing out of something?

IMO you are making nothing out of something. If you watch the OSB videos you will see people who don't breathe normally when awake.

I think this is one elephant-in-the-room that sleep medicine has missed - many (maybe even most) people with sleep apnea don't breathe well when they are awake. Even if they use CPAP and breathe well at night, their awake breathing is such a problem that it causes them significant health problems. This would explain why some of us have great numbers with CPAP and seem to sleep well, but still feel poorly - we are not breathing well during the day!

Dr. Park has mentioned on his website why he believes many elite athletes are driven to train so hard and long. They have sleep apnea but they also do not breathe well during the day - they do not breathe rhythmically. But they do breathe rhythmically when they train hard and this is the only time they feel good. So when they are inactive they never feel well but when they engage in strenuous activity they feel well. This is why they are driven to train so long.

So what I am saying is we are treating one-third of the problem with CPAP. The other two-thirds (our awake hours) remain untreated.

If this is correct, it is something.

The question I have is conscious apnea obstructive or central? I believe mine is mainly central. I also have a problem when resuming breathing where I occasionally aspirate flem or saliva.

Before Cpap I would awaken after an apnea with aspirated reflux, and be hyperventilating, which is an incredibly terrifying experience, and I was constantly fearful of drowning in my sleep. I do not aspirate fluids in my sleep anymore, but do sometimes with a conscious apnea(if that is what they are).

SleepOly wrote:The question I have is conscious apnea obstructive or central?

There are three possibilities -

1. It is obstructive when a narrow collapsing airway causes pauses in breathing.

2. In the example of the novice weightlifter it is "central" in the sense that the central nervous system tells the body not to breathe. The same for turning over in the bed - your brain says use your energy to turn and don't breathe.

3. The common use of "central" would mean the central nervous system has a defect and fails to consistently send a message to the body to breathe. If this can happen at night, I don't see why it would not also happen during the day.

So all three could occur while awake.

The foregoing is speculation on my part but the comments of Dr. Park and the experience patients have with OSB seem to back it up.

In my case I can envisage being able to use CPAP for the next sixty years because I am disciplined and committed. However, I have a great concern that I am not breathing well during the day and that very slowly my health and my joie de vivre are being destroyed before I reach 40 or 50. For this reason I am going to make a commitment to pursue jaw enlargement to cover me night and day!

NightMonkey wrote:[
In my case I can envisage being able to use CPAP for the next sixty years because I am disciplined and committed. However, I have a great concern that I am not breathing well during the day and that very slowly my health and my joie de vivre are being destroyed before I reach 40 or 50. For this reason I am going to make a commitment to pursue jaw enlargement to cover me night and day!

I was fairly young when I started CPAP therapy. I had a hard time with having to sleep hosed up for the rest of my life at first. Now I can not imagine life without CPAP. I also have made a conscious effort to keep my lower jaw moved forward to improve my breathing. It now comes second nature to me and has improved my breathing quality.

NightMonkey wrote:So back to my original question, for those of you who describe these gaps in breathing as normal, do you have evidence to back that up?

Interesting issue to think about, but are you sure this may not be a case of abnormal being normal?

idamtnboy wrote:

NightMonkey wrote:So back to my original question, for those of you who describe these gaps in breathing as normal, do you have evidence to back that up?

Interesting issue to think about, but are you sure this may not be a case of abnormal being normal?

normal, definition 1. usual or ordinary; that which is to be expected

I do believe awake-disordered breathing (ASD) is normal in this sense. It is normal just as today being overweight is normal, taking prescription drugs is normal, diabetes is becoming normal, spending 30 hours per week lounging in front of the TV is normal, etc.

normal, definiton 4. Biology - free from any malformation

I do not believe ASD is normal in this sense. I do believe ASD was not common in our ancestors several generations back. I do believe we still have the genes for wide, healthy jaws and airways but they fail to develop due to lack of breastfeeding, pacifiers, sippy cups, and a poor diet.

For me it is more than something to think about - it is actionable. I am going to delve into the best methods of jaw widening to correct my biological abnormality; to normalize my awake breathing; and maybe to eliminate the need for CPAP.

Blow my oropharnyx? How about widening it instead?

NightMonkey,

You are absolutely right. I definitely experience this 'holding your breath' thing unconsciously.
I catch myself doing it all throughout the day. It is always after I have exhaled all of the air too.
As I am falling asleep (but before actually asleep) my girlfriend tells me I do it all the time too.

I agree with the physical activity / stress seeking to encourage more breathing. I have participated in athletics my whole life up until a few years ago.
I played about every sport you could imagine and played in the NCAA while in college. It wasn't until after graduating college, taking a boring 8-5 M-F job, and rarely exercising (playing sports) like I did before that I started noticing a decline in my health. I have also read that many people that have this problem tend to be thrill seekers and risk takers because it boosts their adrenaline in order to get them breathing more. I think this may tend to be more common in those with UARS as opposed to sleep apnea, however.

I have read a lot about Oral Systemic Balance and definitely like the sound of it. From what I have heard, it can cost anywhere up to $20k for this treatment. I have also watched all of those videos and it definitely looks promising.

If you go to Dr. Steven Park's website, he does all sorts of interviews on related topics. He has one about OSB with an OSB practitioner as well as many that discuss the whole not breathing well for the other 16 hours of the day. I urge you to check those out for more information.

Good luck if you try the DNA appliance made by Dr. Singh. There are other similar appliances such as the homeoblock and A.L.F. (Advanced Lightwire Functional) Appliance.

Me, too--(holding my breath)--; it gives me hiccups!

I do it too. The bad thing is when I am driving the car and I have to take a deep breath too catch up on my breathing. It is scarey. Brad

bradleyjoe wrote:I do it too. The bad thing is when I am driving the car and I have to take a deep breath too catch up on my breathing. It is scarey. Brad

I believe that is a good way to know if you do this or not. Out of no where you take a huge deep breath... probably means you were holding your breath or have been breathing extremely shallow - the "catch-up breath" I like to call it.

chunkyfrog wrote:Me, too--(holding my breath)--; it gives me hiccups!

I do it to cure hiccups!

I subconsciously hold my breath. There will be times that I will have 3 or 4 centrals in a few minutes while I am still awake.

I also agree that with sports, there will be abnormal breathing. Think about swimmers... I can't imagine another sport that trains a person better on holding one's breath and not inhaling and exhaling at a constant rhythm.

John

Know we know why people ask us if the can walk and chew gum at the same time.... Jim