OSA with hypnic jerks

Hi there, I'm new to CPAP and this forum. I'm a bit of an unusual case here, and it's a longish story (so thank you in advance if you're reading through this!). I'm 42, male, slim and probably been suffering from Obstructive Sleep Apnea for a while, but not knowing. Looking back I can attribute the hypertension, the irritable bowel syndrome, the fatigue and the lack of concentration to it.

About four months ago I suffered a health scare (an infection). I got so tense and anxious that I suffered a nervous breakdown because of it. One of the symptoms, which carried on to this day, are hypnic jerks. These are 'sleep starts', a pulse of electricity that hits the brain, every time I try to dose off. When that first happened I was totally bewildered and scared. My doctor prescribed me sleeping tablets which I've been on ever since.

I went to see a neurologist, and he arranged for me to do a Sleep Study. I wasn't hanging a lot of hope since how will they stop my jolts from videoing me sleep? I was wrong. They recorded over 30 apnea episodes per hour. And apparently every time is followed by a jolt. Even after I'd fallen 'asleep' after the sleeping tablets.

Now I read somewhere that Obstructive Sleep Apnea can trigger the body's Sympathetic Nervous System, resulting in a fight or flight mode of respond. Seems pretty credible as there's correlation between apneas and jolts.

I've now started CPAP therapy and last night was the second night. I seem to take to the mask OK – a bit uncomfortable at the beginning but always settle in as the night wears on. By morning I'm barely aware that I'm breathing through it. But the jolts are still there in the morning around 7-8am, when the action of the sleeping tablet wears off.

I'm paranoid that the CPAP is not working. Am I expecting too much after two nights? My body is screaming out for restorative sleep after the nervous breakdown and I do want it to work so badly. I'm using a Philips Respironics System 1 and I've ordered the software and chip reader from the US. Not sure if I'd know how to interpret the data but that seems to be the only way to know whether the apnea's decreased. I wonder if I'd need to use it a lot longer to see any changes (not to mention stopping the hypnic jerks)?

Headintheclouds wrote:I'm using a Philips Respironics System 1 and I've ordered the software and chip reader from the US. Not sure if I'd know how to interpret the data but that seems to be the only way to know whether the apnea's decreased.

Could you please tell us exactly which model machine you are using? If you are unsure the model number is shown on a sticker on the bottom of the blower unit. A 3 digit number.
If your computer has a slot for the SD card you don't need a card reader and you didn't need to purchase the software (which I assume is Encore Viewer 2.0 and I hope that your computer isn't 64 bit and your machine isn't the newer 60 series machine because neither works with the 60 series machine).
SleepyHead software (links in my signature line) will work with the PR S1 machines as long as they aren't the heated hose 60 series machine. You could use it now if your computer has a slot for the SD card.

If you would register and list your equipment in your profile then we could see at a glance what equipment you are using.
Should you happen to have one of the 60 series machines there is a software that will work with those machines but I need to be able to send you a private message with that information. I can't send you a private message unless you register.

I don't know enough about hypnic jerks to comments other than I have experienced them from time to time but not frequent enough to be a problem. I can help with the software though.

Sleep debt is mentioned a lot here. It's where your body is trying to make up for all that time you went without sleep. Some people feel better after a couple days others it takes months. I thought my cpap was going to be magical but nope it's not. Tomorrow will be 5 weeks for me and I am still feeling tired during the day. It's gradually going away but it's taking longer than I thought it would.
I would give it some more time. After a month if you are still having the jerks I'd call your doctor. Do you have an Apap or just a cpap? If you have an Apap you can read your data and Make adjustments from what your data says.

Thanks Pugsy. I've actually ordered the software and card reader so it doesn't really matter. Going to arrive in a couple of days. Though I'm now not sure if this sort of close monitoring is necessarily a good thing. Maybe once a week is OK but I don't know if I can stop the temptation to look every morning. Is this a sure way to drive myself crazy?

I think, for me, Wonderbeastlett, it would be great if I can see the apnea 'events' decreasing over time. That would be most encouraging. I'm seeing an ENT surgeon tomorrow to assess whether there's any structural factor that led to the collapse of my airways during sleep onset. I'm between a rock and a hard place since I've already been on sleeping tablets for three months. Time is not on my side as I don't want to get further entrenched in the pills. On the other hand it seems that time is exactly what CPAP demands. I read again and again that people don't notice any difference for weeks / months.

I wonder if there're any recovery tell tale signs i should look out for?

Honestly I don't know what recovery signs for your jerks would really look like but if you just mean recovery signs of using cpap, there's a few. Now you should know people are affected differently, so you might have some or all of these. You should wake up without a headache. During the day your mind should start to feel clear and not fogged. You shouldn't be waking up gasping or going to bathroom at night as much. Hopefully you should start to feel refreshed during the day.

Those are some, personally I no longer have headaches or a fogged mind. Which is nice. There are probably more but I don't know all of them. I'm still a noob to. Lol

Thanks for your list, Wonderbeastlett. For my jolts, I'd like them to stop. This is what stops me from falling asleep naturally and having to use sleeping pills. During the day I'm having to cope with tiredness as well as symptoms from my nervous breakdown. I literally feel fear with inner tremors. It was pretty nasty a few weeks back but it's getting better all the time. So many things are happening all at once, and I'm taking so many medications (antidepressant, anticonvulsant) I just don't know the symptoms from the side effects any more.

It was a shock learning about the Obstructive Sleep Apnea (and so soon after learning that I have anxiety disorder), but also a strange relief. Finally something that bears correlation to the jolts! I'm still trying to digest the whole having-to-strap-myself-up-to-go-to-sleep thing, not to mention coming to terms with daily maintenance + future issues like travelling.

Okay. Whatever you want to do.
Just wanted to give you a heads up about the software that is for sale for the PR S1 machines and the newest models of PR S1 machines that you might have. The new machines won't work with EncoreViewer 2.0 which is the only software available for purchase from Respironics.
Just trying to save you some time and aggravation.

I used to get those last year, mostly in clusters a few times a month. This was pre-CPAP and sometimes I'd jerk so bad I'd bite my tongue to the point that it would bleed! I never even knew what they were called until I read your post. Amazing what you can learn here. Anyway, they didn't happen too often so I just passed it off for some temporary cross-up of my nervous system's wiring. The good news is that I don't have them since starting CPAP over three months ago! Hope you have the same positive results over a period of time.

Edit and addendum: Now that I think of it, that period of trouble was about the same time I was using too much Xanax. Hmmmm.

Hypnic jerks? Oh, we're NOT talking about the guys working for the DME.

Hello and welcome. Do you have a copy of your sleep study? I'd be interested in reading the exact wording on any mentions of respiratory related arousals, limb movements or PLMs. I have had hypnic jerks in the past and while you may have them, I'm wondering if some of what you're experiencing could be explained outside the realm of hypnic jerks. There may be some clues in your report to help you sort through this in your attempts to get better rest. First step is understanding exactly what you are dealing with.

HI - I think there might be a bit of misunderstanding or misinterpretation going on - the fight or flight thing IS valid in the sense that if your body quits breathing when you're asleep, of course the fight or flight instinct comes into play trying to save your life by waking you up, but isn't usually strong enough to actually do it so that you're aware, just enough though to cause trouble breathing, and the reason cpap works (allows enough air into your system so you don't quit breathing and trigger the ForF response. It's often used in articles about OSA, but it's not a question of it's being a dangerous or troublesome add on to apnea, just a way of describing what happens when you sleep without cpap.

From what you are describing it sounds like one of the manifestations of RLS, restless leg syndrome. I have what seems to start as a creepy crawling feeling that progresses to an electric charge building up to a discharge that causes me to jerk awake. Mine is agrevated by stress, caffine, and poor sleep. I have tried some of the rls meds, but finding the triggers has helped the most. My rls did show on my sleep study, and currently I am using gabapentin to help control the symptoms.

You should talk to your doc about this.

retrodave15 wrote:From what you are describing it sounds like one of the manifestations of RLS, restless leg syndrome. I have what seems to start as a creepy crawling feeling that progresses to an electric charge building up to a discharge that causes me to jerk awake. Mine is agrevated by stress, caffine, and poor sleep. I have tried some of the rls meds, but finding the triggers has helped the most. My rls did show on my sleep study, and currently I am using gabapentin to help control the symptoms.

Hey Dave, do you have RLS and PLMD? I can readily identify with your description for RLS, and thankfully my RLS has greatly improved. Just wondering if that's what's waking you or if it's PLMD? With mine I can wake in the middle or toward the end of a jerk, without awareness that I'd had many rhythmic movements prior to waking. It wasn't until I saw myself on videotape that I became aware of what led up to my waking. Just wondering.

Headintheclouds wrote:Hi there, I'm new to CPAP and this forum. I'm a bit of an unusual case here, and it's a longish story (so thank you in advance if you're reading through this!). I'm 42, male, slim and probably been suffering from Obstructive Sleep Apnea for a while, but not knowing. Looking back I can attribute the hypertension, the irritable bowel syndrome, the fatigue and the lack of concentration to it.

About four months ago I suffered a health scare (an infection). I got so tense and anxious that I suffered a nervous breakdown because of it. One of the symptoms, which carried on to this day, are hypnic jerks. These are 'sleep starts', a pulse of electricity that hits the brain, every time I try to dose off. When that first happened I was totally bewildered and scared. My doctor prescribed me sleeping tablets which I've been on ever since.

I went to see a neurologist, and he arranged for me to do a Sleep Study. I wasn't hanging a lot of hope since how will they stop my jolts from videoing me sleep? I was wrong. They recorded over 30 apnea episodes per hour. And apparently every time is followed by a jolt. Even after I'd fallen 'asleep' after the sleeping tablets.

Now I read somewhere that Obstructive Sleep Apnea can trigger the body's Sympathetic Nervous System, resulting in a fight or flight mode of respond. Seems pretty credible as there's correlation between apneas and jolts.

I've now started CPAP therapy and last night was the second night. I seem to take to the mask OK – a bit uncomfortable at the beginning but always settle in as the night wears on. By morning I'm barely aware that I'm breathing through it. But the jolts are still there in the morning around 7-8am, when the action of the sleeping tablet wears off.

I'm paranoid that the CPAP is not working. Am I expecting too much after two nights? My body is screaming out for restorative sleep after the nervous breakdown and I do want it to work so badly. I'm using a Philips Respironics System 1 and I've ordered the software and chip reader from the US. Not sure if I'd know how to interpret the data but that seems to be the only way to know whether the apnea's decreased. I wonder if I'd need to use it a lot longer to see any changes (not to mention stopping the hypnic jerks)?

Hi Headintheclouds!

In my case, my hypnic jerks became exagerated during a time I was dealing with stress from the yearly anneversary of an attack upon my person by a person who had murdered before and apparently wanted to do it again. Simply, God had mercy on me an mine. However, that time of year my nerves get frayed!

I think stress has a lot to do with it.

I also found out that my "days long panic attacks" included hyperventilation and that I could treat that by using a pulse oximeter to find the breathing rate where my heart rate was lowest holding exertion constant. So now I keep a little pulse oximeter strapped to my hip and use it often to keep my breathing reflexes well trained to breath optimally. It is also useful to do interval training as I walk from place to place (beats putting on a chest strap indeed).

From time to time you might try this simple experiment:

Breath out gently and stop - for five seconds - breath five slow shallow gentle breaths - breath out and stop - for five seconds - repeat once more and breath as gently as possible. Your body will likely fight you with this at first, indeed, much more likely it will if you are hyperventilating.

In my case this resulted in me feeling the blood rush back into my feet - a feeling of being warm - and my urge to breath so fast evaporating. My heart rate also slowed down considerably. My mind became more clear. In me this happened because I was chronically hyperventilating and not aware of that state. It became normal to breath much more than I should. So the CO2 got washed out, circulation constricted, and the oxygen in my blood cells was frustrated from delivering it's precious load.

CPAP, due to the constant pressure, tends to make one breath more. When you train with yours during the day, at you desk, and laying in bed, learn to breath gently. Your body will adapt to the new situation over time but concentration in the direction it should go will get you there faster I have found.

May you find good restorative sleep soon!

Todzo

Re: RLS being the same thing or related to Hypnic Jerks. I had a recent sleep study that showed I had absolutely no Restless Leg Syndrome (RLS). This sleep study was around the time when I was having occasional periods of hypnic jerks at the rate of twice a month. No hypnic jerks happened during my sleep study, so my sleep doctor obviously couldn't look at data regarding them. I've come to the conclusion that hypnic jerks are a different phenomena than RLS, tho the root causes of both probably stem from the brain/central nervous system network. Whatever the causes, I glad this topic came up. As I said before... I'm sure glad they went away because the last thing you want to do while sleeping is jerk violently awake and bite your tongue to the point of bleeding. Who needs that?