Choking when falling asleep

vze2363v wrote:

kuda wrote:I also see that there is a high leak rate at that time too. I wonder if if the mask leaked and then I choked out. I remember ripping off the mask as I shot out of bed too. I always sit up or get up immediately and start breathing really heavy. Ugh, it sucks. Like I woke up from a nightmare. Half the time my hands are numb, and I feel like I have no 02 in my system and I'm gonna suffocate.

I had a problem with choking and panic, but I found they were related to the PAP machine shutting off, even though it didn't show up on the reports. The girl at the doctor's office told me some PAP machines can be a little hinky. I only found out it was turning off by itself because I was trying to meet compliance so I was awake sitting up in a chair and could look at the machine display when it happened. It hasn't happened again since they replaced my machine. FYI in case you don't find out why you are having the choking problem.

Hi,

Good point. I keep hearing about this.

Good incentive for me to get off my duff and re-establish nighttime audio recordings. I have used Audacity (a free Open Source program which is cross platform (works on Windows, Linux, and I think Mac)) but prefer sox (a Linux command line program - very configurable and easy to work with for me).

I like to use my Sonic Super Ear as the microphone as it is quite sensitive and my rechargeable batteries last several days. I may purchase a mic and mixer, who knows. Actually I hope to implant a mic in my mask for some really "close in" audio - probably as a separate channel (nasty humidity problems however).

I know the room audio can contain information about the likes of noisy neighbors - and I think this would catch a machine that stopped working if the microphone was placed to pick that up.

Anyway, thanks for the info - good stuff!

Todzo

Night #2:

AHI 1.51 I had 2 Obstructive Apnea events at 3:00AM and 6:00AM. Flow rate flat lined for about 11 seconds. I do toss and turn a lot, so I'm wondering if that is when i'm going from my back to my side or vice-versa. I always seem to take deep breaths too. 12 second apneas I'm wondering are just the normal for me. The machine seems to pick up the 12-15 second ones.

What's odd is I woke up and was excited that I didn't shoot out of bed and rip the mask off with a choking session. My wife told me that I did get up and sit up like I normally do though twice in the night though. I just sat up and swong my feet around the bed, sat for a minte and then just laid back down and slept. I didn't take the mask off, and I have ZERO recollection of the events.

I'm wondering if it's just a learned behavior at this point, or if it was just a mini-choke out but not enough to wake me up.

Odd.

kuda wrote:Night #2:

AHI 1.51 I had 2 Obstructive Apnea events at 3:00AM and 6:00AM. Flow rate flat lined for about 11 seconds. I do toss and turn a lot, so I'm wondering if that is when i'm going from my back to my side or vice-versa. I always seem to take deep breaths too. 12 second apneas I'm wondering are just the normal for me. The machine seems to pick up the 12-15 second ones.

What's odd is I woke up and was excited that I didn't shoot out of bed and rip the mask off with a choking session. My wife told me that I did get up and sit up like I normally do though twice in the night though. I just sat up and swong my feet around the bed, sat for a minte and then just laid back down and slept. I didn't take the mask off, and I have ZERO recollection of the events.

I'm wondering if it's just a learned behavior at this point, or if it was just a mini-choke out but not enough to wake me up.

Odd.

Hi Kuda!

Well, Tom Sietas can hold his breath under water for twenty two minutes and twenty two seconds (current world record holder). Followers of the Buteyko Breathing method consider you healthy if your urge to breath after a gentile exhale does not express itself for at least fourty seconds in the morning. So I think it is quite possible that you normally have breathing pauses of 12 to 15 seconds. Indeed, as I practice my "optimal breathing" using a pulse oximeter to guide me I find my time between breaths growing to the point where the clear airway sensing pulses (pacing pulses?!?) are an unwelcome and unnecessary part of my breathing while on the machine and my alseep respiration rate is probably greater than it would be without them.

When you look at your data, check out what is happening near the long pause. If you breathing is quiet and you are using a normal quiet volume of air (minute volumes - the height of the flow wave form along with the number of respirations per minute - think volume of air - two deep breaths I am not concerned - ten rapid deep breaths - well...) then I think it was most likely "just a pause". If there is a time of increased breathing before the pause - well then you may be looking at a hypocapnic central apnea. These are two very differant things. The one "just a pause" probably indicates a healthy body. The other "hypocapnic central apnea" indicates events I am more scared of than obstructive apneas due to the vascular gymnastics my brain is likely going through to try to compensate. I recently, partly due to an unavailability of doctors, adjusted my own pressure down (still in process), because I was having some of this kind of activity and I did not wish to stroke out!

It sounds like you are making peace with PAP. I think you will probably do very well.

Have a great day!

Todzo

Kuda,

When you sat up with the mask on, didn't rip it off and fell back to sleep - this tells me your subconscious is starting to accept the mask as its friend. It takes the body and mind some time to really believe it is helping it to breath better.

I had the same problem with ripping off my mask after only one minute of use the first few nights. But once the mind became convinced it could pass through the centrals minefield without suffocating, it became part of the sleep attire.

It's hard for me to believe, but I can now fall asleep within 5 minutes of hitting the pillow because of the great airflow and no worry of suffocating anymore. I hit deep sleep within 20 minutes at times. I just love the adventure of falling asleep now. You need to tell yourself that the mask is your friend over and over as you fall asleep and it will become a fact.

Tom

You also need to find a mask that you trust not to leak and which is comfortable. My first mask was fiddly, so I'd lay down and worry a bit about leaks. Latest mask is solid fit and once the mask is inflated, comfortable. I can roll over from one side to the other and not worry about leaks. So now I'm also falling asleep pretty quickly when hitting the pillow (and when I don't, it's not because of the machine it's other things).

Sage advice friends... thanks.

Day 3:

Had to travel with the S9 unit. I drove 7 hours from Phoenix to LA. So far, not bad. Setup and breakdown isn't bad. I only had 5.9 hours of sleep, but I literally closed my eyes and woke up with the alarm. AHI was .5 on night number three.

I've found that when I take the mask off in the morning (Swift nose pillows). My lungs and chest deflate back to where I was before the unit. I am starting to breathe so much easier and so comfortably at night that when i'm back to "natural" it feels crappy. Ugh, I need to get exercising though that's for sure.

Lastly, I made the 7 hour drive with no cat naps. I used to pull over and "sleep" or choke for 30 minute increments before I could continue. It was stretching out my drive time and I always felt like the road was hypnotizing me to FALLLL ASSLEEEEEP.

So far so good, and I'm looking forward to getting restful sleep at nights.

kuda wrote:Day 3:

Had to travel with the S9 unit. I drove 7 hours from Phoenix to LA. So far, not bad. Setup and breakdown isn't bad. I only had 5.9 hours of sleep, but I literally closed my eyes and woke up with the alarm. AHI was .5 on night number three.

I've found that when I take the mask off in the morning (Swift nose pillows). My lungs and chest deflate back to where I was before the unit. I am starting to breathe so much easier and so comfortably at night that when i'm back to "natural" it feels crappy. Ugh, I need to get exercising though that's for sure.

Lastly, I made the 7 hour drive with no cat naps. I used to pull over and "sleep" or choke for 30 minute increments before I could continue. It was stretching out my drive time and I always felt like the road was hypnotizing me to FALLLL ASSLEEEEEP.

So far so good, and I'm looking forward to getting restful sleep at nights.

Hi kuda!

Great!

In terms of end of the day driving safety - I once worked for an electronic systems supply company which covered the state of Montana. Talk about long trips after the long day!! The boss gave me a tip (much more than one actually). He told me that when we eat we do not sleep - airway safety - now traffic safety. Gum, drops, chips, coffee, whatever. But, do not use this as a way to stay away from stimulents if you think you need them - do those anyway. Gotta keep safe on the road!!! Breaks with some exercise time also recommended.

Have a great week!

Todzo

All,

On an additional note. I'm not 100% sure this is related, but I've suffered from heart palpitations since I was a kid. I always feel them....like every one of them. Sometimes it's like someone kicks me in the chest and i feel a LUB LUB or like a heart heartbeat and for a brief moment I cough, take a breath, or focus on it for a second. It always ends up being nothing, but right when I was choking out, it was horrible. I was having major palps and most were the hard ones. They are classified as PVC or premature ventricular contractions and considered normal. They suck though. I was having 2 or 3 a minute. Nothing I can do about it.

Well, I'm happy to report that they have disappeared. I haven't felt one in the last few days and that is rare.

I have no idea what to contribute this to, but it could be one of 4 things. 1. I started the BIPAP 3 days ago. 2. I have been regularly taking my cholesterol meds and got "optimal" on almost all the ratings. 3. I have lowered my panic state since getting the bipap. I was definitely panicking when all this went down. 4. I was under the weather for a bit and got through a mild cold. I seem to have more when I'm sick.

Everyone has told me that they are normal and not to worry...I only partially believe them most of the time. If any of you have felt them, it's REALLY hard to think "wow, that's just normal".

So far so good though with the whole bipap process and hopefully this info is useful to someone as they surf.

The only thing that has EVER helped me with GERD is eliminating grains from my diet and eating low carb. I've tried it all; weight loss (severe GERD started when I was very thin), antacids and PPI's including Prilosec, elevating the head of the bed, avoiding eating 3 hours before bed, avoiding alcohol, tomatoes, chocolate (I never eat spicy foods anyway). Dairy products close to bed make it much worse and eliminating grains and carbs once eliminated it 100% (first time low carbing) but now reduced it by 95% because grains and carbs are out of my diet.

I always laugh at common advice to avoid GERD like avoiding spicy foods. WATER can give me GERD symptoms.

kuda wrote:On an additional note. I'm not 100% sure this is related, but I've suffered from heart palpitations since I was a kid.

Have you brought up your palpitations with your doctors?

Apnea screws with your heart, your brain, your lungs, your hormones, and your nervous system. Lots of people report various heart conditions, including pulse rate changes, with apnea. A whole lot of things happen to your body when you get strangled dozens of times a night in your sleep.

It wouldn't be surprising if CPAP changes other medical conditions.

Like others have mentioned on this forum, my Dr. sees me for 5 minutes at a time (bills at over 300 for an hour) and generally seemed annoyed that I was even in his office. I'm waiting for my sleep study results and then I'll probably shop around for another Doctor. I have a feeling I'll get much more out of Sleepyhead than I will the actual MD.

Another update:

Had a bad night the other night though. Soon as I started falling asleep, I had that feeling of no O2. I would then gasp awake. I think it was a definite Central episode. It freaked me out of course, then I got insomnia, then I was up til 6 am. (I took a 2.5 hour nap that day so I wasn't sleepy by midnight). At 6 AM I crashed out hard, and didn't have any issues. I think I had a AHI of 1.8.

The next day I did a 20 mile bike ride with my new road bike - I'm on the quest to drop weight - Yeah it was my first ride in years, and yeah, 20 miles was probably overkill. My legs were completely trashed when i got back home. hhaha.

Anyway, I went to bed at midnight completely exhausted. Had 7.6 hours of sleep with AHI of 0.1 lowest yet. I think I need to ride the bike more, and the sofa less.

Kuda

kuda wrote:Another update:

Had a bad night the other night though. Soon as I started falling asleep, I had that feeling of no O2. I would then gasp awake. I think it was a definite Central episode. It freaked me out of course, then I got insomnia, then I was up til 6 am. (I took a 2.5 hour nap that day so I wasn't sleepy by midnight). At 6 AM I crashed out hard, and didn't have any issues. I think I had a AHI of 1.8.

The next day I did a 20 mile bike ride with my new road bike - I'm on the quest to drop weight - Yeah it was my first ride in years, and yeah, 20 miles was probably overkill. My legs were completely trashed when i got back home. hhaha.

Anyway, I went to bed at midnight completely exhausted. Had 7.6 hours of sleep with AHI of 0.1 lowest yet. I think I need to ride the bike more, and the sofa less.

Kuda

Hi Kuda!

I also recently got a new bicycle. In my case it only took an 8 mile hike to take the stuffing out of me. I am in the process of doing a self titration (I had lost a lot of weight and found it hard to connect with a knowing doctor in my new digs) and have come down from 15 to now looking at 9 cm/h2o making a change about every week or so if the data was improved or - since the seasons are changing - at least not degraded. Much exercise is involved in the need to titrate and what I saw in my data which made this urgent was a greater use of air (Minute Volumes - should be for ne near 6 with a 95% not too much higher) and periodic breathing.

I think that interval training exercise such as waking up the hills in my new digs or cycling very well exercise one's breathing reflexes. The CO2 sensors get to see some CO2 to remove (are exposed to high levels) and the O2 sensors get to see the need (are exposed to high levels of deoxygenated red blood cells). So the system, thus "recalibrated", is likely to run with more stability during the night.

At the same time, if our body changes so should our pressures. The body is dynamic, our current medical practice is static. Huston, we do have a problem.

Well, I hope we find good peace with our machines and the night. At least we have more fun during the day!!

Todzo

Well, I think i'm on day 7. Only got 4.9 hours of sleep last night. Woke up early for me, and couldn't get back to sleep. I had an AHI of 2.8 which is my highest yet. Not sure what the problem was....could be that I was up late gaming and I think I had food too late. That maybe affecting GERD issues. Yep - bad habits of eating snacky things late when I'm up.

Also, feeling odd chest things. I wouldn't describe it as pain, but more of an awareness of chest fullness or like a knot feeling maybe in the center of my chest. Maybe it's muscle related, or maybe my esophagus. I'm taking the prylosec every day, so not sure. I read that your chest needs to get used to the increased pressure and it can make some muscles sore. I dunno. Still one day at a time.