Still trying to get used to this, need some thoughts

Okay I was just googling some of what you had wrote and I am actually questioning if I have the opposite problem, hypercapnia. Or basically high CO2 levels. But everything I am reading on it is very confusing. So a few questions.

1. I know without a doubt my breathing is crazy when I first put on the mask for about 5-10 minutes. I feel suffocated and panicky. But once I settle into it, take some big, slow breaths, and get my mind off of it I do fine. I am sure that will continue to ease up. (Not really a question, just a comment lol)

2. My original sleep study was 2-3 years ago. Last year I had a titration which I walked out of after 20 minutes in a panic and of course they would have charged my insurance. Starting March 1st I will have a new insurance through a new job (90 days just came up) would it be unrealistic to seek a new sleep study? Would a new insurance pay for it or not since I just had a titration done (on different insurance). I do want to give the machine a bit more time first. But the reason I ask is because I question if some things have changed since the original sleep study. These are:

I have lost 40 pounds (40 more to go)
I have stopped snoring...BUT...symptoms have gotten worse, much worse


All of my symptoms point to a high CO2 level (or does all apnea have high CO2 levels? I don't recall there being any CSAs in my sleep study. So can normal apnea raise CO2?)

Morning headaches that go away after waking up and breathing for 30 minutes or so. These have worsened and I Googled that they are usually caused not from a lack of oxygen, but a raise in CO2 that can't escape the body.

Extremely red eyes that accompany those headaches along with flushed cheeks that also go away after 30 minutes. Again, I just googled this as a hercapnia (high CO2 sign)

Raised blood pressure. Never had this until the past year, but maybe it's just because I am 41 now

Heart murmer...as far as I know I have always had that as a kid but I did just read that as a hercapnia sign
Increased heart rate...this is new. Past few months my heart will feel like it is pounding hard and I am aware of it (even while relaxing) It makes me nervous but figure maybe I am just acting panicky with all of this apnea stuff

Glaucoma from sleep apnea....thinning nerves, mild loss of peripheral vision in one eye, yet normal pressures. My boss (ophthalmologist) has confirmed that this is likely from the sleep apnea possible lack of oxygen with red eyes in AM

Not breathing while awake and relaxed...this is very new. Noticed it over last 2 months and it's very odd. I just stop breathing and then suddenly start again and realized I hadn't been breathing. I would love if I knew how long I stopped for. Maybe I should monitor with the mask while watching TV for a few hours. Would it tell me?

Confusion and memory loss....next to headaches, this is my worst symptom. I am noticing a huge difference in things I do. It is VERY frustrating and getting worse.


Should I talk to the new sleep doc about CO2 levels? Is there a way to actually measure that? I know there is that oxygen thingy for your finger, does it measure CO2 as well?

Mirrasi wrote:Okay I was just googling some of what you had wrote and I am actually questioning if I have the opposite problem, hypercapnia. Or basically high CO2 levels. But everything I am reading on it is very confusing. So a few questions.

1. I know without a doubt my breathing is crazy when I first put on the mask for about 5-10 minutes. I feel suffocated and panicky. But once I settle into it, take some big, slow breaths, and get my mind off of it I do fine. I am sure that will continue to ease up. (Not really a question, just a comment lol)

2. My original sleep study was 2-3 years ago. Last year I had a titration which I walked out of after 20 minutes in a panic and of course they would have charged my insurance. Starting March 1st I will have a new insurance through a new job (90 days just came up) would it be unrealistic to seek a new sleep study? Would a new insurance pay for it or not since I just had a titration done (on different insurance). I do want to give the machine a bit more time first. But the reason I ask is because I question if some things have changed since the original sleep study. These are:

I have lost 40 pounds (40 more to go)
I have stopped snoring...BUT...symptoms have gotten worse, much worse


All of my symptoms point to a high CO2 level (or does all apnea have high CO2 levels? I don't recall there being any CSAs in my sleep study. So can normal apnea raise CO2?)

Morning headaches that go away after waking up and breathing for 30 minutes or so. These have worsened and I Googled that they are usually caused not from a lack of oxygen, but a raise in CO2 that can't escape the body.

Extremely red eyes that accompany those headaches along with flushed cheeks that also go away after 30 minutes. Again, I just googled this as a hercapnia (high CO2 sign)

Raised blood pressure. Never had this until the past year, but maybe it's just because I am 41 now

Heart murmer...as far as I know I have always had that as a kid but I did just read that as a hercapnia sign
Increased heart rate...this is new. Past few months my heart will feel like it is pounding hard and I am aware of it (even while relaxing) It makes me nervous but figure maybe I am just acting panicky with all of this apnea stuff

Glaucoma from sleep apnea....thinning nerves, mild loss of peripheral vision in one eye, yet normal pressures. My boss (ophthalmologist) has confirmed that this is likely from the sleep apnea possible lack of oxygen with red eyes in AM

Not breathing while awake and relaxed...this is very new. Noticed it over last 2 months and it's very odd. I just stop breathing and then suddenly start again and realized I hadn't been breathing. I would love if I knew how long I stopped for. Maybe I should monitor with the mask while watching TV for a few hours. Would it tell me?

Confusion and memory loss....next to headaches, this is my worst symptom. I am noticing a huge difference in things I do. It is VERY frustrating and getting worse.


Should I talk to the new sleep doc about CO2 levels? Is there a way to actually measure that? I know there is that oxygen thingy for your finger, does it measure CO2 as well?

Hi Mirrasi!

The thing about CO2 levels is that they are transitory. With Obstructive Sleep Apnea (OSA) you are likley to see times of hypocapnia (too little CO2), eucapnia (the right ammount of CO2), and hypercapnia (too much CO2) all in the space of a few minutes.

The reason is that OSA messes up our chemoreflexes (blood gas sensors and breathing control systems).

So testing for CO2 would have to be done in real time to be valid to find out what is going on. They can look at end tidal CO2 (the amount of CO2 in the air expelled at the end of a breath) but this is expensive and impractical since it must also be done as you use your own PAP in your own bed to be valid.

What I do is to look at the breathing airflow waveforms and compare to times when I know things are going well. It is pretty easy to see if you are using more air and if your peak use of air is unstable.

I do remember daytime symptoms of hypercapnia when I first started using CPAP. They were with me for about the first month or so.

I think it does help to exercise ones chemoreflexes with aerobic (and when in shape add some 85% of maximum heart rate interval training) along with some resistance training. Walking a lot seems to also help.

The PAP machines are designed to supply many times what one would normally use while at rest. The fact that you feel like you are suffocating is one of the things that makes me think your breathing reflexes are telling you to use much more air at that time than you actually need. You need to rig to use your PAP data to know for sure.

Take care!

Todzo

Hi Mirrasi!

You got me Googling "Glaucoma from sleep apnea" - wow!

It reminded me of this (not an easy read but understanding how hypocapnia messes up circulation and metabolism in the brain - and the eyes are an extension of the brain I think - is worth my continuing efforts):

Philip N. Ainslie and James Duffin, Integration of cerebrovascular CO2 reactivity and chemoreflex control of breathing: mechanisms of regulation, measurement, and interpretation Published online before print February 11, 2009, doi: 10.​1152/​ajpregu.​91008.​2008 AJP - Regu Physiol May 2009 vol. 296 no. 5 R1473-R1495
Link: http://ajpregu.physiology.org/content/296/5/R1473.long

Mirrasi wrote:Okay I was just googling some of what you had wrote and I am actually questioning if I have the opposite problem, hypercapnia. Or basically high CO2 levels. But everything I am reading on it is very confusing. So a few questions.

1. I know without a doubt my breathing is crazy when I first put on the mask for about 5-10 minutes. I feel suffocated and panicky. But once I settle into it, take some big, slow breaths, and get my mind off of it I do fine. I am sure that will continue to ease up. (Not really a question, just a comment lol)

2. My original sleep study was 2-3 years ago. Last year I had a titration which I walked out of after 20 minutes in a panic and of course they would have charged my insurance. Starting March 1st I will have a new insurance through a new job (90 days just came up) would it be unrealistic to seek a new sleep study? Would a new insurance pay for it or not since I just had a titration done (on different insurance). I do want to give the machine a bit more time first. But the reason I ask is because I question if some things have changed since the original sleep study. These are:

I have lost 40 pounds (40 more to go)
I have stopped snoring...BUT...symptoms have gotten worse, much worse


All of my symptoms point to a high CO2 level (or does all apnea have high CO2 levels? I don't recall there being any CSAs in my sleep study. So can normal apnea raise CO2?)

Morning headaches that go away after waking up and breathing for 30 minutes or so. These have worsened and I Googled that they are usually caused not from a lack of oxygen, but a raise in CO2 that can't escape the body.

Extremely red eyes that accompany those headaches along with flushed cheeks that also go away after 30 minutes. Again, I just googled this as a hercapnia (high CO2 sign)

Raised blood pressure. Never had this until the past year, but maybe it's just because I am 41 now

Heart murmer...as far as I know I have always had that as a kid but I did just read that as a hercapnia sign
Increased heart rate...this is new. Past few months my heart will feel like it is pounding hard and I am aware of it (even while relaxing) It makes me nervous but figure maybe I am just acting panicky with all of this apnea stuff

Glaucoma from sleep apnea....thinning nerves, mild loss of peripheral vision in one eye, yet normal pressures. My boss (ophthalmologist) has confirmed that this is likely from the sleep apnea possible lack of oxygen with red eyes in AM

Not breathing while awake and relaxed...this is very new. Noticed it over last 2 months and it's very odd. I just stop breathing and then suddenly start again and realized I hadn't been breathing. I would love if I knew how long I stopped for. Maybe I should monitor with the mask while watching TV for a few hours. Would it tell me?

Confusion and memory loss....next to headaches, this is my worst symptom. I am noticing a huge difference in things I do. It is VERY frustrating and getting worse.


Should I talk to the new sleep doc about CO2 levels? Is there a way to actually measure that? I know there is that oxygen thingy for your finger, does it measure CO2 as well?

A pulseox will tell you nothing about your CO2 level.

Any apnea will tend to raise CO2 and lower O2.

Feeling suffocated at the start may mean your starting pressure is too low. Or it may just be psychological. Sometimes, just lifting the mask up off the edge of your face for a few seconds may reassure you.