Waking with palpitatipns

I am just getting started with CPAP. Surprisingly the equipment doesn't bother me and I sometimes wake thinking I forgot to put my nasal pillow on and then realize it's there happily blowing away.

Unfortunately i more commonly wake about 1.5 hours into the night with palpitations and often some hyperventilation symptoms (tingly/burning sensations particularly in my cold feet) that thoroughly arouse me so the rest of the night is a struggle. I've seen my primary care physician and a cardiologist and after some extensive tests they have pronounced me healthy (with the exception of apnea).

Anyone else have these problems? Any advice in addition to "don't give up" using the CPAP? Though I know it's impossible to know how long such problems might persist it would be nice to have some hope that there is light (sleep) at the end of the tunnel (of sleep deprivation).

1.5 hours into sleep corresponds with likely first REM sleep stage where sometimes we have more apneas and/or need more pressure.

Please add your equipment to your profile. Hopefully you will be using a machine that has full data and easy to use software so you can see what might be going on during that time frame. Once we know what you are using we can explain further.

wiki/index.php/Registering_Equipment_in_User_Profile

I had the same symptom nearly every night before starting cpap.
After 3 years, still none; maybe a couple of old lady sweats, though.
Effective treatment helped me.

I've added my equipment. I downloaded Sleepyhead software also.

Thanks for the reply. I am interested in how others worked through problems like this. I've had one sleep study, a split study, with inconclusive results about recommended pressures. Unfortunately I feel kind of like I'm flying blind and need some feedback

Thanks

viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html

See above link where we talk about what you see on the reports.
If you can post an image of one of your detailed reports maybe we can spot something.

SleepRunner wrote:I am just getting started with CPAP. Surprisingly the equipment doesn't bother me and I sometimes wake thinking I forgot to put my nasal pillow on and then realize it's there happily blowing away.

Unfortunately i more commonly wake about 1.5 hours into the night with palpitations and often some hyperventilation symptoms (tingly/burning sensations particularly in my cold feet) that thoroughly arouse me so the rest of the night is a struggle. I've seen my primary care physician and a cardiologist and after some extensive tests they have pronounced me healthy (with the exception of apnea).

Anyone else have these problems? Any advice in addition to "don't give up" using the CPAP? Though I know it's impossible to know how long such problems might persist it would be nice to have some hope that there is light (sleep) at the end of the tunnel (of sleep deprivation).

Hi Sleep Runner!

I started having these after I was attacked (robbed, stabbed, beaten - 27 staples and all).

Yes, ventilatory instability is a real issue for many with Obstructive Sleep Apnea(OSA)!!

You need to monitor your CPAP data closely.

After a year of eucapnic breathing I lost weight and was able to reduce my pressure from 15 to 8. Even at the lower pressure the anniversary of the attack would bring unstable breathing back into the picture.

Fortunately I found EERS[1] and use it in the winter to get by. There may be better therapies in the pipes[2].

Talk with your doctor about ventialtory instability with OSA, it's relationship to stress, and share the references[1,2] please.

Thanks!

Todzo

[1]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741

[2]: Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes
Yoseph Mebrate, Keith Willson, Charlotte H. Manisty, Resham Baruah, Jamil Mayet, Alun D. Hughes, Kim H. Parker and Darrel P. Francis
J Appl Physiol 107:696-706, 2009. First published 23 July 2009; doi: 10.1152/japplphysiol.90308.2008
Link: http://www.ncbi.nlm.nih.gov/pubmed/19628721

Thank you very much. This makes good sense. I was doing well until I had two stressful events (but not stressful at all compared to you!). One was a day where I was unprepared and had prolonged exposed to cold, windy conditions which left me with these symptoms for the first time. I seemed to recover from this rather quickly. But this was shortly followed by second stressor which was sleeping for a week at just under 10,000' (even things that are great fun can be physiologically stressful). Had a great time on the cold, hypoxic mountain...but since returning my sleep has never recovered. I didn't stay at elevation long enough to adapt but certainly long enough to hyperventilate and lose a lot of CO2 and perhaps dis-regulate my breathing controls.

is the equipment for EERS commercially available? I assume it has to be titrated in a sleep lab? If you cound give me some info on what equipment you use I would greatly appreciate it.

Thanks again, this is the first bit of hope I've had in quite a while.

How much coffee (or caffeine) do you drink? After starting PAP, I had to decrease by half my usual 2-cups, or have palpitations. It is as if I no longer need that stimulant.

Zero caffeine. Actually I have no trouble going to sleep (being sleep deprived helps and when I record my AHIs they are almost always below 2 and usually below 1. But that doesn't affect that bone jarring waking that I get usually 1.5 (sometimes 3 or 4) hours after I go to sleep. OSAs don't seem to be my problem, my AHIs remain low but I can't stay asleep and get thoroughly aroused more nights that not. I'm going to push for another sleep study (my 2nd) as I believe that CSA (as indicated on SleepyHead) are my current problem.

SleepRunner wrote:Thank you very much. This makes good sense. I was doing well until I had two stressful events (but not stressful at all compared to you!). One was a day where I was unprepared and had prolonged exposed to cold, windy conditions which left me with these symptoms for the first time. I seemed to recover from this rather quickly. But this was shortly followed by second stressor which was sleeping for a week at just under 10,000' (even things that are great fun can be physiologically stressful). Had a great time on the cold, hypoxic mountain...but since returning my sleep has never recovered. I didn't stay at elevation long enough to adapt but certainly long enough to hyperventilate and lose a lot of CO2 and perhaps dis-regulate my breathing controls.

is the equipment for EERS commercially available? I assume it has to be titrated in a sleep lab? If you cound give me some info on what equipment you use I would greatly appreciate it.

Thanks again, this is the first bit of hope I've had in quite a while.

EERS uses off the shelf equipment in a unique way. If you read the article it tells how the ammount of space was chosen.