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Anxiety and intermittent awakenings
#11
RE: Anxiety and intermittent awakenings
The doctor i visited said i didnt need cpap. Just weight loss. Im posting the PSG below. The doctor is a well known and trusted chest physician and i do trust him. What i cannot deal with is the anxiety after each awakening. I cant help but obsess about things like what if its central apnea? what if i need more than 1 nights study to get more accurate results? what if the study was flawed? 

The doctor advised against titrations and cpap. joked that I was sleeping better than him!
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#12
RE: Anxiety and intermittent awakenings
(09-21-2017, 06:57 AM)HalfAsleep Wrote: Do you have your sleep study? Make sure you have a copy of the whole thing.

IMO it would be very hard to match conditions of sleeping many places in Africa with sleeping in Europe. There are so many variables--such as onset time of darkness, the familiar sounds of the world, the feel of the air--that could impact a sleep habit. (I spent my childhood in West Africa.)

While folks on this board are trying to help you get sorted out, get to work on "sleep hygiene". I'm new to this too, but I believe there's an obvious link to that info somewhere.

My personal AHI story might have a bearing on your own. I have an AHI of 18, moderate OSA. BUT.......per our government and medical system, I only have an AHI of 5 and barely qualify for treatment. That's because the government only counts episodes with a 4%+ oxygen desaturation, and not episodes with 3%+ desaturation. So you see, it's important to look carefully at your whole sleep study. You can post it here if you need help analyzing.

I also don't believe that my sleep study captures all my sleep issues. There's plenty for me to work on in addition to apnea.

Hang in there...I feel confident that posters will contribute insights and things will get better for you.

My sleep hygiene is extremely poor. I have always been a late sleeper. But since an acute episode of severe clinical depression in 2014 which lasted exactly 30 days and disappeared as quickly as it had appeared, i deal with my anxieties by binge watching tv shows and settling into a night time routine. I also take 0.5 mg klonopin to help me sleep (with prescription of course) and no i dont think this is causing apnea, as ive been taking this for nearly 3 years without any incident and my apneaic episodes (if thats what they are) have worsened only in the last 3 months. I dont understand why they have worsened so suddenly, as I have not gained much weight. I have now lost 4 KGs through a change in diet and the episodes are still there, if not worse.
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#13
RE: Anxiety and intermittent awakenings
(09-21-2017, 07:21 PM)Hojo Wrote: I know it may not help but you are not alone.  I'm not the classic sleep apnea patient, I'm not obese, I'm very fit, my heart is in excellent condition, but yet of all the types of apnea, mine is mainly central and I don't have a good reason for it. 

Most of my nights had me waking up several times a night feeling like I just ran a marathon.  Once I had my sleep study and found out what was going on, yes, I was scared to fall asleep, I pretty much wanted to just stay up all night  The only reason I was able to fall asleep was knowing that I had survived several years with the condition, just didn't know it, and hence, figured I could make it a few more weeks while waiting on the results and be given the machine.

Hang in there, your not alone.

thank you hojo, this means a lot. I get it that I am not alone but i wouldn't wish these anxieties on my worst enemy. I am sorry that you have gone through the same hell and sincerely wish you the best.

i hve a question. Would central apnea show up on a solo sleep study? or is it something that manifests itself on some nights and not others? what if my sleep study missed something? know what I mean?

Another stupid question, how does a cpap machine help if you have central sleep apnea. I think CPAP just helps your body breath, but if your body is not breathing (as in CSA), what does the positive air pressure do?
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#14
RE: Anxiety and intermittent awakenings
This is coming from a different angle/perspective and may not be applicable to your situation…

I have had awakenings with anxiety, also occurring towards the end of my sleep (for me, 2-3am, but I'm an early riser) and the development of a sleep phobia.

Mine was due to traumatic incidents that occurred when I was a child. I have no conscious memory of (most of) them, but the emotions of those incidents started resurfacing after a witness casually mentioned something about one of them, some 30 years after it happened.

The emotions first began resurfacing while I slept. Which made me fearful of sleeping. At the time, I was not aware of the source of the problem - only that I was waking up with unexplained emotions and fears. It is very strange to have your body & spirit remember things that your mind does not recall.
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#15
RE: Anxiety and intermittent awakenings
Here are the sleep study results attached in PDF.


Attached Files
.pdf   psgy-compressed.pdf (Size: 334.54 KB / Downloads: 76)
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#16
RE: Anxiety and intermittent awakenings
(09-22-2017, 09:40 AM)kiwii Wrote: This is coming from a different angle/perspective and may not be applicable to your situation…

I have had awakenings with anxiety, also occurring towards the end of my sleep (for me, 2-3am, but I'm an early riser) and the development of a sleep phobia.

Mine was due to traumatic incidents that occurred when I was a child. I have no conscious memory of (most of) them, but the emotions of those incidents started resurfacing after a witness casually mentioned something about one of them, some 30 years after it happened.

The emotions first began resurfacing while I slept. Which made me fearful of sleeping. At the time, I was not aware of the source of the problem - only that I was waking up with unexplained emotions and fears. It is very strange to have your body & spirit remember things that your mind does not recall.

Kiwii, thank you for sharing and i am sorry (hope it doesn't offend you) about your childhood trauma. I hope you can overcome your sleep phobia.

FOr me I have not had any traumatic experience either in childhood or as an adult, at least none that I can consciously remember. Other than waking up taking deep breaths, like i have been holding my breath for 20 seconds (i cant even say that I am gasping for air, nor does it feel like drowning), i have no other reason to fear sleep. These events that have been downplayed by my doctor, and probably for good reason, are causing me severe anxiety, and this is probably because I already have mild OCD about my and my family's health (somewhat of a google hypochondria).

when these events occur, i find myself semi awake obsessing about the causes and thinking about the reasons. is it because I ate too  late, did i eat spicy food, is my mattress too soft, should i be sleeping on my stomach, is my nose congested, is it daylight, should I turn onto my side, or back or face-down?

i dont remember hearing myself snoring before waking up, even when i am semi alert drifting in and out of sleep. so if i dont hear the snoring i get more scared..could this be central and no obstructive, did the PSG miss that?

Its driving me nuts.
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#17
RE: Anxiety and intermittent awakenings
It is completely understandable that it is driving you nuts.

How far nuts is somewhat under your control though. I can say with some authority that "taking the ball and running with it" is probably the least productive thing you could do, so it is imperative that you find a way to change that tendency. You are already distracting yourself, which is a very good technique.

You are already reaching out for help, so that is good too. You can also start taking care of some of the sleep hygiene issues and getting them in order. It really does help!!

So if distracting yourself by watching television is working for you, maybe 2 hours before bedtime you change that to distracting yourself with reading (but not on a device). The light from devices/computers can interfere with melatonin production which interferes with sleep.

Even though you may not have had trauma, what you are choosing to watch on television can affect your brain too. Maybe steer clear of violence or things/topics that might trouble you. Even something as simple as watching the news can have a surprising amount of impact on your underlying mood/stress/anxiety.

Of course sleep hygiene is only one piece of the puzzle, but it is something that you can actively address now. It may help enough to take the edge off of going nuts.
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#18
RE: Anxiety and intermittent awakenings
Taha, your sleep study shows simple obstructive sleep apnea, with considerable oxygen desaturation, lots of snores and a moderate AHI. You have a lot of respiratory event related arousals (RERA). Nothing in these results suggest central or complex apnea should be a problem. It is not unusual not to recall or be aware of arousals or snoring. You should benefit CPAP, and I would encourage you to not overthink this too much, but to get on good quality therapy, and if there is a problem with that, we can go from there. Getting an auto CPAP with data should be your first priority.

I know you have a lot of anxiety whether these results are representative, and whether you might have problems not identified in the study. Having looked at many studies and seeing the results, it is my opinion you will do very well. There is always a rare possibility that exposure to CPAP could raise issues with central apnea, but again this is unusual. You should get an auto CPAP like the Resmed Airsense 10 Autoset and be pretty confident it will fit all your needs. We'll be glad to help.
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#19
RE: Anxiety and intermittent awakenings
I'm not an expert on this, but I'm of the feeling that unless you have an extremely high AHI, one sleep study may not show enough information.  My sleep study showed an AHI of 6.61 but I felt I had a good night.  I've had several nights with an AHI of above 12 while on CPAP therapy, so that may show that if I had several sleep studies, my results without CPAP may have been much worse.
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#20
RE: Anxiety and intermittent awakenings
(09-22-2017, 09:03 AM)taha Wrote:
(09-21-2017, 02:36 AM)srlevine1 Wrote: It is virtually impossible to diagnose someone at a distance, especially from self-described symptoms.

Therefore, my first thought would be to visit a psychiatrist (the one with the M.D.) for a full medical workup with a specific eye to looking at stress and other hormones that may be cyclical. It may also be that your oxygen levels may be low or that you have a heart arrhythmia, maybe associated with your electrolyte balance. Pretty much why you need to eliminate causal issues with a competent physician who can also deal with the anxiety component -- which may be a consequence of an underlying medical issue.

And, of course, for some temporary coping techniques to reduce or eliminate the anxiety. Possibly some form of mindfulness training or Cognitive Behavioral Therapy (CBT).

As for sleep tests, it might be possible to do an "at home" type of study with the equipment posted to you or a local clinic for temporary use and then some form of remote analysis.

Unfortunately, I have no other advice for someone who is located so far away.

I wish you the best of luck in recovering your health and eliminating your anxiety.
Thank you for your response:

I understand it is difficult to obtain a diagnosis at a distance. my predicament is that I live in a country in East Africa (name of country withheld, for patriotic reasons) where it is nearly impossible to get any psychiatric help, especially for nuanced conditions such as mine. I did mention that I searched across all major hospitals and private clinics and did not find a single center that had the equipment to carry out a polysomnography, which is why i spend most of the money I had to travel abroad and get it done. I have a history of GAD and Depression but I was totally ok for 3 years until i started waking up with the breathing issues. I have mild OCD related to health anxiety so I knew what OSA was and i basically self referred myself to get a PSG done. Posting the results below. THe psychiatric help available in my city is usually in the form of pharmacology with very little significance given to CBT, and even if I did find access to CBT, i wouldnt know how to trust it.

Yes, I'm hearing you, and I'll rephrase for the good of the order. Hope this helps.

Most countries don't have as robust a psychology industry as we do in the US (and other western countries) and it's not as culturally acceptable in most areas of the world to consult a psych professional or have something that needs to be consulted about.

All of us have a lot of things going on....apnea is just one dimension. So, it's always useful to attend to the variety of conditions that can make life miserable. However, it's not always possible, even if they're important...

Sometimes taking on one thing at a time is the most productive, and for you it's apnea right now.

You're at the right place. Welcome.
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