New to the whole thing
Over the last year, my wife has told me numerous times that she was worried about my breathing while I slept, and that I would go from loud snoring to complete silence at a moment’s notice, and then “gasp” for air. So while I knew that it was likely I had sleep apnea, I much preferred the convenience of living in denial. The thing is, I had and still have no problems staying awake during the day, and no drowsiness while driving. If there were other signs, I either dismissed them or just ignored them altogether. That was until a couple of months ago when I started actually waking up a couple of times a night, heart pounding and feeling like I needed to catch my breath, a new and unpleasant situation all by itself, but only the beginning of things to come. About three weeks ago I woke with that urgency to catch my breath and within just a few seconds started having a litany of very uncomfortable and downright terrifying symptoms. They included a “flush” feeling that began in my gut, as if I had just been filled with hot water, and coursed throughout my entire body in continuous waves, waxing and waning. My heart was beating so hard that I thought I could hear it through my chest as it tried to escape and my head felt as if it would follow along. Being no stranger to anxiety attacks, I took this as such and even concluded that I had induced this upon myself by mixing alcohol and Benadryl earlier that day. This hypothesis seemed to stand on it’s own merits as the following day found me feeling much better, and the next several days being completely back to normal.
Much to my displeasure and without the aid of alcohol or OTC meds, the episode repeated itself about a week later, with a vengeance. I was unable to control the symptoms regardless of relaxation techniques. After about 6 hours worth of suffering was all I could take and decided to drive myself to the emergency room just in case. They took me in immediately and within mere minutes had taken all my vitals and got me wired up for an EKG. I was also sent for a chest x-ray and had blood work done. As anyone who has ever been in this situation knows, the last thing you really want to hear from the ER doctor is “all your tests are normal, so this is probably just an anxiety issue”. Now, it’s not that one isn’t relieved to know that they haven’t suffered a heart attack and are not about to. It’s not as if devastating news of any kind would be greeted with anything other than shock and terror, but unanswered questions don't feel right in that setting either.
Fortunately, I had a doctor’s appointment the next day, which was only coincidental to the ER visit, and intended to be a yearly checkup. Obviously it evolved into an ER follow up. The doc mentioned to me that my initial blood pressure in the ER was 185/107 and it was a good thing I went, even if only to be monitored. It was also noted that my blood pressure in his office was elevated as well, but not quite as extreme. He too felt that I was experiencing anxiety issues, having been treated for them at length in the past, but also sort of casually mentioned an abnormal hematocrit number in the ER blood work. As I understand it, that is the concentration (%) of red blood cells in your blood and relates somehow to oxygen levels. If your heart requires more oxygen, then your body increases the number of red blood cells it supplies to your blood. That’s when he brought up the question about whether or not I had any reason to suspect I might have sleep apnea. When I said said “yes”, he went ahead and referred me for a sleep study.
I had the sleep study done at the clinic on Monday night of this week. As of this post, the diagnosis is still unofficial since I’ve heard nothing and have yet to be scheduled to meet with anyone to discuss the results. However, the technician woke me a few hours after falling asleep and started me on CPAP (nasal mask), citing that I had reached or exceeded the criteria for cpap therapy tests to be administered. He did not reveal many more details (except to say he had reached 12cmH2O of pressure- more about that later) so I’m basing most of my comments about the impending diagnosis from here on as assumptions based on my many hours of studying the internet about the wonderful world of apnea, how it’s diagnosed, and how it’s treated. I’m also assuming, for now, that it’s obstructive in nature. Even though I was off the charts in terms of anxiety about having the test, and tried talking myself out of going all day prior, I have to say that it was really not anywhere as bad as I had made it out to be in my mind. One possible reason for that is I took a lorazepam earlier in the day, and one on the ride over to the clinic. I fell asleep quite easily and had no “episodes” during, nor after the test. In fact, even though I didn’t get abundant sleep that night, I actually felt pretty normal the day after.
I have a CPAP that was given to me by a family member. It’s an older Resmed S6 that had almost no hours on it and an older brand new nasal mask. I was able to figure out the settings via the Clinician’s Manual found on the internet, and determined the output pressure was set at 8cmH2O. As soon as I began having these troubles I started to use it “as is” figuring it couldn’t hurt to get used to wearing it and might be of some benefit in dealing with the issues. It did not, however, seem to make any difference in general. After the sleep study I adjusted the pressure to 12cmH2O that the tech said was the pressure he titrated up to and have been using it while waiting for my follow ups with the results of the test. It has not worked. I’ve had several waking disturbances with the “episodes”, and for the past two nights I’ve had a waking “attack” as described above within a few minutes of falling asleep, every time.
So I am feeling aweful today after only one or two hours of broken “sleep” last night and only a bit more than that the night before. What’s worse is it’s now late Friday and I won’t hear anything from anyone for at least another three nights. Three nights of heaven only knows what. Sleeping without the machine is probably not an option since the “episodes” seem to be far worse without it. I’m considering adjusting the pressure up to 12.5 and see what happens. If it still doesn’t work for me then 13 tomorrow night. If that doesn’t work and I’ve managed to survive it anyway, then I guess I go sightseeing Sunday night and show up at my primary doctor’s office as a walk in 9am Sunday morning.
Has anyone else here ever experienced anything like these episodes? Were they attributed to anything specific such as the adrenaline shot you get from arousing to breathe? Or was an underlying anxiety issue just being compounded by the apnea? Any other thoughts or advice you can share with me about all of this?