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Waking up from apneas with CPAP (again)
Hey, guys.

I came to you folks when I was having this problem about 7 months ago, and it's back again. I am waking up gasping for breath with my mask on and my pressure at full. I have a Remstar Pro M Series, but it is not auto-cpap. It does give me some information, but it's not very good. All I know is that my average AHI for the past 7 days is 4. But I think that makes it sound better than it is, because when I'm having bad nights (and I've been having bad nights for around a month) I feel like I wake up gasping for breath immediately upon falling asleep. This happens 5-6 times until I'm tired enough to sleep through the events. When I sleep through them, I usually wake up feeling functionally rested. However, twice in the last few weeks, I've woken up not just gasping for breath but with my heart racing. When that happens, I am exhausted, no matter how much I sleep.

It's those more severe events that have me worried. When my apnea first became severe, I had a few panic attacks. Could the waking up with the heart racing be a night time panic attack? I heard those were possible. Or is the heart racing indicative of a very severe (maybe life-threatening?) event?

I've tried everything and I'm finally just biting the bullet and going back to the sleep doctor on Tuesday (to see a nurse - to see the actual doctor would require a month wait!). But among the issues I've tried to address, I've noticed my apneas are MUCH worse when my nose is stuffy. Before I had a CPAP machine, I used nasal sprays. And even with no other thereapy, about 80% of the time, the nasal spray alone would be enough to eliminate events severe enough to wake me up.

I'm having severe nasal issues now. Not enough to bother me during the day, but enough to make my full face mask unbearable. I'm going pretty far beyond the recommended allowance of OTC nasal spray (I've been spraying one nostril a night for about two weeks - you're supposed to stop using it after 3 days). I am not currently using a humidifier, but I've had nasal issues both with and without the humidifier, but generally prefer to use the CPAP without humidity. I've tried oral decongestants but both the "new" Sudafed and the "old" Sudafed seem to be completely useless. But last night, I think at least one of my nostrils was fairly clear, but I still had one of those bad, heart-racing events.

My prescribed pressure was 13, but oddly enough I discovered that I had been sleeping at a pressure of 11.4 for months with no real issues. (Somehow my older machine got reset, probably the last time I was having trouble when I was trying to adjust the pressure myself, I set it too low one night and forgot to adjust it back.) Anyway, I've gone as high as 14.5 and it hasn't stopped the events. Tonight, I'm prepared to go as high as 16, but I'm starting to think maybe I have central apneas. Because it feels to me like I'm just forgetting to breathe, rather than not being able to breathe.

I'm a weird case, because I can go months without my sleep apnea bothering me at all (my sleep study techs told me my sleep apnea was pretty mild). And then, usually coinciding with a period where I have a stuffy nose, it obliterates me. I wake up half a dozen times even with my mask on at pressure. Now, there have been few times when I woke up with my mask half off or completely off. But those events don't worry me as much as the probably equally numerous events that wake me up when everything should be going fine.

I don't know. It just seems like nothing ever seems to work for me like it should with this stuff. Any suggestions?
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Some random thoughts?

Yes, panic attacks *can* do this, and they can happen at really weird times (I've gotten them when having fun).

\Sleep position?? Eating shortly before bed?

I ended up getting both nose and throat surgery, of the two, the nose surgery did me the most good.

bad pillow position?

Hang tight, others will have better ideas
*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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I am in the same boat as you, I stop breathing and it has something to do with my sinuses just behind my nose. Some days it feels like a have a growth back there or something unnatural for years I thought it was allergies or a "snuffy nose" but it was just the mechanics of my breathing airway that was off. After years of tests and not being allergic to anything, even poison oak/ivy, finally found out my clogged nose was the actual airway closing that was not caused by anything environmental.

I also get what you describe as "panic" attacks sometimes and it's not a panic attack so much as you stopped breathing and your body shoots adrenaline to wake you up and gets your heart racing as a survival mechanism so you don't die in your sleep from lack of oxygen.

Also, get a local steroidal spray (like Nasonex) that you need a prescription for. My doctor gives me a year supply of nasal spray prescriptions each time I visit. DO NOT use those OTC sprays like Dristan, they will give you rebound congestion and are addictive. They do more harm than good in the long run, the prescription steroidal sprays can be used everyday with no rebound congestion.

I notice I have good nights and bad nights in my short time on Cpap, and I am trying to pin point what is causing a bad night and what I am doing in the day or night to cause a good night by reviewing Sleepyhead data everyday and keeping a log. It's constant research of trial and error. I have pin pointed caffeine as a major AHI trigger if I drink it after 8pm.

I am not a doctor so I can just give you my experiences and let you know that you're not alone, plenty of people are going though the same thing, but your doctor is the best to diagnose and treat you.

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Sounds a lot like panic attacks my friend. They dont just happen when we are awake
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Thanks, everybody.

The thing is, I haven't had a waking panic attack in years. And if it's just a night panic attack, why does it make me feel so tired? The daytime panic attacks never did that. But when I wake up at night with my heart beating fast, I feel absolutely destroyed. It's worse than not sleeping at all.

I know or know of people who have died in their sleep supposedly from sleep apnea, and when I wake up like that, I wonder if I've just had a close call. I realize it's a symptom of panic attacks to think that you're about to die, but people have died in their sleep from sleep apnea.

I do plan on asking for some prescription nasal spray. I do feel some of my problem now is caused by the OTC sprays, but when it's 1 AM and you can't breathe with your mask on, you do what you have to do just to make it through another night.
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(02-02-2014, 07:09 PM)SnuffySleeper Wrote: I also get what you describe as "panic" attacks sometimes and it's not a panic attack so much as you stopped breathing and your body shoots adrenaline to wake you up and gets your heart racing as a survival mechanism do you don't die in your sleep from lack of oxygen..

So, it's not a panic attack, it's a really bad apnea event? That's what I was afraid of.
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Hi ScrewtapeJenkins, welcome back to the forum.

Waking up with my heart racing and gasping for breath was what caused me to go to have a sleep study done. CPAP therapy has corrected this in my case.

I read through a thread which you started in July:

Have you been able to get a copy of your full sleep report? (The full report will include time plots of when events happened, etc.)

Your Remstar Pro M Series may be a good backup machine after you know what your pressure needs are, so don't trade it in unless you must. But for now, for your in-home titration I recommend buying a used but fully data-capable APAP machine which automatically adjusts the pressure and reports separately Obstructive Apneas versus Clear-airway Apneas (central apneas).

I think the cheapest good choice at Supplier #2 would be:
"Gently Used DS550 System One REMstar AUTO with Heated Humidifier & Accessories: $439.00"
Or, can pay a little more for the newer model DS560 with heated hose option.
I think these may include a 6 month warranty. To find out, email Supplier #2 before purchasing.

A better choice may be the "Winter Special" used S9 AutoSets with a 1 or 2 year warranty for $569.00:
"Gently Used ResMed S9 AutoSet with Heated Humidifier, and ClimateLine Tubing. This Gently Used device comes with travel bag, new ClimateLine, and Slimline tubing, new filter, power supply and 2 year warranty. As always, no sales tax, and no charge for shipping on domestic orders." Says 2 yr warrantee, but that may be a temporary "Winter Special" or a typo, because this model machine when bought used from Supplier #2 usually has a 1 yr warrantee. To find out, email Supplier #2 before purchasing, and may need to purchase using the "Winter Special" listing on the home page instead of its regular listing on the full CPAP/BiPAP page.

A link to our Supplier List is given at top of all forum pages.

Or you could buy from a private party on Craigslist or wherever, but you would want to replace the hose and disinfect the mask well before using. Would need to be careful to not let even a single drop of water get inside the blower unit. I think ResMed machines will still be under their original factory warranty if it has been less than about 27 months since date of manufacture. ResMed customer service department will tell you date of manufacture and whether the machine is still covered by their warranty if you call and give them the REF# and SN# for the blower unit. However, ResMed never deals with end users (patients) only with DME providers, so someone needing a machine repaired under ResMed's factory warrantee would need to find a DME (can be any DME) willing to send in the machine as a warranty repair, in return for your good will and future business in CPAP supplies.

(I would never recommend buying from Craigslist except locally, meeting at a public place where can power up the machine and verify it starts up and looks like it is working before handing over any cash.)

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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(02-02-2014, 08:35 PM)ScrewtapeJenkins Wrote: So, it's not a panic attack, it's a really bad apnea event? That's what I was afraid of.

That's my layman's opinion, because the same thing happens to me when I sleep on my back (cpap or not). Only way to know for sure is doing a sleep study by a sleep doctor so you can get diagnosed.

A data capable Cpap machine is also very important so you can tell what is going on at night. Most important thing is to get a sleep study done so there is no guess work.

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I had a sleep study, but it was a year ago and it was a split night study. I think they caught me on one of my good nights, because I slept pretty easily and only woke up when they woke me up. They said I had mild OSA and didn't mention any central apneas.

vsheline, I never got the results a couple of months ago, because like always, as soon as I started feeling marginally better I just tried to push through. I guess I should have gotten my sleep study results by now. I am getting them tomorrow when I see the sleep specialist again. But I didn't want to do what I'm about to do, which is possibly have another sleep study. I can't really afford it. But I guess my body doesn't care about what I can't afford.

I'll look into those auto cpaps. I have another back-up machine, and I'd be more than willing to trade them both in for a data capable auto machine I can afford.

Thanks for all your help, and I'll let you guys know how it goes tomorrow.

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Hi ScrewtapeJenkins, I have not been here for very long so I don't know if dairy foods and gluten has been mentioned in regards to sinus problems.
I think that if you have sinus problems then it is well worth at least stopping dairy food for a month to see if your sinus problem improves.
I have been tested for gluten allergy and the tests came back that I was not gluten intolerant, but when I eat gluten my body tells me otherwise. Too much dairy and my sinus's go crazy, especially if I eat that sandwich slice cheese in the individual plastic wrappers. Many people have improved their sinus health by getting off the dairy foods.
Just my 2 bob's worth, diet may help and it is probably worth a google of gluten dairy sinus.
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