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really violent arousal
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Paptillian Offline

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Post: #1
really violent arousal
Last night while sleeping my body abruptly 'snapped' and made me lift off of the bed a bit. It woke up my wife because the whole bed shook. This wasn't a typical hypnic jerk such as an arm or leg that twitches while you're about to fall asleep. It's like my body was spring-loaded.

This was around 5 in the morning. I got up to look at the machine and the clock. Pressure setting was about 7.

When I get some time I want to analyze the data. I took a quick look this morning and saw what looks like an arousal in the flow data when it happened. Has this happened to others?
07-15-2013 01:41 PM
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JudgeMental Offline

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Post: #2
RE: really violent arousal
I don't think there is a "typical" hypnic jerk. Some are very much more pronounced then others. The one you described is a grandioso type. I have had those. Haven't had one in a very long time. I believe that they are in someway related to our apneas and the stoppage of our breathing. The brain, while we are in our semi-comatose condition (sleep) recognizes the sudden need for oxygen and jolts us to wake up and breath ..

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07-15-2013 02:11 PM
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PaulaO2 Offline
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Post: #3
RE: really violent arousal
Or you were dreaming and don't recall the dream.

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
07-15-2013 03:32 PM
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Paptillian Offline

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Post: #4
RE: really violent arousal
(07-15-2013 02:11 PM)JudgeMental Wrote:  I believe that they are in someway related to our apneas and the stoppage of our breathing.

This is what I'm thinking, too. It's interesting that before CPAP I would not get these kind of sudden jolts. A slight kick of the leg or something as I'm falling asleep, yes, but I never popped up off the bed like a click beetle.

When I've had apnea arousals that make me fully wake up, it's been a different sensation. Those usually come on with an intense terror or nightmare that "slowly" builds (at least I perceive it that way) until I wake up and then feel hot/flushed with a rapid heartbeat.

I'm wondering if the machine is not playing well with my body. Here's what I believe is the arousal from this morning, based on the time:

[Image: arousal.png]

That doesn't say much by itself, but what concerns me is that I have a whole lot of those kind of erratic flow curves each night and a lot of "flat lines" which don't get flagged as apnea events because they're too short.

My most "normal" flow curves look like this:

[Image: normal_flow.png]

They're not the nicely rounded sine waves that I've seen elsewhere and seem to be slanted to the right. Half-way through the inhale there's a brief plateau before the characteristic bell curve.

I'd appreciate input on whether or not these look typical. My understanding is that an APAP should find just the right pressure to prevent any kind of flow limitations or labored breathing.
07-15-2013 08:29 PM
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Paptillian Offline

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Post: #5
RE: really violent arousal
Here's another example from a different night. This lasts about 15 seconds but doesn't get flagged by the machine. It looks to me like a central/clear airway event (there's no flow limitation).

My theory is that it's actually two separate events joined together around the 09:40:51 mark so the machine scores them separately and they both fail the 10-second rule.

[Image: no_limitation.png]

Extrapolate over a whole night, and it's hard to imagine how these don't affect sleep quality. Sure the AHI might be less than 1.0, but sleep is fragmented nonetheless, right?

Maybe I really ought to bite the bullet and get one of those CMS50D pulse oximeters?

Or is this all normal and I'm just being a hypochondriac? lol
07-15-2013 08:50 PM
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PaulaO2 Offline
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Post: #6
RE: really violent arousal
An oximeter is a good thing to have, if nothing else to help with things like this.

It could be you are making too much of it but then I'm not you. But here's a theory.

Your body got used to low O2, disruptive sleep, etc. That was its normal. Now you introduced the CPAP and set a new normal. Then you have an event and your body and brain decided NOT NORMAL and reacted more violently than it would have before.

Just also remember that one night here and there is not trend. Keep gathering evidence and noting when things odd like this happens. If you start to see a pattern in it, then you'll be able to discuss it with the doc.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
07-15-2013 09:18 PM
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Paptillian Offline

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Post: #7
RE: really violent arousal
Thanks, Paula. I was just reading over the UARS / BiPAP article and all kinds of wheels started turning.

I'm still interested to know if my second graph (the "normal" flow) is atypical based on what others see in their own graphs.
07-15-2013 09:34 PM
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Bompa Offline

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Post: #8
RE: really violent arousal
(07-15-2013 01:41 PM)Paptillian Wrote:  Last night while sleeping my body abruptly 'snapped' and made me lift off of the bed a bit. It woke up my wife because the whole bed shook. This wasn't a typical hypnic jerk such as an arm or leg that twitches while you're about to fall asleep. It's like my body was spring-loaded.

This was around 5 in the morning. I got up to look at the machine and the clock. Pressure setting was about 7.

When I get some time I want to analyze the data. I took a quick look this morning and saw what looks like an arousal in the flow data when it happened. Has this happened to others?

I have experienced the same "snapping" on a few occasions but more so the jerking of an arm or leg.

The wife says I scare the heck out of her.
Coffee
07-16-2013 09:36 AM
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