07-03-2025, 09:21 AM
Any solutions to low arousal threshold
Hi,
First-time poster here so apologies in advance if I get anything wrong in terms of etiquette.
After feeling pretty awful for several years and seeing a range of doctors across different specialties I eventually stumbled upon the topic of sleep. Several months ago I was diagnosed with mild REM-only sleep apnea (AHI of 8) and a low arousal threshold. As it was explained to me (or at least how I remember it) my breathing itself isn’t particularly bad as my oxygen levels don’t drop to dangerous levels but my brain seems to be hyper-vigilant. It keeps waking me up or pulling me out of deeper stages of sleep, perhaps unnecessarily. That over-responsiveness appears to be the core issue, more so than the breathing itself.
I’ve been using a BiPAP machine since April and while it does help to some degree, the improvement hasn’t been as significant as I’d hoped. I recently had a drug-induced sleep endoscopy which showed a few areas of collapse or narrowing in my airway, but all were considered mild. Surgery is an option to address those but the surgeon was candid in saying that although it’s the only solution he can offer, he’s hesitant. Given that the collapses are mild and the problem may stem more from how my brain is responding rather than a mechanical obstruction, he wasn’t sure surgery would actually help and unfortunately he couldn’t suggest any alternatives.
I’ve had various people, including some professionals, review my PAP data through OSCAR and SleepHQ. The general consensus is that my pressures should be raised. I’ve tried this several times in different ways but every time I do I end up feeling worse. To me that makes sense - if the pressure is too low, I struggle with breathing events, but if it’s too high, it likely disturbs my already over-sensitive brain and worsens how I feel.
Lately I’ve started to think that addressing the low arousal threshold might be the key to making real progress but I’m not sure how to approach this. Has anyone else been in a similar situation? If so, what have you tried, and what’s worked for you?
Thanks!
First-time poster here so apologies in advance if I get anything wrong in terms of etiquette.
After feeling pretty awful for several years and seeing a range of doctors across different specialties I eventually stumbled upon the topic of sleep. Several months ago I was diagnosed with mild REM-only sleep apnea (AHI of 8) and a low arousal threshold. As it was explained to me (or at least how I remember it) my breathing itself isn’t particularly bad as my oxygen levels don’t drop to dangerous levels but my brain seems to be hyper-vigilant. It keeps waking me up or pulling me out of deeper stages of sleep, perhaps unnecessarily. That over-responsiveness appears to be the core issue, more so than the breathing itself.
I’ve been using a BiPAP machine since April and while it does help to some degree, the improvement hasn’t been as significant as I’d hoped. I recently had a drug-induced sleep endoscopy which showed a few areas of collapse or narrowing in my airway, but all were considered mild. Surgery is an option to address those but the surgeon was candid in saying that although it’s the only solution he can offer, he’s hesitant. Given that the collapses are mild and the problem may stem more from how my brain is responding rather than a mechanical obstruction, he wasn’t sure surgery would actually help and unfortunately he couldn’t suggest any alternatives.
I’ve had various people, including some professionals, review my PAP data through OSCAR and SleepHQ. The general consensus is that my pressures should be raised. I’ve tried this several times in different ways but every time I do I end up feeling worse. To me that makes sense - if the pressure is too low, I struggle with breathing events, but if it’s too high, it likely disturbs my already over-sensitive brain and worsens how I feel.
Lately I’ve started to think that addressing the low arousal threshold might be the key to making real progress but I’m not sure how to approach this. Has anyone else been in a similar situation? If so, what have you tried, and what’s worked for you?
Thanks!
