Anxiety and intermittent awakenings

[taha]

So I am obese with a bmi of 40. I first started waking up taking deep breaths through my nose. The episodes started 1.5 years ago and were rare. 2 months ago the became more frequent. Now it's every other day. 

I got a sleep study done and results were mild OSA, AHI 10.6.  But the night of the study I didn't have an awakening with a breathing episode that I can remember.

I am having extreme anxiety because I have developed a sleep phobia and cannot function on the days when I have the episodes.

Beginning to doubt the study.

I have noted that these awakening usually occur at day break or later. Hardly ever in the middle of the night. And when they start it doesn't matter if I turn to my side's or on my stomach. They continue happening till I can't take it any more and just get out of bed. 

Why is my apnea on and off. I can't hear myself snoring or grunting before I wake up. Just taking 2 to 4 deep breaths as i wake up. Why doesn't it happen everyday. 

I have not gained much weight in the last few months, have always been this big but why is my apnea worsening.

The episodes and associated anxiety is destroying my life. Keep obsessing about it. 

Really need help. I live in Africa and there are no sleep clinics in my country . Had to travel to europe for a sleep study. Not possible to go back again.

Any advise.

[srlevine1]

So I am obese with a bmi of 40. I first started waking up taking deep breaths through my nose. The episodes started 1.5 years ago and were rare. 2 months ago the became more frequent. Now it's every other day. 

I got a sleep study done and results were mild OSA, AHI 10.6.  But the night of the study I didn't have an awakening with a breathing episode that I can remember.

I am having extreme anxiety because I have developed a sleep phobia and cannot function on the days when I have the episodes.

Beginning to doubt the study.

I have noted that these awakening usually occur at day break or later. Hardly ever in the middle of the night. And when they start it doesn't matter if I turn to my side's or on my stomach. They continue happening till I can't take it any more and just get out of bed. 

Why is my apnea on and off. I can't hear myself snoring or grunting before I wake up. Just taking 2 to 4 deep breaths as i wake up. Why doesn't it happen everyday. 

I have not gained much weight in the last few months, have always been this big but why is my apnea worsening.

The episodes and associated anxiety is destroying my life. Keep obsessing about it. 

Really need help. I live in Africa and there are no sleep clinics in my country . Had to travel to europe for a sleep study. Not possible to go back again.

Any advise.

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.

[Kryogen]

Do you have a cpap already? If not, order online?

Losing weight to a normal bmi will probably help a lot also.

[HalfAsleep]

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.

[HalfAsleep]

With an AHI, your events are evidently happening either all night or a whole lot when you are near awake, since AHI is a per hour average. That's a much different picture than you have of only struggling at the end of your sleep.

[HalfAsleep]

Not being able to breathe properly can definitely cause anxiety, panic, a feeling of drowning.

[PaulaO2]

Did you have these episodes prior to the diagnosis of OSA?
If you did, what did the sleep clinic say about them?
If not, please try to relax over this. You have had OSA for a while and have survived so far. Start or continue treatment.

Do you currently use a CPAP?
If not, are you going to get one?
If you do get one, please make sure it is data capable. This will let you see the data and let you see physical evidence of what is happening.
If you are paying out of pocket for a machine, check out Supplier #2. I believe they ship internationally.

[trish6hundred]

Hi taha,
WELCOME! to the forum.!
Hang in there for more responses to your post, good luck to you.

[Hojo]

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.

[taha]

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.