"Awake" Apnea - is there such a thing?

[Ugly]

Is there such a thing as "awake" apnea? Sometimes when I'm trying to relax, and breathing "automatically" as usual, suddenly I stop, and I have to force myself into taking a breath. I find it awkward and it often generates anxiety when it happens. But I want to know what is happening? Is there anything I should be doing? Or anything I could do?

[zonk]

You might find some answers to your question here: Can you have sleep apnea during the day?
http://www.apneaboard.com/forums/Thread-...ng-the-day

[Ugly]

You might find some answers to your question here: Can you have sleep apnea during the day?
http://www.apneaboard.com/forums/Thread-...ng-the-day

Thanks for the insight. It usually happens when I'm lying down trying to sleep. I also usually, by this point, have my mask on and running. I have self-appointed a new pressure setting of 12.0 to see if that will help. Up from 11.4 - and it will probably remain there until the nightmare of waiting for an AutoSet is over and I finally install it on my night table. Tomorrow my DME should be entering her office space (she doesn't have her own office as VitalAire is an open environment) and getting my message saying, sure, Wednesday the 20th is perfect. Set the time and I'll be there. And to be sure, I need the AUTOSET, not the Escape Auto.
I consider how majorly botched up my sleep study was back in October. I never read the notes but I had the same kind of problem as I described here. I have what could be interpreted as an apnea event - except that I wasn't asleep yet. I just found that I failed to take a breath and I had to sit up and force a breath.

But this never seemed to be noted. And I don't know who to talk to about this? My otolaryngologist or my neurologist? Neurosurgeon? I can count on this happening several times a week. And probably more once I get to sleep. My wife says I exhale through my mouth quite often and sound like a horse.

But the experts say they know what they're talking about and who am I to question them? If they say there's no problem then it's all in my head (which is where the neurologist comes in I suppose.)

"You never think of breathing
Though you do it all day long
You even have to breathe
To sing this funny little song
You've got to take a breath
Before you try to blow a bubble
And if you stop your breathing
You've got big big trouble!" -Elmo

[DocWils]

The short answer is jaein (yes and no). There are multiple response for breathing cessation during a wakened period, and the definitions correspond to apnoea in the dictionary sense (there is a reason we call it SLEEP apnoea - there is a general medical term apnoea as well) - are the causes the same as most sleep apnoeas? No, most times, not, since the sleeping and waking breathing triggers and regulators are somewhat different. Some are "central apnoeas" triggered by the brain, which is common for instance in Alzheimer's patients, since the breathing centres of the brain are often affected in the process of degeneration. Most are for more prosaic reason - a sudden collapse of the throat or uvula similar to obstructive sleep apnoea (basically if it is loose enough to happen at night it can happen during the day, too), usually far rarer than at night, or a sudden surge of mucous or saliva that blocks the trachea, or shifted tongue position that does the same. Sometimes strong concentration can lead to sudden "forgetting how to breath" for a moment, and this is not so uncommon as one might think, and usually is in combination with an obstructive apnoea event, since it usually happens at the extreme bottom of an out breath, which may cause a collapse of the throat or uvula for a moment, just as in night time apnoea.

Almost always it is harmless and requires no examination - if it is a repetitive event, happening often every day, there may be other causes and needs to be looked into, but what you described above happens to me and all my colleagues more often than we care to admit. Generally the first thing you should ask yourself is what is happening around the event - am I concentrating or am I drifting off or is there too much saliva or mucous building up and I haven't swallowed, etc.... When it happens to me it is usually a signal to drink some water and blow my nose.

[DocWils]

You responded while I was writing the above, and seeing that it is while you are lying down preparing to sleep, then it is likely the same processes involved in your sleep apnoea, and your PAP should take care of it. Again, the questions to ask are as above (when, what is happening around the event, etc). If they correspond to a known pattern, then they will be part of that.

The sleep entry phase is often accompanied by breathing cessation - I have it, a lot of people do - it can be from several things, including the brain "switching over the software" to other common problems. Having the correct pressures from the start should ease this. Also, there is a point in downward spiral into sleep that often causes a sudden panicked reawakening, as if one couldn't catch a breath - this is attributed to different things, according who you talk to - some, including me, ascribe it to the switchover from wakened breathing to sleep breathing, which is normally a longer breath with greater interval between outbreath and the next inbreath, which takes a few tries for the body to get right, some say it is our inbred fear of death or danger, and some say it is airway collapse of some sort. I suspect that all three have validity at any given time. It is, however, mostly normal, even in healthy people with no discernible sleep apnoea of any sort. If you have described this to your doctor and he sees nothing to act on seeing as he is fully familiar with your case file and has made the examinations, etc, then I should ascribe to it the explanations I have given you.

[Ugly]

You described my experiences well. Let me sort out what you said in what happens with me.

The sleep entry phase is often accompanied by breathing cessation - including the brain "switching over the software" to other common problems.

Also, there is a point in downward spiral into sleep that often causes a sudden panicked reawakening, as if one couldn't catch a breath - this is attributed to different things, according who you talk to - some, including me, ascribe it to the switchover from wakened breathing to sleep breathing, which is normally a longer breath with greater interval between outbreath and the next inbreath, which takes a few tries for the body to get right, some say it is our inbred fear of death or danger, and some say it is airway collapse of some sort. I suspect that all three have validity at any given time.

These seem to fit my experiences. I feel things are going OK, settling down, trying to relax. Doing what I can to ignore the tinnitus when suddenly, I try to inhale and - nothing happens! It usually does put me in a panic. Oftentimes I sit up quickly and try to force a breath. But at that time my relaxed state is long gone.

[DocWils]

This sounds to me like your starting to enter into the pre-sleep breath cycle and the body hasn't caught up with it. I probably wouldn't worry, but again, and I stress this, I am not your doctor and do not diagnose online - at most I can sift through ideas and explain them for you and maybe point you in a direction if it needs be. If this is a serious worry, I would take it up with your doc. But in all truth, this sounds relatively common and fits in my above explanations.

What this sounds like is that you are trying to take in a breath out of sequence from the sequence that you are settling into, and there is a momentary confusion. In addition, if you are wearing the PAP at the time, many of them try and force a breathing pattern and may feel blocked if you take a breath out of its sequence time - you may feel the resistance of the PAP and that could be the problem. This can usually be fixed by going to AUTOPAP, which is more responsive to your breathing pattern.

[archangle]

If only you hadn't been screwed by getting an Escape machine, you'd be able to look at your data and have a better idea of what's happening for the cases when this happens as you're falling asleep.

[Ugly]

If only you hadn't been screwed by getting an Escape machine, you'd be able to look at your data and have a better idea of what's happening for the cases when this happens as you're falling asleep.

I remember when I was given the darn thing. I had to change the time on it since daylight savings time just ended. Now it's just started up again. What a mess. It used to be the end of October and the end of April until the USA started messing with it and we here in Canada followed suit like a puppy and its master.

But I got the phone call to make an appointment. It's official now.
November 20 at 11:00 a.m. EDT.