Clue to night waking panic attack in data?

[willo]

I'm wondering if my Sleepyhead data offers a clue about something that has happened to me three times now, most recently the night before last.

My respiration seemed to drop off right before it happened, but I'm new to all of this and maybe misunderstanding the data? You'll see it right around 2am. I had to take the mask off and get up to settle down after this happened.
   

Here's more data. It's the stuff I've been looking at more often (the top of the Sleepyhead page.)    

During these episodes, I'm sound asleep, and wake up with my heart pounding. I practice deep breathing and try to stay calm and still until it passes. After the first two attacks (months ago), I was diagnosed as having panic attacks and given a low dose benzodiazepine for occasional use.

These attacks  have only ever happened during sleep; I've never had a daytime panic attack. I consider myself a somewhat anxious person, but it has never controlled my life in a significant way or had a major impact on what I can or can't do. (Just how hard I have to work to make myself do frightening things!)

It was actually much scarier this time because I'd come to believe my apnea was triggering these events, so treating it (I assumed) would mean no more terrifying episodes where I think I'm dying of a heart attack.

My apnea was well controlled that night (less than 1) so I'd really like to figure out if I have some other medical issue to deal with. Is there a clue in my data?

Having learned here on ApneaBoard that two of my medications trigger central apneas, which figured heavily (40%) in my sleep study, I've cut back as much as possible on both, but I am living with a chronic condition and I can't get in to see my specialist until January.

[mesenteria]

If the representation of the event is at the break in data, it looks to me as if it could be during your second  REM event...probably when you are dreaming.  Further than that, I cannot comment.  I hope someone with a lot more smarts than I have can help you to overcome these.  They can't be much fun.

[Sleeprider]

Your tidal volume and minute vent really drops just after 1:45, then returns above average along with a slower respiration rate. This suggests much deeper slower breathing, but the detailed chart does not include flow rate. I can't interpret much without that, and cannot point to a cause. You have a hypopnea and RERA just before arousal, so your sense of panic is probably from oxygen desaturation and an associated adrenaline surge related to the hypopnea. All of this is a natural defense mechanism intended to arouse you to BREATHE. It worked.

[MyronH]

Sleeprider's suggestion makes sense. I suffer from anxiety/panic attacks mostly during the day, and take Klonopin(Cloneazapam) as needed. I get awoken with a jolt sometimes and major heart palpitations. When I look on my Contec SpO2 watch, it sometimes shows oxygen drops as low as 78%. Then my watch either alarms me or I wake up with a jolt. Unfortunately after a year on therapy, I still get them and sleep doctor says I'm well treated and that they are no concern. Seems like I have no choice but to live with the occasional oxygen drop during OA's.

[willo]

Thanks for sharing that, MyronH. It’s helpful to hear someone else’s experience. 

Truth be told, the night waking/heart pounding episodes were the only potential “symptom of my apnea” that I really thought was related to my breathing during sleep. (It’ll be nice if my autoimmune condition symptoms are reduced, but that’s a long shot, probably.)  Panic attacks were what I most hoped CPAP would address! 

I hope this attack was just a fluke and not somehow triggered by the CPAP therapy. It left me afraid to go to bed for the next couple of nights. I don’t like the odds that it is a coincidence that the third such episode of my life happened shortly after beginning CPAP. (The other two were over a year ago and also spaced far apart from each other.)

[Sleep2Snore]

If you find the CPAP is making you a bit more inclined to be Anxious you need to get help to sort it out.
The CPAP itself will not cause it, but if you are inclined to have Anxiety attacks, you may find that if you waken with a mask on it may trigger it.
However, if you get things sorted out with the machine it should help a lot.
Don't give up with the CPAP, keep trying.  

This suggests much deeper slower breathing, but the detailed chart does not include flow rate. I can't interpret much without that

If this is not turned on or showing on your data you need it to show.

[willo]

The mask doesn’t make me feel anxious or claustrophobic. (I’d feared both before I got it.) It did, a little, when brand new because the plastic smell bothered me. That’s eased up.

Or, I should say, it doesn’t trigger anxiety with the air flowing. If I forget to keep my mouth open to breath as I put it on, that first moment (especially when my arthritic fingers fumble pressing the button!) feels bad. My nose is blocked; no air! Otherwise, the CPAP offers easier breathing than I’ve ever had for sleep, so the MASK isn’t provoking anxiety.

The mask is just modestly uncomfortable, but I hate almost anything touching my face. I don’t think it is a fit issue, just a “thing touching my skin” reality. I think I’ve already got mask types with minimal skin contact. My biggest CPAP challenges are partner and basic comfort related, so far.

I was just terribly disappointed that treating the apnea doesn’t prevent the night panic episodes.