Extreme Anxiety during day after CPAP usage...something physiological?

[gohoos1998]

Hi all - hope everyone is enjoying the holidays (if you celebrate) and generally well if you don't!

I was diagnosed with an AHI of 9, along with severe PLMD, for an arosual index of 35/hr. I am attempting to take care of my PLMD, but my question here is about CPAP.

I am actually someone who does not have a particularly difficult time with comfortability of the mask/machine. I have been able to sleep the night a few consecutive times after just a couple of weeks of usage. 

However, as I started using it the whole night, I would wake up with extreme anxiety. Similar to taking an adderall or the like. Much more than a few cups of coffee. Extremely unpleasant. For background, I do take medication for anxiety and is a condition I deal with. But this makes matters so much worse - this is why I haven't used the CPAP in a month. It is NOT anxiety about the machine itself - I was looking forward to trying it out and sleeping with it. It feels like there most be something happening during sleep that is causing this.

It almost feels like there is some sort of physiological phenomenon occuring. Despite OSCAR saying my AHI is below 2 during those full-usage nights, I experience this anxiety, Does anyone have experience with something like this?

I know it's extremely important to use and it will continue to cause problems down the road if I don't. I am a 25 year old male, who once had a fantastic memory and was (somewhat!) smart, but I feel like I've been lobotomized. I have to treat it, but I simply can't deal with the anxiety CPAP is giving me. 

Thank you guys for all you do here!

[Old Steve]

Can you post some OSCAR charts, perhaps someone could tell you if different CPAP settings might help with you problem.

[gohoos1998]

Thanks for the response. Yes, I will provide some OSCAR charts. Weirdly enough, this anxiety has happened at every pressure - however, it's easily believable that I just may have not found the correct pressures yet.

My computer is currently at the apple store getting fixed up, but I will be sure to post some graphs once I have it back. Thanks again.

[Sleeprider]

Over the years, I have encountered a number of members that experience irrational anxiety and often attribute that to their CPAP therapy. You have said that you find the CPAP therapy comfortable and effective, and that you are dealing with a major challenge from PLMD. Logically, it is unlikely your anxiety is attributable to your CPAP therapy, but it is a common theme that the blame falls on the CPAP, an inert device that predictably provides pressure to your airway and seems an unlikely source of anxiety. The causes of anxiety are complex and how that transfers to CPAP is hard to guess, other than I think it is the hope for an easy solution to a difficult and life altering disability. There are experts that can change your behavior, identify anxiety triggers, and desensitize you to them. I'm not one of them, but I think your solution lies in that direction. Some of the pharmaceuticals used for PLMD can affect anxiety, and that is actually the first place you should look. Meanwhile, I'll be glad to help in any way possible with optimizing your CPAP results and helping identify anything that might be a trigger. Do you not experience anxiety if you do not use CPAP therapy? With an untreated AHI of 9, CPAP therapy is actually borderline for you, and your high arousal index can be mostly attributed to PLMD. Not using CPAP and focusing on PLMD therapy is a viable option for you.

[gohoos1998]

Awesome response and thank you so much. You are absolutely right in that it seems like a device like the CPAP would not necessarily cause anxiety itself, but through some other mechanism - the CPAP then gets unjustly blamed. I do have anxiety regularly, but it is on a whole other level when I've used the CPAP through the night. It goes from bearable to unbearable. 

Also, good point on possible PLMD meds. I definitely noticed heightened anxiety on the original dopamine agonist I was on, but also realized that these were not a long term solution as I learned more about PLMD. I am attempting to wean off of my anti-anxiety medication, a class of drug known for making restless legs and PLMD much worse, or possibly causing them in the first place. Rather than further medicating myself for PLMD, I feel that this makes the most sense. Ferritin is high so that is no issue.

Really appreciate your willingness to look at my OSCAR results - my main computer (currently posting from my work computer) is currently getting fixed but I will come back here to post some of my charts once I have my laptop back. 

Lastly, you are aboslutely correct that most of my arousals are due to the PLMD. We can infer this from mildness of the OSA and the severity of the PLMD, but it also explicitly states in my PSG that about 75 percent of total arousals were from PLMD, about 15 from spontaneous arousals and the remaining 10 percent from my OSA.

Obviously, I want to keep an eye on it, but I do agree that just if I was able to eliminate by PLMD overnight, I would feel pretty darn good. As it currently sits, my life consists of getting to my next nap, and that is no fun. 

Again, really appreciate it. Will see you back here once I post those charts (will be this weekend). Happy holidays!

[Leedsunited92]

Hi, I googled and found your post..I’ve started sleep therapy just 5 nights ago and am experiencing the same anxiety you describe!! I’ve always been An anxious person but have dealt with it. I also knew I was getting bad sleep for the last few years and I finally got a sleep study done. My results were horrific with an AHI of 93.9 and my oxygen saturation as low as 52% and averaging 78%. I’m going to download Oscar to dive deeper into this. The anxiety is pretty bad and the gym is helping a little but not much… 

I was told that it has to to with central nervous system constantly firing off when we were tired and sleeping poorly and now that extra energy and alertness is causing anxiety.. I’m hoping it’s just an adjustment period for all this extra energy I have and in meanwhile I’ve cut out all caffeine.

I will post my sleep study results as well.. hoping someone on these forums can shed some light for us.. there must be a common issue we’re facing because your explaining the same thing I’m feeling brother

[gohoos1998]

Welcome Leedsunited92! I'm sorry to hear you're going through this, but it does make me feel a little bit better that someone else is having this experience. 

You are much more severe than me as it relates to OSA. You have some really high figures (or low figures as it relates to O2) and I am glad you're looking to get some help.

TBH, the nervous system hypothesis that you mention does seem to make sense, but man, it sucks. I have also been using the gym even more than I already do as it does take the edge off a bit, but definitely not nearly enough.

I am hoping that too. I want to remedy this but simply can't if that's how I am going to feel. 

So you at least feel like you have some extra energy? I guess that is good, and I would assume that since your numbers are so bad. I recall feeling a little more energy as well.

I will be checking back here to see if we can get some help!

[Leedsunited92]

Gohoos, thanks for the warm welcome. I’m 100% feeling the extra energy and I know the machine is doing its job. I’ve cut caffeine out completely for now. Yes the gym does take the edge off but not as much as I wish it did. 

My friend who is a police officer told me to get L-Theanine. I ordered a bottle on Amazon after reading the reviews. You take it right before bed and it’s supposed to relax and calm you through the following day. Also have you tried any other over the counter remedies? I’m just trying to stay busy and try whatever I can before i go to see a doctor.

[gohoos1998]

If you're feeling the extra energy, you may just have to push through unless it gets to be legitimately unbearable. With your numbers, you can't necessarily afford to play around. 

L-Theanine has definitely helped me in the past. Some other things you can possibly try are Ashwagandha and magnesium. Hope these give you a little bit of relief.

[Leedsunited92]

So I took 400 mg of magnesium last night, I heard it takes a while to feel the affects…going to start running it with the L theanine every night. When did you take your L theanine? My friend recommended take it right before bad and it’ll last me the whole  next day. 

Another question for you, my results were from the initial sleep study. What can I use to check my oxygen level and stuff like that now with my machine? I need to download Oscar I heard it gives you a lot of things to look at. I’ve also been waking up 1-2 times a night to pee but I’ts probably because I loosened my mask and may be taking it off in my sleep. Regardless my AHI is under 9 in most nights, last night was 3.1

I am going to ride out and try everything I can to see if it’s just an adjustment period to the extra energy and whatnot. What are you trying next for yourself?