[Health] Woke up, felt like I had no breathe and panicked

[VanWrinkle]

Hi all. This isn't a first time experience for me but the panicked feeling (pounding, extremely fast heart) got so bad I almost called 9-1-1. Woke up, knew I had mouth open or mouth breathing because gums were super dry. Felt like I wasn't breathing then began hyperventilating. Now, I do have a history of panic attacks so it's very difficult sometimes to ascertain what is a sleep panic attack versus a respiratory event while sleeping. After I regained my wits over the past hour, I checked my data on OSCAR and it indeed looks like I had a period of really shallow breathing. 

Anyone with experience reading the OSCAR data able to confirm that it shows I was mouth breathing and/or not getting enough air?

[staceyburke]

I'm won't comment on the shallow breathing but you need to make a close up of the flow rate graph.  Pick a segment where it looks like depressed breathing (by clicking in that area) then use the up arrow on the keyboard to zoom in to be able to see the individual breaths.  also they will probably want to see a screenshot of an area of a normal breath that is also zoomed in on. 

The two things I will comment on is large leaks - You have quite a few and when this happens you are leaking more than your machine can compensate for, you are not getting any therapy.  You need to work on stopping the leaks.  The 2nd thing is you look to be having positional apnea.  That is where you are cutting off your own breath.  Much like kinking a hose - no air is getting through.  No pap pressure can help with that you have to find out what position you are getting into and stop it. 

Positional apnea happens anytime your chin drops to your sternum and cuts the airway.  If you sleep on your back you can try sleeping only on your side.  If you are using fluffy pillows change then to flatter pillows.  If neither one help you may need a collar to keep your neck aligned.   I have a link to collars at the bottom of my post.  It shows people who do not were a collar and the same people with a collar the difference is dramatic.

[VanWrinkle]

I'm won't comment on the shallow breathing but you need to make a close up of the flow rate graph.  Pick a segment where it looks like depressed breathing (by clicking in that area) then use the up arrow on the keyboard to zoom in to be able to see the individual breaths.  also they will probably want to see a screenshot of an area of a normal breath that is also zoomed in on. 

The two things I will comment on is large leaks - You have quite a few and when this happens you are leaking more than your machine can compensate for, you are not getting any therapy.  You need to work on stopping the leaks.  The 2nd thing is you look to be having positional apnea.  That is where you are cutting off your own breath.  Much like kinking a hose - no air is getting through.  No pap pressure can help with that you have to find out what position you are getting into and stop it. 

Positional apnea happens anytime your chin drops to your sternum and cuts the airway.  If you sleep on your back you can try sleeping only on your side.  If you are using fluffy pillows change then to flatter pillows.  If neither one help you may need a collar to keep your neck aligned.   I have a link to collars at the bottom of my post.  It shows people who do not were a collar and the same people with a collar the difference is dramatic.

Re: Large Leaks. I have no clue why this shows this as much. I just got new tubing and the machine itself now shows like 35% mask for the night. Can a new hose throw off the machine? I use a Mirage Quatro along with Remzzzs to minimize leaks. 



re: positional apnea. I tend to be a side sleeper but it's possible I was on my back. Especially since I had a dry mouth leads me to believe I was on my back with my mouth open. I use a soft cervical collar but I think the foam has got condensed to the point that it's not doing its job. Thankfully a new one is supposed to arrive today.


I believe I have attached two screenshots of what the portion you were asking for. Regular breath zoomed in vs. depressed breathing

[SarcasticDave94]

Your OSCAR data shows the PAP machine reports your unintentional leaks are quite high, so this can be a major issue. The air that should be keeping the airway patent is likely being blown out the sides of the mask.

You indicate airflow is quite frequent with a very dry mouth. It depends on how wide your mouth opens while sleeping. You may be dropping your lower jaw so much it pressed beyond the mask, causing huge leaks.

I'd suggest you pay careful attention to mask fitting and adjusting straps properly.

Secondly, either your PAP is unable to treat your Hypopnea with the settings as they are or leaks are the culprit, or there may be some positional Apnea as Stacey mentioned.

[VanWrinkle]

You indicate airflow is quite frequent with a very dry mouth. It depends on how wide your mouth opens while sleeping. You may be dropping your lower jaw so much it pressed beyond the mask, causing huge leaks.

It's not that frequent or enough that I notice regularly but the extremely dry mouth is usually the sign for me that I had been mouth breathing. I have a new soft cervical collar and I ordered a new one that is 3inches in height. I measured my neck the other day and it is 22.5''. The collar I use is an extra-large by their standards but only listed up to 21.5" for necks. 


Might not be the right place to ask, but is it possible the wedge pillow I'm using is causing more issues than it helps with? My GERD has gotten a lot better but since I'm a side sleeper, I'm wondering if it's maybe causing the mask to move more than it should.

[SarcasticDave94]

A wedge pillow could be a source of the positional Apnea we referred to. If it causes your chin to point towards your chest, that's the likely reason for the event clusters then.

[VanWrinkle]

A wedge pillow could be a source of the positional Apnea we referred to. If it causes your chin to point towards your chest, that's the likely reason for the event clusters then.

I think it might. Do you recommend anything I can use instead that wouldn't cause this? I was told a wedge pillow helps with respiratory drive.

[SarcasticDave94]

I don't know if it helps, but what I used to do with a wedge was place it under the mattress. Then I used a rather flat pillow more or less as normal before the wedge.

Now that I've got a DME's supplied electric tilt hospital bedframe, I don't use a wedge.

I've not heard a wedge helping with respiratory drive.

[VanWrinkle]

I don't know if it helps, but what I used to do with a wedge was place it under the mattress. Then I used a rather flat pillow more or less as normal before the wedge.

Now that I've got a DME's supplied electric tilt hospital bedframe, I don't use a wedge.

I've not heard a wedge helping with respiratory drive.

Thanks Dave, that's a good idea. I used to elevate the mattress with pillows but maybe the wedge under it is the way to go with the positional issues. Another issue I have is my mattress really sucks and has craters in it.

[SarcasticDave94]

Maybe the mattress should be on the replacement list. My Drive Medical air mattress with alternating pressure and low air loss technology is nice but it's scripted. That probably means it's costing insurance a small fortune.