Sleep disturbances

[chd3143]

I've been plagued by frequent sleep disturbances which cause me to quickly wake (almost always during dream phase) and 9/10 times in a panic state (rapid heart rate, shallow breathing, etc.). This state lasts between 15 and 60 minutes depending on my state. When this first started happening, I assumed I was having some type of apnea episode. I started using Sleepyhead months ago, and charted every one of these episodes (nearly nightly). I never see anything except a few seconds of rapid breathing -- exactly like it would look if you awoke from a nightmare.

The timing of these episodes is uncanny. Precisely 3 hours after I go to sleep. If I go to bed late, they're worse. If I have a particularly bad episode, I can count on bad ones for several nights until I have a good night (psychological I'm sure).

I finally gave up and did another sleep study and, thankfully, I had one of these episodes. I started tearing off the leads (part of the panic), and the tech came in and kind of chuckled ... "Huh ... not sure what that was." So, I'm more confused now than ever. I haven't been back to talk to the doctor, but the tech and I talked while I was freaking out -- he said it looked like I flipped the "switch" right when I started to transition to REM sleep. But he didn't see anything else. In fact, my treatment, mask, pressure all seem to be doing exactly what they're supposed to do.

Interestingly, the worse my sleep (like when I have a cold or wear a leaky full face mask), these episodes are rare. But my AHI increases. It's been rough to be sure. The better my sleep ... the worse my sleep. Hoping to get some sage advice from someone!

[me50]

Have you talked with your doctor? Can you remember what the dreams/nightmares are about? I don't know what to suggest about why this doesn't happen much when you have a mask leak or a cold. Maybe more info would help. It might be possible that you have a different type of sleep disorder as well as OSA.

[chd3143]

Yeah, he sent me to do the sleep study. The only thing that came to mind is that the more restful my sleep, the more likely this is to happen. The tech said something interesting -- that if you haven't ever had a history of deep sleep (like I likely haven't), then the brain detects that level of sleep as a warning ... like it's TOO asleep, if that makes sense. But when my sleep is horrible - -the events don't typically occur, yet I feel exactly like I did before I started CPAP therapy. In other words, I'm not ever reaching deep stages of sleep.

---

OH. The dreams. Sometimes they're bad. Sometimes not. I've never seen a pattern. When my apnea was untreated, my nightmares were horrid. If I have bad dreams now, it's usually related to late night eating

[PaulaO2]

Well, there's "night terrors", which is not to be confused with nightmares.

The universal feature of night terrors is inconsolability.[8] During night terror bouts, patients are usually described as "bolting upright" with their eyes wide open and a look of fear and panic on their face. They will often scream. Furthermore, they will usually sweat, exhibit rapid respiration, and have a rapid heart rate (autonomic signs). In some cases, individuals are likely to have even more elaborate motor activity, such as a thrashing of limbs—which may include punching, swinging, or fleeing motions. There is a sense that the individual is trying to protect himself and/or escape from a possible threat which threatens bodily injury.

http://en.wikipedia.org/wiki/Night_terror

[me50]

perhaps a neurologist is the place to start if you have seen the doc that ordered your sleep study and he/she offered no suggestions on what to do. I sent a PM to you a few minutes ago with two links that list several types of sleep disorders that you can read about and see if any of them fit what you are experiencing. Paula mentioned night terrors which is included in the info I PM'd you.

[chd3143]

I kind of wondered about night terrors. My mom had those. The only difference is that I'm under control when I wake up. I know exactly what's happening. I just have to work through it. Sometimes it's quick. Sometimes not so much. If it's worse, I've had some panic attacks after the fact, but they don't feel like panic at the onset. Thanks for the PM. I'll follow those links and do some reading before bed!

[quiescence at last]

rapid breathing is normal for REM sleep. waking is normal after REM sleep. I take it that when you awaken the panicky feel is not related to the subject of the dream? Do you take any supplements, such as valerian or melatonin? 3 hours is a while to get to first REM sleep. does your sleepyhead chart show events during this period of rapid breathing? or at transition (at the very end of the 3 hour precursor)?

QAL

[chd3143]

QAL, yes I awaken feeling normally, though quickly, except that when I notice everything is amped up and rapid, I start to over think things. That's what usually leads to the panicky stuff. No supplements, and the one med I take isn't known for sleep disturbances. I've been journaling each occurance and here's the single thread I can come up with --

I'm typically bloated full of air (assuming aerophagia). This usually happens in the first part of the night (for example, I slept three hours last night and had an episode and was full of gas/bloating. Then I slept four and woke up fine). The difference, it seems, is that I'm a late eater with GERD. I wonder if there's something to the eating, GERD and then the aerophagia that's contributing somehow? It seems odd that I can sleep the second half of the night without some occurance.

[quiescence at last]

pre CPAP I had 6 or 7 TUMS per day to combat indigestion and heartburn. I have had 2 TUMS in the last 3 months. cool!
now, to be fair, my eating habits are different, as well. less to no caffeine, more protein less bread and sweets. shameful what you do to yourself in perpetual cyclic stress disorder (pcsd). I am glad to be back in my right mind (or at least a higher percentage than when I had to choose between sleeping and breathing.)

when you wake up, just expect it and it won't make you as anxious. just reach out and press the ramp button.
QAL