[Symptoms] Stop Breathing While Concentrating

[NicksterFL]

I've been having some odd symptoms lately that started about a month ago.

I was driving one morning and had a slight cough. At the bottom of my exhale/cough, my heart began to race and I had tunnel vision w/ tingling in the arms.
Called 911 and as I was describing what happened, I began to feel somewhat normal again and said I think I may have hyperventilated.  20 minutes later it happened again and I called 911 and they took me to ER. My blood work was fine. EKG fine. Blood Pressure was a little high, so they put me on BP meds. Everything else was ok so they released me.

Two days later, it happened again and off to ER I go. This time they did CT scan of my brain, blood work ok. Thyroid ok. Chest X-ray ok.
My Primary Doc referred me to a cardiologist. 

The cardiologist did a stress test, heart dye scan and echocardiogram, and all came back ok. With the exception of high BP. 
They put me on TENORETIC (atenolol and chlorthalidone) Beta Blocker and Diuretic. 

I've had two episodes since then and have been analyzing when this happens. It seems to be when i'm concentrating very intensely. I've also realized that I may have stopped breathing before the onset of one of these episodes. It's almost as if I have apnea during the day while i'm concentrating. I breathe very shallow and at some point stop, not realizing i'm stopping and then I begin to have this sensation in my chest and the episode starts.

Is this possible? I don't feel it's anxiety because I've had them during times with little stress (Fishing and was concentrating on  tying a knot). It is definitely related to breathing.

Thoughts?

[OpalRose]

Hi NicksterFL,
Sorry that you have been through that, but I have to wonder that with the many trips to the ER, someone would have suggested that you have a sleep test.

Check in with your regular doctor or cardiologist and see if you can get one scheduled. It may be nothing, but at least rule it out.

[NicksterFL]

Hi NicksterFL,
Sorry that you have been through that, but I have to wonder that with the many trips to the ER, someone would have suggested that you have a sleep test.  

Check in with your regular doctor or cardiologist and see if you can get one scheduled.  It may be nothing, but at least rule it out.

Thank you Opal.
I've seen several doctors and not one mentioned a sleep test. My father-in-law did however. He's on a cpap and said it made a world of difference for him and how he felt during the day. Although he did not have any of my symptoms.

[Mosquitobait]

We're not medicos but it is entirely possible it is related to the brain since you mention concentration as an issue. The problem is that unless they see something on the CT scan, there probably isn't a lot that they can do. You could ask your cardiologist if it seems a neurological visit would be of benefit. Could be that they order different tests. I had male family members always die at around age 65 almost like clockwork and it wasn't until my brother had a stroke that a neurologist did additional blood testing and found that there was an inherited blood clotting disorder. So, sometimes different specialties look at things differently. You have to check with your insurance though - some require a referral, mine does not.

[NicksterFL]

We're not medicos but it is entirely possible it is related to the brain since you mention concentration as an issue.  The problem is that unless they see something on the CT scan, there probably isn't a lot that they can do. You could ask your cardiologist if it seems a neurological visit would be of benefit. Could be that they order different tests.  I had male family members always die at around age 65 almost like clockwork and it wasn't until my brother had a stroke that a neurologist did additional blood testing and found that there was an inherited blood clotting disorder.  So, sometimes different specialties look at things differently.  You have to check with your insurance though - some require a referral, mine does not.

I can concentrate fine. I just found that when I do, I occasionally tend to hold my breathe. Not all the time, but i've had these episodes about 3 times a month. 

I've called my primary doc and asked for a sleep study so I can at least rule that out if nothing becomes of it.

BTW, i'm 42.

[SarcasticDave94]

While your circumstance and mine aren't identical, I've had in the past these episodes of having breathing stop while awake and doing deep thinking while sitting on the sofa. It was during the time I was still using the BiPAP this time last year and not long before central apnea was diagnosed. Since then, I'm on an ASV, and those breath holding episodes haven't happened.

Do not take this as my confirmation you have central apnea or some other issue similar illness. I'm just chiming in to share a somewhat similar experience as your own. I'm not a doc nor play one anywhere.

I'll say though I agree with others that you have to get a specialist doc to help find the cause and get a solution. Best wishes it occurs soon.

[dmeRT]

my guess is a vasovagal response during the cough...

[NicksterFL]

my guess is a vasovagal response during the cough...

It has only happened once (first time) during a cough.
The other episodes have been during deep thinking.

[ShaunBlake]

I'm hesitant to suggest something seemingly unrelated, yet you've invested so much effort and expense already without having clear answers that this may not be as off-the-wall as I feel: I suggest you get a portable oximeter such as the CMS50F that I use; wear it all the time that such an episode is possible so that if you have another you can see if your O2 saturation was low.

Although not exactly the same, I've had a similar experience while driving. There were several factors that combined to cause my episodes which aren't the same for you -- such as your heart (mine was discovered to have a weak electrical current) -- yet the result is eerily similar.

[NicksterFL]

I'm hesitant to suggest something seemingly unrelated, yet you've invested so much effort and expense already without having clear answers that this may not be as off-the-wall as I feel: I suggest you get a portable oximeter such as the CMS50F that I use; wear it all the time that such an episode is possible so that if you have another you can see if your O2 saturation was low.

Although not exactly the same, I've had a similar experience while driving. There were several factors that combined to cause my episodes which aren't the same for you -- such as your heart (mine was discovered to have a weak electrical current) -- yet the result is eerily similar.

Wouldn't this show up in all the tests the cardiologist ran? I wore a 24 hour haltor monitor as well, (of course I didn't have an episode then).

I own one of these [link removed - Google Pro Series 500DL] I guess I could carry it around and check my O2 saturation when it happens?

My other thought was as simple as it being related to allergies. I've noticed 99% of the time, this happens when i've been outside and my nasal cavities are congested/swollen and there is a restriction when I breathe through my nose. Combine this with holding my breathe subconsciously / shallow breathing. 

I'm going back to my primary doc to get a sleep study so that I can at least rule that out. I'm wondering if my symptoms of possible daytime apnea are similar to that of night time?

-----
Moderator Action: Link Removed

To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites.  This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

-----