Tons of CA events due to anxiety?

[jasonw]

Hello,

I'm having a lot of difficulty trying to sleep with my APAP (ResMed AirSense 10 AutoSet). I've tried about 5 different masks and seem to tolerate the P30i the best (which isn't saying much).

I've been dealing with pretty bad anxiety lately that seems to rear its head around bedtime. I quit caffeine a few weeks ago and it feels like that really opened the gates. I can't tell if the anxiety is due to caffeine withdrawals or me finally feeling the poor sleep I've been dealing with for years. 

In any case, when I go to bed, before falling asleep it feels like my breathing gets shallower and shallower and then I end up holding my breath. This ends up giving me a "wake" jolt and then it just happens again and again until I somehow manage to get an hour of sleep in between. It's torture and I can't figure out what's going on. I'm wondering if anyone has experience with this? 

Could it be central sleep apnea? How do you deal with this?

I still don't know what my ideal pressure is because I can hardly stay asleep long enough to pinpoint anything. 

I'm attaching a screenshot of the last time I tried the APAP where I managed to catch a lot of these events. I haven't used it since. Anxiety is still doing a number on me and making me think I'm having heart failure or something. Almost went to the ER a couple of times early on. Nights are so mentally difficult... I wouldn't wish this on anyone.

Also - here's a link to an interactive SleepHQ chart w/ all of the data: https://sleephq.com/public/74307398-0b67...bf91c05e3f

I'm 42, 200lb, athletic build, around 15% bf.
Resting pulse rate is around 58-65
Blood pressure is around 120/70
Oxygen throughout the day is 97% - 99% but it can drop below 90% during these weird breathing events (caught using pulse oximeter)

Any help would be appreciated, thank you.

   

[DevinJones]

Although you say that you experience the cessation of breathing as you're falling asleep (sleep-onset central sleep apnea?), it appears to me in your data as if your clear-airway (CSA?) events occur in the middle of a session. 

What I see in your data is what happened to me when I used an APAP device for my central sleep apnea events and periodic breathing pattern: a series of many clear-airway events. 

I don't know what kind of sleep study you've had or your sleep apnea diagnosis. But IF you have CSA, then CPAP and APAP devices can aggravate CSA or even cause treatment-emergent CSA. 

Do you have your sleep study report (redacted to remove names) for the experts here to look at?

[jasonw]

Although you say that you experience the cessation of breathing as you're falling asleep (sleep-onset central sleep apnea?), it appears to me in your data as if your clear-airway (CSA?) events occur in the middle of a session. 

What I see in your data is what happened to me when I used an APAP device for my central sleep apnea events and periodic breathing pattern: a series of many clear-airway events. 

I don't know what kind of sleep study you've had or your sleep apnea diagnosis. But IF you have CSA, then CPAP and APAP devices can aggravate CSA or even cause treatment-emergent CSA. 

Do you have your sleep study report (redacted to remove names) for the experts here to look at?

I do, here it is: https://www.dropbox.com/s/dcr4qqhzbuepka...9.pdf?dl=0

This sleep study was from 2021 so its a bit dated. I didn't do well w/ therapy and gave up for a long time but am realizing that I have no other option but to to figure this out and make it work.

During this sleep study, I don't remember having these types of events as I was falling asleep (nor the anxiety).

I mean, I was able to fall asleep without frequent instances of holding my breath. I would just constantly wake up over and over. I feel like I'm awake and can remember every time I wake up and have to move. Its difficult to sleep on my sides... I feel like I hold my breath more frequently when I lay on my left side but it's also happening a lot on the right side now as well.

[DevinJones]

Your sleep study report should be helpful data for the experts in this forum to look at. It looks as if during the study in 2021, you had mainly obstructive hypopneas while in lying on your back in REM sleep. I don't know if you have new sleep apnea issues. 

You keep taking about sleep-onset events, but I see events in the middle of your sessions.  

Let's see what the experts here have to say.

[jasonw]

Your sleep study report should be helpful data for the experts in this forum to look at. It looks as if during the study in 2021, you had mainly obstructive hypopneas while in lying on your back in REM sleep. I don't know if you have new sleep apnea issues. 

You keep taking about sleep-onset events, but I see events in the middle of your sessions.  

Let's see what the experts here have to say.

Ah I see what you mean. That’s probably because I sat awake with the mask for a while before being able to fall asleep.

[DevinJones]

What you describe in your first post about what happens when you fall asleep sounds like sleep-onset central apnea, which I can experience as I'm falling asleep. At that time, I'm awake enough to know that I've stopped breathing and have made no effort to breathe against an obstruction. It stops once I'm asleep.

But I noticed in your OSCAR screenshots that your inspiration time is greater than your expiration time. Some experts here have said that may suggest obstructive events.

[hopeforusall]

jasonw, I have had the exact same issue. Since recently getting an ASV the jolts are much less frequent when asleep, but still a nightmare when awake and trying to sleep. SpO2 often plummets to 70%+. This could go on for hours. I know exactly how you feel.

Do you take any medications (beta blockers, ppi's, muscle relaxers, etc.)?

DevinJones, did not know you had this as well. Hopefully we are not all in the same sinking boat. At least the ASV helps us while asleep!

[DevinJones]

jasonw, I have had the exact same issue. Since recently getting an ASV the jolts are much less frequent when asleep, but still a nightmare when awake and trying to sleep. SpO2 often plummets to 70%+. This could go on for hours. I know exactly how you feel.

Do you take any medications (beta blockers, ppi's, muscle relaxers, etc.)?

DevinJones, did not know you had this as well. Hopefully we are not all in the same sinking boat. At least the ASV helps us while asleep!

hopeforusall, I'm definitely not in any sinking boat. I'm succeeding with my ResMed 10 ASV device. Read my post to you in your thread to see how I'm succeeding.

[hopeforusall]

DevinJones, I misunderstood your current position when you stated "...what happens when you fall asleep sounds like sleep-onset central apnea, which I can experience as I'm falling asleep. At that time, I'm awake enough to know that I've stopped breathing and have made no effort to breathe against an obstruction. It stops once I'm asleep." It is excellent that you are showing success and it is an ispiration to others on ASV (including me)!

It has been a rough day for me but I will follow-up with you on your post in my thread this weekend. Thanks!