Video proof of me struggling to breathe last night - UARS?

[MyronH]

Around 6pm I started having unusual tiredness, malaise. I had this type of feeling the past, and usually associated it with my Multaq medicine for AFIB. I didnt think much of it, but I went to bed around 10p. I noticed when I layed down it was a little bit more difficult to breathe, like my throat was closing off. Or like something was stuck in my throat.

I went to sleep, then at 2:20am, woke up with drenching night sweats, and like my heart and lungs was really struggling to keep me breathing at night.

I have been video recording myself to catch an event like this. When I woke up at 2:30am with night sweats, I reviewed the video. and my sleepyhead logs. The video clearly shows me mouth breathing and struggling to breathe.  I slept on my back with cervical neck collar which has been helping prevent obstructions. I also inadvertently raised my left leg up at my knee. My leg was bent at the knee, and stayed there for about 30min during this episode. I'm not sure if raising my leg could cause breathing issues or what happened.  After about 30min, my leg went back down and I woke up.

I woke up not feeling well, drenched in sweats, dry mouth, and like my throat was closed off. Felt like something was in my throat closing it off at the Adam's apple.


I already sent this information to my doctors this morning. I don't know what to do at this point. Is this some form of UARS, or is my Multaq medicine causing breathing difficulties in me? Is it a spinal issue with my neck that is closing off the airway? Or is it an food allergy issue closing my throat off.

It seems to get worse on these nights, when I lay down. Then it feels like me throat is closed off, and I have trouble breathing. When I sit up, it gets better. I'm seriously thinking it could be Multaq causing some heart and breathing issues in me. But I don't know what to do at this point, since none of my doctors had answers in the past.

[yrnkrn]

If this were my graphs, I'd first deal with the leaks.
Mouth breathing/leaking at this rate is quite bad, will dry up the mouth and nose, possibly cause congestion and arousals.

[Sleeprider]

The real question is whether this problem is respiratory related, and it's not.  You video yourself in distress with mouth breathing and raising your leg, but while this causes a leak, you continue to breath and there is neither an apparent obstructive nor central component.  A slight increase in FL raises pressure.  The OA event appears isolated and would not be remarkable other than it seems to precede this event.  With regard to Multaq, your symptoms are included in the list of reactions that require you to "contact your doctor at once". https://www.rxlist.com/multaq-side-effec...m#consumer 

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:

• shortness of breath (even with mild exertion), swelling, rapid weight gain;
  
  
• chest pain, wheezing, trouble breathing, dry cough, or coughing up mucus;
  
  
• breathing problems while lying down trying to sleep;
  
  
• severe dizziness, fainting, fast or pounding heartbeats;
  
  
• slow heart rate, feeling like you might pass out;
  
  
• a new or a worsening irregular heartbeat pattern;
  
  
• kidney problems--little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
  
  
• liver problems--nausea, upper stomach pain, itching, unusual tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
  

Your BiPAP therapy does not seem implicated here, and I think you should not include a discussion of it when talking to the doctor or cardiologist about this event, as it just confuses them and takes attention away from more likely problems.

[Gideon]

Around 6pm I started having unusual tiredness, malaise. I had this type of feeling the past, and usually associated it with my Multaq medicine for AFIB. I didnt think much of it, but I went to bed around 10p. I noticed when I layed down it was a little bit more difficult to breathe, like my throat was closing off. Or like something was stuck in my throat.

I went to sleep, then at 2:20am, woke up with drenching night sweats, and like my heart and lungs was really struggling to keep me breathing at night.

I have been video recording myself to catch an event like this. When I woke up at 2:30am with night sweats, I reviewed the video. and my sleepyhead logs. The video clearly shows me mouth breathing and struggling to breathe.  I slept on my back with cervical neck collar which has been helping prevent obstructions. I also inadvertently raised my left leg up at my knee. My leg was bent at the knee, and stayed there for about 30min during this episode. I'm not sure if raising my leg could cause breathing issues or what happened  (look at Restless Leg Syndrome which I do not think you have FB).  After about 30min, my leg went back down and I woke up.

I woke up not feeling well, drenched in sweats, dry mouth, and like my throat was closed off. Felt like something was in my throat closing it off at the Adam's apple.


I already sent this information to my doctors this morning. I don't know what to do at this point. Is this some form of UARS, or is my Multaq medicine causing breathing difficulties in me? Is it a spinal issue with my neck that is closing off the airway? Or is it an food allergy issue closing my throat off.

It seems to get worse on these nights, when I lay down. Then it feels like me throat is closed off, and I have trouble breathing. When I sit up, it gets better. I'm seriously thinking it could be Multaq causing some heart and breathing issues in me. But I don't know what to do at this point, since none of my doctors had answers in the past.

First, all of what you wrote is important.  Bolding above is all mine.
Step 1 you have already done, contact your doctor.  This is beyond what we typically deal with here, we will help where we can.

In my past, I was a First Responder, First Aid Instructor, Fire/Rescue, EMT, and Ambulance attendant, all as a volunteer.  The initial evaluation was always ABC, Airway, Breathing, Circulation.  Note the order it is important if you didn't have an airway you cannot treat breathing if you are not breathing then your circulation/blood (heart) matters little, the last initial step is to evaluate circulation. If I were to meet you as a patient I would be at the 1st step of considering an epi-pen which is used with anaphylactic reactions to open the airway which is always followed by a doctors evaluation in the ER.

Food allergy is a possibility, you are noting a feeling of your throat closing off.  What about Asama?  similar symptoms there.

Let's get a little more data,  In addition to the charts you have here, add some 2-minute detail segments of the various stages of what you have detailed here.  I can see that in what I thought was fairly normal sleep at the beginning you were having some issues, some breathing falling off, and at this scale favoring inhalation over exhalation, this could be the mouth breathing you mentioned.  At this scale that should look like a solid black bar.  


Add these detail charts, and always a full night chart to provide context.
1:55-1:57 (the "good" section)
2:00-2:02 (the Start of the bad)
2:02-2:04 (the Start of the bad)
2:04-2:06 (the Start of the bad)
2:09-2:12 (very low flow period)
2:21-2:23 (a period after what looks like the worst)

I honestly don't know what this will show, my hope is some good info to show a pulmonologist and get you traveling down the right path.

Fred

[Gideon]

Note in my reply I did not indicate anything about your BiPAP treatment.  EVERYTHING was about your breathing and to further document it.

[ardenum]

I'd want to see the video myself. Besides that tray taking zyrtec just in case, it wont hurt to try.

[MyronH]

Add these detail charts, and always a full night chart to provide context.
1:55-1:57 (the "good" section)
2:00-2:02 (the Start of the bad)
2:02-2:04 (the Start of the bad)
2:04-2:06 (the Start of the bad)
2:09-2:12 (very low flow period)
2:21-2:23 (a period after what looks like the worst)

I honestly don't know what this will show, my hope is some good info to show a pulmonologist and get you traveling down the right path.

Fred

Here is the full chart, along with those specific times. I've already seen a pulmonologist a few months ago, when I was having these issues. They ran a breathing test on me and I passed and they said I didn't have to come back.

I took a look again at the video. It appears I had two minor snores. But before I woke up at 2:30am, It appears I was breathing deeper. Not sure if these charts show that?

FULL Graph for last night



1:55-1:57am


------------------------------------
2:00-2:02am


=============================
2:02-2:04am

===============================================

2:04-2:06am

====================================

2:09-2:12am


================================================

2:21am-2:23am

[MyronH]

I just got off the damn phone with my sleep doctor. He claims he looked at my report for last night, and didn't see any issues and that my AHI was low. He also didn't have any comments about my NIGHT SWEATS, even though they were severe last night.

Another sleep doctor I went to, that puts a PES device in your nose and down your throat called me. They said they use it to measure negative pressure in the throat. I made a sleep study appointment with them, but it isn't until December. Not sure if this will benefit me or not?

[ardenum]

I just got off the damn phone with my sleep doctor. He claims he looked at my report for last night, and didn't see any issues and that my AHI was low. He also didn't have any comments about my NIGHT SWEATS, even though they were severe last night.

Another sleep doctor I went to, that puts a PES device in your nose and down your throat called me. They said they use it to measure negative pressure in the throat. I made a sleep study appointment with them, but it isn't until December. Not sure if this will benefit me or not?

It will, thats how to diagnose UARS.

[MyronH]

I just got off the damn phone with my sleep doctor. He claims he looked at my report for last night, and didn't see any issues and that my AHI was low. He also didn't have any comments about my NIGHT SWEATS, even though they were severe last night.

Another sleep doctor I went to, that puts a PES device in your nose and down your throat called me. They said they use it to measure negative pressure in the throat. I made a sleep study appointment with them, but it isn't until December. Not sure if this will benefit me or not?

It will, thats how to diagnose UARS.

How will that help me though? UARS comes before sleep apnea, correct? 

I'm already on BI-LEVEL and dental appliance for sleep apnea. When I talked to the new sleep doctor, I asked them how they treat UARS, and that is usually with CPAP/BI-LEVEL. 

I also had Environmental Allergy testing, and this showed I was allergic to Wheat Cultivated, and a few other things like Cedar. I had some simple food allergy tests earlier in the year and that didn't show anything.

Do you think this all could be caused my food allergies closing my throat more at night, some nights and causing unwell feelings?