Shallow breathing on CPAP

When I am on my machine (pressure of 18) I wake up in the middle of the night to find that when I inhale it is very shallow...the exhalation is fine. It seems to be the shallow breathing that wakes me up. Does anyone else experience this?

I have also noticed that sometimes when I am falling asleep with the CPAP I sometimes "forget" to breath in. Even though I am still awake, I can fell my body exhale and then do nothing. Eventually I either force myself to breath in or it finally kicks in. Is this caused by Central apnea? If so, what is the cure?

That should read "pressure of 18"! A smiley face snuck its way in!

I have experienced the "forgetting to inhale" thing, and also the shallow breathing thing.

CFLEX seems to help the second.

The first, I don't recall getting an adequate answer for. I believe this is called a 'central apnea', but I don't know why I only seem to get them when I'm on the CPAP. I asked about it once, but with all of my continuous whining on this site, if someone answered it, the answer has long since leaked out of my limited mental capacity for information.

Liam, who wonders if "Forgetting to Inhale" would be a good sequel to "Waiting to Exhale".

Shallow breathing can be the result of extra weight around the mid-section. The diaphram and surrounding muscles have to move to breath. I have noticed myself shallow breathing because of my big belly.

Not everyone who breaths shallow has a belly as I do, but it can be a factor.

I wonder if Marlon Brando had sleep apnea. You know, pound for pound he was our GREATEST actor.

Cheers,

Ted

Liam,
Central apnea's can sometimes be caused or aggravated by a pressure that is too high. One reason I decided to opt for apap after using cpap for over a year. The constant pressure just seemed too high, and seemed to make me worse at times, rather than better.
Debbie

snoozin' wrote:Central apnea's can sometimes be caused or aggravated by a pressure that is too high. One reason I decided to opt for apap after using cpap for over a year. The constant pressure just seemed too high, and seemed to make me worse at times, rather than better.

Y'know, that rings a bell, I think someone DID tell me that before. There's so much info to assimilate here.

One more reason why, if I can get past my breathing focus and actually fall asleep, trying an APAP might be a good idea.

Thanks!

Liam, who says "CPAP blows". Um... duh...

You know, Ted, that may be my problem. The irony is that I can't get enough breath to exercise to reduce my weight! (I have severe asthma too).

Maybe the high pressure is a problem. I will check with my DME and RT to see if I still have time to exchange my VPAP.

Research "obesity related hypoventilation" to learn more about the shallow breathing Titrator described.

Interesting that you should mention this. Just yesterday I read a discussion among sleep techs, where one of them said that "sleep onset central apneas" are "common" for some patients on CPAP. Once sleep is achieved it goes away for most of these patients. He did not say if these "sleep onset central apneas" were related to CPAP anxiety or respiratory drive normalization, however.

SWS, this is something that would concern me if I were a straight CPAP user. You are titrated at a pressure that rids you of apneas, hypopneas, and then they tell you your set pressure is 4 units above that (or at least I think that is what it is). Many of the sleep studies don't even seem to check for central apneas or perhaps you didn't sleep long enough at a time to have them show up.

Wouldnt the 4 points above what was really required be detrimental if you were having central apneas? And if so, this would be another reason for not starting people off on straight CPAPs.

Janelle wrote:SWS, this is something that would concern me if I were a straight CPAP user. You are titrated at a pressure that rids you of apneas, hypopneas, and then they tell you your set pressure is 4 units above that (or at least I think that is what it is).

To my knowledge that is not standard CPAP-titration protocol. Perhaps that added 4 cm you heard about is relative to a Bilevel titration (not CPAP). Typically for a BiLevel titration, they start with a fixed pressure titration exactly as you described. Once a pressure is derived to clear those obstructive events you mentioned, that setting is then used as an initial EPAP setting. The initial IPAP setting is quite often set at 4 cm above that. Then additional PSG monitoring occurs to see if EPAP and/or IPAP pressures need additional adjustment.

Many of the sleep studies don't even seem to check for central apneas or perhaps you didn't sleep long enough at a time to have them show up.

Some of the home-based sleep studies do not. But all the PSG sleep studies use a "respiration effort belt" and other data channels to monitor for central apneas right from the very beginning of each study.

Wouldnt the 4 points above what was really required be detrimental if you were having central apneas? And if so, this would be another reason for not starting people off on straight CPAPs.

So it's really not 4 cm above required pressure for CPAP as mentioned above. But your point goes to the fact that some central apneas are positive-pressure machine induced. As it turns out, there are a variety of physiological factors that can cause central apneas. Some of those etiologies are completely unrelated, and so are their treatments. For instance, sleep onset central apneas can be purely anxiety-driven. In these patients the central apneas occur immediately prior to falling asleep. Then the central apneas disappear during sleep, but quite often resurface as soon as the patient starts to wake---including during intervening periods of wakefulness throughout the entire night. Some cases of central apneas are treated with CPAP and an oxygen bleed, most are treated with BiLevel, some with medication----and, of course, various combinations of treatments are often tried as well. AutoPAPs tend to strive to avoid pressure-inducing central apneas for those patients who are so inclined. Yet, AutoPAPs are probably not an excellent choice for taking care of central apneas related to neuromuscular dysfunction, or even those anxiety-induced sleep onset central apneas. Central apneas can entail an entire host of possible physiological failing mechanisms, requiring a host of treatment methods to treat the various etiologies.

I am not a medical professional about any of this. But I do find it verrrrrry interesting, and have been researching it lately!

i feel EXACTLY the same way, people! i JUST woke up from shallow breathing, and i was scared that i would die because i'm always scared of things happening to me.....anyways, i wanted to ask why this was happening?? forgetting to breathe? i dont know why. but tonight was the only night it's happened. so far.

I think I sometimes have sleep onset central apneas. This is because I'm' aware of drifting into sleep and it seems like I can somehow tell I stop breathing as I fall asleep. it's kind of a peaceful feeling, like everything just suspends. I never knew it was called that, but I'm pretty sure it happens sometimes.

I didn't have any central apneas on either of my sleeep studies.

i need some one help i was in a coma for about 2 week and i was on life support for 3 in a half weeks witch gave me shallow breathing of cource...but anways i have been going to speach theropy for 8 months now and thats not really helping does anyone know what i can do to help with my shallow breathing??? thank you!!

I hope that some answers out there for me. My experience with CPAP has been a living hell from the first day. During the testing I was told I had shallow breathing at a rate of 32 per hour and they tried to put a mask on me. Between anxiety and being woke up at 1:00 am, I laid there for about 45 minutes before giving up and going. The second test went the same, laid there for over hour and could not sleep at all, not even for a couple seconds.

They sent me home with a machine that has a auto setting for the pressure and everyone was sure that I would get use to it in a few days. To cut short all of the normal suggestions (pillow position, hose position, full face, nasal, full face with forehead strap, full face without, mask adjustments, putting mask at the start of sleep, in the middle and end of the night) there are many more that I have tried or got planned. The result so far is that after wearing it for 45 days for about an hour and half each day, I have gotten a total of 10 minutes of sleep, NOT 10 each day, so out of wearing the mask 70 hours, I got 10 minutes of sleep.

There are two main problems I have with trying to sleep. First is mask leaks, the only way to stop the leak is to tighten the mask to the point that you cannot move and even if you do move the mask will start leaking again. So after pulling the mask very snug and making sure not to move my head or body position for the night I tried to sleep. Something happens just as I nod off, maybe its a mask leak or something else.

Something new that I found is that with the machine, I can stop breathing for as long as want. The machine blows enough air that I do not have take a breath, I can hardly wait to show the doctor how I can go for several minutes without breathing.

basically all the problems that you are suppose to have with apnea I got after using the machine (falling asleep at work, being tired all the time).
All in all, I think the cure is worst then the problem. I really question if shallow breathing should be considered a problem. Am I the only person in the world that has problems with CPAP? the doctors and techs sure do act like that they never heard of someone having problems

This is exactly what's going on with me...CPAP made symptoms worse...And doctors say they never heard of it...It's horrible