Feeling like I was forgetting to breathe

OK, here is a strange (to me, anyway) problem I was/am having.

I started on CPAP about 1 week ago.
After 1 night of struggling against a 12cm setting, I backed the machine down to 9.
(During the titration study after half the night I needed to attend to nature's call. The tech and I had gotten friendly and even though he wasn't supposed to, he told me I was at 10cm when I asked. In the AM he said he had me up to 15cm but I had taken Ambien and had been asked to be on my back, a position in which I rarely sleep.)

So I figured 12 was a good place to start, and after the problems I set it to 9. Just because.

Anyway, after sleeping for the first 60 to 90 minutes I wake up. This has been happening for a few months anyway, nothing new to me. When going back to sleep though, just as I start to drift off I get a sensation that I need to breathe and that I just didn't do it. It's very difficult to explain, but it is almost certainly not a feeling of "something is stopping me from breathing" or that I was snoring, or anything. It's a definite feeling of "I need a breath, why didn't I take one?"

This was the second night when it started. The exact same thing happened for 4 hours, perhaps 4 or 5 times each hour as I laid awake trying to fall asleep.

Is this a common sensation? If not, anyone else get this? Does it go away over time? Is it just me being anxious?

Thanks again.

OH yeah, the other thing.
I assume this is normal but in addition to the well described feeling of difficulty in exhaling against the pressure (which I am getting very used to at 9cm) It seems as if there is quite a bit of air left in the lungs after I'm done exhaling - If I remove the pressure a lot of air comes out. I'm assuming this is quite normal, but just wanted to toss it out there to the experienced folk here.

I know the exact sensation you are talking about, but I would get that before I started treatment.. Its is a really bizarre sensation. It would happen when I was almost asleep and cause me to sort of gasp or inhale somewhat sharply, and that was my thought, why am I forgetting to breath?

Ron,

Are you sure you're not mouth breathing? The sensation you describe is how I feel when I'm mouth breathing.

[quote="RonS"]OK, here is a strange (to me, anyway) problem I was/am having.

I started on CPAP about 1 week ago.
After 1 night of struggling against a 12cm setting, I backed the machine down to 9.
(During the titration study after half the night I needed to attend to nature's call. The tech and I had gotten friendly and even though he wasn't supposed to, he told me I was at 10cm when I asked. In the AM he said he had me up to 15cm but I had taken Ambien and had been asked to be on my back, a position in which I rarely sleep.)

So I figured 12 was a good place to start, and after the problems I set it to 9. Just because.

Anyway, after sleeping for the first 60 to 90 minutes I wake up. This has been happening for a few months anyway, nothing new to me. When going back to sleep though, just as I start to drift off I get a sensation that I need to breathe and that I just didn't do it. It's very difficult to explain, but it is almost certainly not a feeling of "something is stopping me from breathing" or that I was snoring, or anything. It's a definite feeling of "I need a breath, why didn't I take one?"

This was the second night when it started. The exact same thing happened for 4 hours, perhaps 4 or 5 times each hour as I laid awake trying to fall asleep.

Is this a common sensation? If not, anyone else get this? Does it go away over time? Is it just me being anxious?

Thanks again.

OH yeah, the other thing.
I assume this is normal but in addition to the well described feeling of difficulty in exhaling against the pressure (which I am getting very used to at 9cm) It seems as if there is quite a bit of air left in the lungs after I'm done exhaling - If I remove the pressure a lot of air comes out. I'm assuming this is quite normal, but just wanted to toss it out there to the experienced folk here.

RonS, I know exactly what you're talking about, and it definitely freaks you out! Had a night like that last Sunday, in fact, and wished I'd had the software then to show me what kind of events had or had not taken place.

Who knew we'd ever get to such a place where satisfying sleep was so elusive, huh?

Take care!

Peggy

P.S. Snoredog, I greatly appreciate the explanation of what is going on when that happens!! I didn't have a clue -- just knew it didn't make for a restful night and I hoped to avoid it in the future. BTW, I think you are the one who has discussed Calms Forte in previous threads. I bought a bottle last night. I notice it suggests taking one to three tablets before bed. What have you found to be the optimum, if you don't mind my asking?

Snoredog wrote:Those events as you fall asleep (or attempt to) are sleep onset events, very similar to a central apnea. Basically you are forgetting to breathe, similar to holding your breath. Soon after your natural "fight or flight" response should kick in and "startle" you back completely awake. If you were not on the machine you would probably awaken finding your bed soaked from sweat.

This can happen for what seems like dozens of times when attempting to fall asleep. Anxiety usually follows where now you cannot sleep at all.

First off, thanks for such a detailed response.

I don't understand what you're saying here. I've never felt this sensation before, never woken up in a panic or sweat soaked, and I've been falling asleep nearly my whole life.

Until last week, I've been fully waking after the first 2 hours for months now, and then getting up and going back to bed several hours later, and sleeping very late, getting nearly 8 hours per 24. (I am VERY lucky in that I have no set work schedule).

Anyway, I have a "gut" feeling that it has to do with my lungs being propped open by the pressure somehow suppressing my respiratory drive, but of course gut feelings mean absolutely nothing.

Do you have any sources that I can read up on for this situation?

Thanks a million!

Anonymous wrote:I know the exact sensation you are talking about, but I would get that before I started treatment.. Its is a really bizarre sensation. It would happen when I was almost asleep and cause me to sort of gasp or inhale somewhat sharply, and that was my thought, why am I forgetting to breath?

Bizarre, right? Except mine started on my first CPAP night at home. In the lab I was Ambien'ed up.

Pineapple wrote:Ron,

Are you sure you're not mouth breathing? The sensation you describe is how I feel when I'm mouth breathing.

Don't think so, I have no recollection of mouth breathing at that time. I've been incredibly good at keeping my mouth shut!

pjwalman wrote:RonS, I know exactly what you're talking about, and it definitely freaks you out! Had a night like that last Sunday, in fact, and wished I'd had the software then to show me what kind of events had or had not taken place.

That's exactly why I want my next machine to have the best reporting software possible!

Sometimes the sensation is more mild than at other times, but I've not yet needed to or tried to open my mouth to gasp. Just a draw in through the nasal mask.

Thanks all. Great place here.

Your pressure isn't high enough to keep you from having apneas. You need to increase it more along the lines that Snoredog was talking about. It can take several weeks to become accustomed to therapy and you do not want to chance pressures every few days as it will make it more difficult to become adjusted to the required pressure.

Set your ramp as suggested. Is your c-flex setting on? What is it set at? Try setting it to a 3 for maximum comfort and see if that helps.

If you have had your plus machine for a week you might see if the doctor is willing to let you swap to an apap. If you wait to long you will be out of luck as the DME will fight you tooth and nail on it.

You are possibly mouth breathing as well and you will not know you are even doing it.

Without software there is no way you can be 100 percent sure your therapy isn't going out your mouth.

RonS wrote:

Snoredog wrote:Those events as you fall asleep (or attempt to) are sleep onset events, very similar to a central apnea. Basically you are forgetting to breathe, similar to holding your breath. Soon after your natural "fight or flight" response should kick in and "startle" you back completely awake. If you were not on the machine you would probably awaken finding your bed soaked from sweat.

This can happen for what seems like dozens of times when attempting to fall asleep. Anxiety usually follows where now you cannot sleep at all.

First off, thanks for such a detailed response.

I don't understand what you're saying here. I've never felt this sensation before, never woken up in a panic or sweat soaked, and I've been falling asleep nearly my whole life.

Until last week, I've been fully waking after the first 2 hours for months now, and then getting up and going back to bed several hours later, and sleeping very late, getting nearly 8 hours per 24. (I am VERY lucky in that I have no set work schedule).

Anyway, I have a "gut" feeling that it has to do with my lungs being propped open by the pressure somehow suppressing my respiratory drive, but of course gut feelings mean absolutely nothing.

Do you have any sources that I can read up on for this situation?

Thanks a million!

Sorry, but I don't know HOW else to explain it!!

-you wake up because you turned your pressure down because YOU thought it was too high.... that allowed apnea to appear when you are in REM sleep which you cycle through about every 60 to 90 minutes

-next, after the above wakes you up every 2 hours if you TRY and fall asleep it "feels like you have stopped breathing" where you get up and remain for several hours what did I say was sleep onset events?

I also said if it wasn't for you being on the machine when you woke up after those 2 hours you would probably wake in a bed of sweat.

And as sleepycarol pointed out you can be mouth breathing and LOSING all your cpap pressure out the mouth, that is the same as leaving the mask on the night stand, you are NOT going to get the pressure where it needs to be to keep your airway patent.

pjwalman wrote:RonS, I know exactly what you're talking about, and it definitely freaks you out! Had a night like that last Sunday, in fact, and wished I'd had the software then to show me what kind of events had or had not taken place.

Who knew we'd ever get to such a place where satisfying sleep was so elusive, huh?

Take care!

Peggy

P.S. Snoredog, I greatly appreciate the explanation of what is going on when that happens!! I didn't have a clue -- just knew it didn't make for a restful night and I hoped to avoid it in the future. BTW, I think you are the one who has discussed Calms Forte in previous threads. I bought a bottle last night. I notice it suggests taking one to three tablets before bed. What have you found to be the optimum, if you don't mind my asking?

if the event happens when you are trying to fall asleep it is most likely sleep onset events, these are artifacts that appear at the beginning of sleep and resemble central apnea (non breathing) but it is you relaxing to a state of where you forget to breathe. You would not think we do that buy many do. The bodies natural response when you don't get enough oxygen is to kick in your fight or flight response, that kicks you back to a completely wake state where you were probably in stage 1, the medical professionals say you are not conscious of that during stage1 but I beg to differ, all I have to do is try and take a nap without the machine on the couch and they come by the dozens.

I take melatonin, it helps me stay asleep, when I take Calms Forte I only take 1 tablet according to instructions (both about 1/2 hour before sleep).

Here is a similar thread

viewtopic.php?t=29409&highlight=sleep+o ... tral+apnea

Snoredog wrote:Sorry, but I don't know HOW else to explain it!!

-you wake up because you turned your pressure down because YOU thought it was too high.... that allowed apnea to appear when you are in REM sleep which you cycle through about every 60 to 90 minutes

-next, after the above wakes you up every 2 hours if you TRY and fall asleep it "feels like you have stopped breathing" where you get up and remain for several hours what did I say was sleep onset events?

I also said if it wasn't for you being on the machine when you woke up after those 2 hours you would probably wake in a bed of sweat.

And as sleepycarol pointed out you can be mouth breathing and LOSING all your cpap pressure out the mouth, that is the same as leaving the mask on the night stand, you are NOT going to get the pressure where it needs to be to keep your airway patent.

Please don't start getting all riled up, it's not worth it to either of us.
Why do you feel a need to take a contrary position? How does repeating yourself with the phrase "I said" in front of it do anything for my edification other than demand that I believe you because you said it?

How would you feel if your doctor talked to you like this?

Thanks for your opinions, but please don't demand that I accept them as fact.

Most of these people answering you have been at this a lot longer than I have, but just wanted to say I had the same sensation at first. Even in the sleep lab on a very low pressure (5) I had central apneas which they figured were due to the pressure. They stopped after I got used to it, but I continued to have the same sensation for the first couple weeks even with the CFLEX. My machine was not working right, though, and the new machine I got the CFLEX seems to work much better and I haven't had that problem anymore. I dunno much about that machine you have but if it has CFLEX I would recommend trying it. If it doesn't have it, maybe you should ask for one that does have it.

MrRandom wrote:They stopped after I got used to it, but I continued to have the same sensation for the first couple weeks even with the CFLEX.

Thanks for the reply!

Were you getting these just at the very begining of the night or were you also having them in later attempts to sleep?

How many a night were you having?

What, if anything, did you do to get used to it?

Thanks!