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Hi - I fairly regularly waken several times per night with panic attacks - 'lurching' in stomach, fast heartbeat and sweating.  I use my CPAP machine every night and occasionally, but not always, these attacks coincide with my husband telling me that my machine was particularly noisy or that my mask wasn't sealed properly.  Anyone else have these symptoms?  Any advice / suggestions?

Cheers

Mags

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In all probability, Mags, these panic attacks are caused by apnoeas. Is your CPAP infact an APAP? A simple pressure adjustment should take care of the problem - you can learn to do it or you can ask your clinic to do it.

 

My bet is that you have an APAP set at 4 and 20 - wide open. Do you have any idea what your 90% pressure is, what thwe max and min pressure settings are and very importantly, your AHI?

 

TF

I agree with TF in that your settings probably need adjusting.  When we're undiagnosed with OSA, everytime we have an apnoea our body goes into flight-fight state, which is what panic attacks are.  This is also why a lot of people with undiagnosed sleep apnoea suffer panic attacks during the day as well.  In the past when you weren't on treatment you would have been kicked out of REM into a lighter stage of sleep, and slept through the panics.  However, now that you have the CPAP pressure, it sounds like this is why you're waking up with the panics.  Are you on APAP or CPAP?

Hi Mags. I am on CPAP and have these too, when I first started and recently as I am still recovering from pneumonia which restricted my taking deep breaths. It also then led to DVT and EP which has lengthened my recovery time . It is horrible, but the way I deal with it is to think after a couple of minutes, 'Well I haven't died or passed out, so although it is uncomfortable, I am safe and it will pass'. I then use 'visualisation' to cope. I picture myself sat leant against a tree on a slight incline in a meadow with a light breeze blowing and lambs strolling a few metres away. I used to 'listen to' (in my head) the Fleetwood Mac track 'Albatross' to calm me down, but after Marks and Spencer used it now it reminds me of Belgian chocolate cakes lol. I now think of some yoga music I have to help. Anyway, you will be ok, honestly. As the others said, also check your strap settings to stop leakage. Take care. Greg

I have been diagnosed with sleep apnoea, plus night time panic attacks which my consultant tells me often go together. Unfortunately they see the remedy as medication, which I do not believe is the answer for me having tried it. It could be you are subconciously reacting to wearing the mask. My consultant said it can take six months to a year to settle down on CPAP and stop having linked panic attacks, especially as your body has had years of learning which needs to be retuned.

Without doubt, my throat is closing to stop acid reflux and making me wake suddenly as if I cannot breathe. This is not an apnoea although at night it can feel the same. The pressure entering the body, can make reflux more likely according to my consultant and a specialist reflux consultant I also saw. If you think this is possibly your problem, raise the head of your bed by 4 - 6 inches (on wooden blocks), watch what you eat and drink after 6pm and try some anti acid tablets for a short while.

 

Phil

 

Phil

I have experienced the night panic attacks (rapid heart beat) and headaches since using CPAP. I have been able to link it with the CPAP machine not able to operate correctly due to a leaking mask which also causes the noise. As a consequence it causes you to suffer the side effects of apnoea's. i would ensure your mask is secure and not not causing leaks when you are moving in your sleep. If you are suffering with large leaks you will have a noisy CPAP machine and revert to the symptoms prior to its use.

If your husband says your attacks coincide with a noisy machine then it does sound like a leaking mask may well be part of the problem. This is all so complex and there are lots of possible reasons for the panic. You have lots of good advice already on the site but the first one I think is to do everyhting you can to ensure that the mask seals well.

Use the special moisturiser and see if repositioning the straps helps. I often find that getting the mask to one side or the other of my nose can help, depending on where your head hits the pillow. So be prepared to adjust the mask straps once you are lying on the pillow and of course, use the wonderful hose lift so that the hose doesn't pull the mask away from your face.

Perhaps put a reed diffuser or some lovely fragrance (lots of different ways of doing this) near to the inlet on the machine so you get sweet fragrance whilst sleeping. I breathe the lovely smell into my mask deeply and this helps me go to sleep initially although I still wake up in the night, not in such a panic any more thankfully!

 Hope this all gets easier. This cpap / apap is not a straightforward exercise but it does get easier eventually.

Best wishes, Rosemary  

Mags, what type of mask do you use? I'm assuming it is a full face mask or nasal mask to stop leaks make sure you have your hose coming from above your head either from a bed head or use a hose lift. Mask liners normally help and save you washing your cushion as much and reduce marks. Also depending where the leaks come from i.e. from the top of your mask into your eyes, tighten just the top straps slightly until you get it right. Also if you use a FFM with a dial, try adjusting it. On the waking up depending on which machine you have make sure your ERP settings are right that is your exhale settings.

You certainly aren't new to cpap are you Mags? It isn't just a matter of getting used to things then is it! Is the panic that you feel like you can't breathe or is it perhaps that there is a general state of stress in your life at the moment made a heck of a lot worse by being trapped inside a mask?

I expect you've talked to your GP about the panic attacks and have been offered help from him / her? I sure hope so! Especially as your cpap clinic / sleep study professionals reckon they've helped as much as possible and have no more suggestions. The GP has ultimate responsibility for your well being as you probably know.  

I think that the aroma stuff is really nice. Someone said they rinsed their tube with a weak solution of mint mouthwash. That might also be a nice thing to try. I think deep breathing (the relaxation technique sort of breathing) when you first put the mask on is great and I tend to go to sleep more easily when I do this and feel more comfortable generally.

Is your bedroom warm enough perhaps or maybe not warm enough? Do you wake up because you need to go the loo perhaps? Anything that will make it possible to stay asleep comfortably may help you to not wake up in the night in a panic.

Frankly, I don't think I'm sure whether I wake up because I need to go to the loo or whether I realise I need the loo when I wake up. What comes first, the chicken or the egg and all that! All I know is that when I sleep soundly I tend to feel less stressed. Broken nights also make me more stressed and it is a self perpetuating problem that can cause panic in itself.

I do hope it settles down for you because lots of the good effects of the cpap are wrecked if you keep waking up in a panic. You ceratinly aren't alone on this site and hopefully all the different people's experiences will result in at least a few ideas that may be able to be reorganised into something you can use! All the best to you Mags.

Rosemary

 

 

 

You have not answered the vital question, Mags! We now know you have a CPAP set at 8cmH2O but  what is your AHI? Without knowing that, all else is conjecture.

 

TF

Glad you've found sharing this to be of help Mags.  However, you definitely need to find out your AHI to make sure the set pressure is working for you.  It's good you get an annual overnight sleep study, but you need them to be able to check your machine.  What machine do you have by the way?  A pressure of 8 isn't particularly high, and if it's too low for you the apnoeas will still be getting through, which may be what's causing this.

Also, you mention having asthma.  Some people with asthma also have to use oxygen with their CPAP so that might be another area to look at if it's not connected to the CPAP pressure.

Is there any chance of you getting checked out whilst in the US, as 6 months is a long time to go with these problems?

The information is recorded as a 7 day and a 30 day average in most if not all machines, Mags. Tell us the machine name and model and someone here will know how to get at the read-out.

If you are over there on business, you should have medical cover and the firm can pay for a check-up. If on holiday, read the small print of your travel insurance. OSA is an accepted exclusion, unless you took out cover for it, of course.

 

TF

Sorry for delay in replying Mag (having major computer problems + can't even view some things on my own sites!!!).  You should be able to view your AHI on your machine (as long as your clinic haven't barred it) by clicking through the arrow buttons and find the menu for AHI.  Do you have a date card in the slot on your machine?

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