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Waking up at night with a rapid heart rate

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Waking up at night with a rapid heart rate.

Postby sjames37 » Tue Feb 08, 2011 8:24 pm

I was diagnosed with OSA in November 2010, I am 37, very thin, and have no major health issues, and am relativley healthy. I was told I have moderate OSA, I get about 17-19 an hour from the report. Got my CPAP machine, a Philips Resperonics with THE HEATED HUMIDAFIRE, and I use a nose pillow. I am not sure what my preassure is or how to tell. My AHI average on the machine info is at 3.5. I tried for acouple of weeks but hated the effect or suffocating feeling it gave me. When I dont sleep with the CPAP, I wake up one or more times with a rapid heart rate, and a really dry mouth. If I sit up my HR goes faster. This will last for about 5-10 min at the most, and then I calm down. What is puzzling I dont ever hear of anyone describing this symptom. Is it just me or is this a symptom of OSA. When I do use the machine I dont wake up like that but I do still wake up a few times in the night form the mask being on my face. Just wondering in case I may want a second opinion or another direction. Things I do notice that make me sleep better are: Not eating large meals or chocolate 4 hours before bedtime, taking my prilosec at bedtime(I have GERD), using my nasal spray my sleep doctor prescribed me, going to sleep earlier. Thaks for any help.
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Postby SleepyToo » Tue Feb 08, 2011 9:40 pm

Stop breathing every 3 minutes for an hour. Then repeat another 7 times (that's the whole set of 20 times each hour). Do that while you are awake. Oh, and each stoppage needs to be at least 10 seconds long to count as an apnea. Now, how do you feel?

Seriously, what you describe are definitely possible apnea symptoms. You are not doing your body any favors by not using the machine - in fact, you are hurting yourself. If it feels like you are suffocating, you probably need a pressure increase, but you must talk to your docs about that. If you have a ramp pressure set-up where the pressure increases slowly over 20 minutes or so, the starting pressure is often (always?) set too low by default. Talk to your equipment provider about that.

It takes a while to get used to the mask on the face, so post back here with specifics about the machine and mask that you have. Someone will help you find out what your pressure is, and how to adjust the straps to get comfortable with the mask. Have you read the manuals for both mask and machine? If not, do so - they were written for a reason. You are the only person who is going to work to get your treatment right, so do yourself a favor and GET TO WORK! Don't just say it doesn't work. You are what is not working to get it right. Before you seek a second opinion, listen and act on the first opinion. Sure, you can ask questions. Just do it!
SleepyToo
Philadelphia Area
Diagnosed September 2009, Respironics System One w/ C-flex and humidifier
Aloha nasal pillows
Not a medical professional, just a patient with severe OSA (31) who has done a lot of reading.
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Postby sjames37 » Tue Feb 08, 2011 10:46 pm

Thanks for the advice, and the info. Actually I went for a sleep test 3 years ago because I was falling asleep at the wheel in the daytime on my hour commute. One time I woke up with my car stopped in the middle of the hiway. I had no other symptoms, and I never woke up at night, I assumed I was fine and just was working too much and I didnt have sleep apnea or needed the CPAP. So three years later as of May 2010, I started waking up at night with the rapid HR, along with anxiety from it. They said it was Sleep panic attacks at first and loaded me up on sleep meds and zanex. But it still kept happening. I had ECG's(3 of them) Blood tests, Xrays, and finally an ER doctor told me He was 100% pos it was classic sleep apna symptoms, and possibly caused by my newly diagnosed GERD. So In Oct I had two tests, And I found out that the test's were very close to the ones 3 years ago were I had 17 episodes an hour. So not much of a change from three years ago but why and how in one night through now can apnea go from me not aware to being very aware. I also remember years back there were times I would wake up(very rare) with my heart beating rapidly and chocking and having to gasp for air. It would freak me out for a minute or two, I thought maybe I was choking on saliva or something but it must of been the begining of apnea back then(I was in my mid to late 20's then)so this time again i though i dont need this but now i cant go very many nights at all without using the CPAP. So I started again. I do fell more rested and way less daytime sleepyness but I still wake up 3 times a night I seem to be breating right. What i am getting at is it possible to go from what seemed normal to me to this? That is my wonder and questioning. But I will use my machine because it is very uncomfortable and depressing to wake up like that all the time, and way less uncomfortagle to use my CPAP. Thanks. My Mask or nose pillow is a ResMed, and its a woman's mask because they didnt have the mens one in stock, but it fells very comfortable, and my only concern is the plastic smell I seem to get by using it. The machine is a Philips Resperonics, and it has the flex deal and the ramp button, and also 5 different setting for the humidifire(which i have never used, i put the water in but never turn it on?
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Postby SleepyToo » Tue Feb 08, 2011 11:14 pm

Yes, you can go from not being aware, to being very aware overnight. The brain seems to deny that there is anything out of the ordinary. If you wake up in the middle of the highway, it is hard to deny there is something wrong any longer! I discovered that I had a problem when I woke up on the bathroom floor in a pool of blood. No other explanation than possibly some neuro damage due to the hypoxia that I was very definitely getting when I slept.

With the smell of the mask, try cleaning the mask every day with an unscented mild soap - the manual should tell you. Also, make sure you replace the pillows every 4-6 weeks at most - some people may need to replace them more often than that.

With the woman's mask, WHO CARES? You are the only one who needs to know. There is no truer expression than if the mask fits, wear it! Some people have a great deal of hassle finding the right mask. If your face size is 'wrong' for the masks for your gender, try the other ones!

It actually sounds like you are on the right road, with the right attitude. Find out your pressures, and make sure that you are getting enough air, and that the ramp is set to be comfortable for YOU. I actually don't use the ramp at all at a pressure of 10. I also only use the humidifier in pass-over mode (which sounds like what you are doing). Works well for me, so I continue doing it!
SleepyToo
Philadelphia Area
Diagnosed September 2009, Respironics System One w/ C-flex and humidifier
Aloha nasal pillows
Not a medical professional, just a patient with severe OSA (31) who has done a lot of reading.
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Postby Linda » Tue Feb 08, 2011 11:57 pm

Hi sjames37,

Keep at it, and be sure to have followup appointments with your doctor to make sure things are going ok. And ask lots of questions.

You've described many of the classic symptoms of sleep apnea. You have seen what happens when you don't use your cpap. Untreated sleep apnea puts a strain on the heart and other organs. The heart pumps harder, trying to get more oxygen into your system, because you lose blood oxygen when you stop breathing in your sleep. I had the same racing heart upon waking at night that you had, before I was treated with cpap. People with untreated sleep apnea are at significantly higher risk for heart attacks, strokes and other related heart problems. There are other advantages to using cpap. You mentioned having GERD. The use of cpap can alleviate that in many people. GERD can be caused by or worsened by untreated sleep apnea.

So keep at it, don't give up. If you haven't tried using the heated humidifier, give it a try. Humidification needs vary from person to person. You may or may not need it. Same thing with the ramp. If you have a feeling of suffocation at the beginning of sleep and you use the ramp, it could be you don't need the ramp. It's a comfort feature for people just starting to use cpap, especially for those with very high cpap pressures. If you want to know what your pressure is, just let it run for several minutes before sleeping, and view the reading on the machine, you may have to flip the lid to view it. It should show a number rising from about 5 (if you are using the ramp) to a number that stays the same, that is your cpap pressure.

Let us know how things go. Hang in there. I know it's disconcerting at first, getting used to this new way of sleeping. But once you start feeling better, it all won't seem so bad and it will become habit. Good luck.


Linda
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Postby pain32 » Thu Feb 10, 2011 3:37 pm

yeah I had the same symptoms, waking up with heart racing and don't know what it's from.
I have a problem with my blood levels that only came up after repeated blood tests and I'm
seeing and endocrinologist now. I find taking Natural Sources raw thyroid helps me
anyway it's really a bad disease to have this sleep apnea and I don't know how I got it either
or the breathing problems and GERD
Resmed asv, settings??
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Postby pain32 » Thu Feb 10, 2011 3:42 pm

I tried sleeping for 2 nights without CPAP and it was terrible, the same heart racing that continued while awake and my cortisol levels are low now- I may have an adrenal problem
if you find out what causes this I beg you to please let me know since I am still suffering from this strange disease
Resmed asv, settings??
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Postby Vicki » Thu Feb 10, 2011 6:38 pm

Sjames,

I want to mention to that, as you now know, there is no typical Obstructive Sleep Apnea (OSA) patient. We have old and young (see our pediatric forum) fit and not so, male and female and in one study of 405 people with OSA around 30% did not even snore. It is also extremely common for people with undiagnosed OSA to blame the way they feel on work, stress, etc. Your story and misdiagnosis, sounds like almost everyone else's story here so you are in good company with a great bunch of new friends.

Vicki
Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Vos Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.
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Re: Waking up at night with a rapid heart rate.

Postby SleepLife » Sun Feb 13, 2011 12:37 pm

sjames37 wrote:I was diagnosed with OSA in November 2010, I am 37, very thin, and have no major health issues, and am relativley healthy. I was told I have moderate OSA, I get about 17-19 an hour from the report. Got my CPAP machine, a Philips Resperonics with THE HEATED HUMIDAFIRE, and I use a nose pillow. I am not sure what my preassure is or how to tell. My AHI average on the machine info is at 3.5. I tried for acouple of weeks but hated the effect or suffocating feeling it gave me. When I dont sleep with the CPAP, I wake up one or more times with a rapid heart rate, and a really dry mouth. If I sit up my HR goes faster. This will last for about 5-10 min at the most, and then I calm down. What is puzzling I dont ever hear of anyone describing this symptom. Is it just me or is this a symptom of OSA. When I do use the machine I dont wake up like that but I do still wake up a few times in the night form the mask being on my face. Just wondering in case I may want a second opinion or another direction. Things I do notice that make me sleep better are: Not eating large meals or chocolate 4 hours before bedtime, taking my prilosec at bedtime(I have GERD), using my nasal spray my sleep doctor prescribed me, going to sleep earlier. Thaks for any help.


What you are experiencing is called hyperventilation. It is often an early symptom of Sleep Apnea. I had it for a period of 15 years before I was diagnosed.

Once you have obstructions you get too little oxygen in the blood. If this level gets too low, you will wake up and breathe very quickly. This will quickly give you too much oxygen in the blood, which is the really cause of your symptoms.

When you hyperventilate, it feels like you're about to die, although the condition is completely harmless.

CPAP treatment will eliminate these symptoms. Therefore it is important to achieve good CPAP compliance.

Good luck

SleepLife
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Postby sjames37 » Sun Mar 06, 2011 1:37 pm

Thanks everyone for all of your support, and help. It is nice to know there are people out there who can relate and give advice. I am using my machine every night but I have a constant problem of falling asleep with it on then waking up after four hours and cant get back to sleep. I take off the mask at that point then fall asleep two or three hours later with it off to only find myself having the apnea episodes with the rapid heart rate. Is there any advice on how I can keep myself asleep longer? Or do I need to take some kind of sedative to keep me asleep with the mask on longer. What am I dealing with now it not helping me get my full night of rest, or keeping my out of the harsh danger of low oxygen levels, blood preassure, ect. Thanks for any advice.
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Postby insomniac123 » Sun Mar 06, 2011 2:18 pm

Thats how my symptoms started. My wife tells me that I used to snore always. One fine day, I woke up with a racing heartbeat. Thinking it was just an off night, I went back to sleep. The same thing happened the next day, but this time I was unable to go back to sleep. It started getting worse till the point I was unable to fall asleep. I went to the sleep specialist and was diagnosed with mainly OSA (with some Hypopnea and some central). I am still trying to get used to the CPAP. So far, two weeks have passed, and my symptoms haven't changed noticeably. The AHI on my machine says 4.6, but I am barely getting any sleep and having frequent awakenings. My titration study had said that at this pressure, I had 1 OSA event, 0 Central and 0 Hypopnea events. So, I am thoroughly confused as to why I am still not improving. I have a doctor appointment tomorrow. Lets see what happens over the course of the next few weeks.
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Postby sjames37 » Sun Mar 06, 2011 3:40 pm

Yep, One night I woke up at 4AM and had a fast HR it freaked me out never anything like this prior(although in my 20s and now thirts once in a while I would wake up with a gasping choking feeling and not breathing it must have been the start of apnea), the next night, the samething, same time same symptoms. I was diagnosed with night panic attacks, and the Zoloft and Atavan were not working. I went to the ER one night because after almost two months of this !@#! and no sleep(I got to the point where I did not want to fall asleep at all, I though I had a mojor wacked up Heart problem and I was going to die in my sleep!) and the ER doctor told me it was classic sleep apnea, and he was almost 100% sure. her set me up with the sleep study and here I am now. When I use the machine I have no episodes or any that wake me, and my AHI says 3.4 currently. But when I dont use the machine or I forget to put it on, BAM I wake up at least once or twice with the HR deal. So I put it on and it will automatically turn on when I fall asleep, at least when I wake up it is on, and working. There was one or two times with the mask on I woke up and had a milder rapid HR but the mask was leaking out my nostrils, and the other time my mouth came open so I use a chin strap. I feel lke a freak with all this on but if it saves my life then I must do it. But I will tell all there are some nights I like to just curl up in bed with my face in the soft pillow and just fall naturally alseep like I used to do months ago before all this, with no attachments but I am sure to be disturbed 3-4 hours from then with a fast HR a seriously dry mouth, and most likely a case of high blood preassure from the apnea spell/s. I hope you find out why your not getting the results you need, and keep in touch.
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Postby Janknitz » Sun Mar 06, 2011 5:48 pm

You must NOT sleep without the CPAP. Sleep apnea is a "death of a thousand cuts" and every time you sleep without the machine, you are harming your body. You should be able to get a clue from waking with that rapid heartbeat!

It takes time to get used to the machine, but the only way to do it is to use it. If you are having trouble falling back to sleep after it wakes you, try something for relaxation and distraction--I listen to podcasts with an MP3 player. That way I'm not focusing on going back to sleep and I fall asleep again quite naturally. Or try practicing some relaxation techniques.

If your machine has data, it would be helpful to see what might be waking you after 4 hours. Could it be leaks or increased pressure, perhaps?

Normally we come to various degrees of sleep during the night, cycling into lighter stages about every 2 hours or so. When CPAP is new, you are likely to come to an even more aware stage, because you're not used to this chunk of plastic blowing air in your face. As you get more used to the machine and more comfortable with it, it will start to disturb your sleep less and less. But the only way to get there is to keep trying.

Don't give up--you don't want to end up asleep on the highway again!
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Postby sjames37 » Sun Mar 06, 2011 7:01 pm

Janknitz, Thank you for the advice. I am going to try again tonight. I have never been able to last more than 4 hours. The death of a thousand cuts pretty much sums up sleep apnea, each cut is one step closer to not good things on your cardiovascular system. And I think of every time I wake up like this without my CPAP, how much more will my body take. I am still young but that doesnt matter with apnea, it will take you down eventually.
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