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Can Your Brain Forget To Make You Breath?

This area is for Sleep Apnea questions and general Sleep Apnea Discussions.

Can Your Brain Forget To Make You Breath?

Postby Josh V » Thu May 06, 2010 5:42 am

Im new and just trying to better educate myself so please forgive me if The Title sounds like a funny question.

Anyway, for a about 2 years now I have been having this breathing issue. It seems like My brain stops sending the signal for me to breath both during the middle of sleep and especially when Im just starting to doze off to sleep. I wake up in a panic literally jumping out of bed and running to the living room preparing to run outside just in case I die so that at least someone will see me lying there on the ground instead of never being found till weeks later in my home. It sucks so bad!
I happens every couple of months, for a couple of days at a time.Sometimes it also feels as if my heart is skipping beats.

I looked into Sleep apnea but i dont have what seems to be normal sleep apnea like others.I dont have anything blocking my lungs or chocking on anything.I mean, its not a physical thing. It seems like its all in my head (Ya, that dont make me sound insane ^_^)

I do suffer from heart burn and that seems to make it worse because of the panic that something is wrong with my heart from the chest pain while in bed.Also, Im not over weight at all. I'm 30, 5'11 and have been between 140-150 lbs since I was 18.So what gives?

I have a friend that told me that it may be anxiety related and Im beginning to wonder. I have been out of work for the last two years do to a job injury with a pending settlement. I've worked since I was a teenager and being out of work so long has really taken a toll on me. I feel very unproductive and down about that.They let me go from my job and stopped my health benefits so ya, been kinda ruff.

Im still skeptical though.I mean what does your mental health have to do with your breathing.Isn't that supposed to be just automatic?You dont need to think about breathing, you just do.

Well sorry for making this long so Ill just leave it at that. Was just wondering if anyone felt the same or if there are different types of Sleep Apnea.Advice would be appreciated. thanks.
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Postby ShannonMB » Thu May 06, 2010 7:54 am

Gosh, Josh, that sounds incredibly awful, and I'm sending you a big cyber-hug! I hate to hear you are going through something like that!!!

I'm not an expert, that's for sure, and I'm sure someone who is will chime in to try to help you. But I wanted to comment on my particular experience and understanding. There ARE 2 types of sleep apnea, one is *obstructive*, where your airway collapses while you are sleeping because all the muscles and tissue in your throat relax and block your windpipe. You might very well not be aware it's happening, because your tissues wait to relax like that till you are sleeping. That's the kind of sleep apnea I have, and honestly I would have never known it if my husband didn't tell me I snore really loudly and stop breathing while I sleep. This can be caused by being overweight, but it can also be caused by a receding chin, long soft palate, and many other anatomy problems in your throat/airway. You don't have to be a snorer or an overweight guy with a big neck to have it. I recognize your symptoms, I would bolt awake occasionally with my heart pounding or *skipping beats*, and not really know what was causing it except knowing that I was probably going to die! This type of sleep apnea is connected with gastroesophageal reflux in some way, though I'm not exactly sure how it ties in. Anxiety can be tied in, too, because your "fight or flight" mechanism is totally out of whack when you stop breathing and your brain is screaming "WAKE UP AND BREATHE" all night. In that case, sleep apnea is causing the anxiety, anxiety is not causing the breathing to stop.

The other type of sleep apnea is called *central* apnea, and that is caused by your brain "forgetting" to breathe. Since I don't have that type, I'm not as educated about it. But I'm sure there are some people here who could fill you in.

I hate to say this since you are out of work and extra expense is the last thing you need, but it really sounds to me like you need a sleep study. They will wire you up and watch you sleep and tell you EXACTLY what's going on -- if you are having obstructive apnea, central apnea, or no apnea. It really is a wonderful thing to find out WHAT THE HECK IS GOING ON! Even if you don't like the answer. I have severe obstructive sleep apnea, and my quality of life was really suffering. I was tired ALL the time and had a general feeling of not being "well". I feel SO much better after just over a week of treatment with a CPAP!! But you can't know if any of this applies to you without that sleep study.

I hope this helps a little and that others will post their thoughts for you!
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Postby JDD » Thu May 06, 2010 11:21 am

Yes, in fact your Brain can forget to make you breathe,

That is the problem I have.

About a year ago I was having all the normal problems of someone sleep deprived. (Had been having them for years, they just had been building though) And my wife sent me to the Doctor because I would stop breathing in my sleep a lot.

In the end here was the results.

Central Sleep Apnea, 42 events a hour. Blood ox would drop to the low 70% at the worst.

I went in for a CPAP Tiration, which I failed... and then was changed to a Bipap One which I did not do so hot on, and then I went in for a Bipap ASV one that did not cure me either. In the end my Dr decided that we would try a mix of a Bipap and supplementel oxygen.

I am currently using a Resmed VPAP auto 25 Bilevel. Set to 15 / 11. With 2 LPM of O2 added into the system. (The reason for the Auto 25 over the ASV machine is because I got the same results with either machine and the Auto 25 is about $2'200 and the ASV is about $5'000.)

Each Morning I check my machine and I am usully 1-2 on the AI (Apena events per hour) and AHI of 7-12 (Shallow Breathing).

Your best bet is to go into a sleep Dr and have a sleep study, My sleep Dr is a Nerougolist. And I would reccemend that you either go through one who is a Neurogolist or a Pulmoligst (I know my spelling is subpar)

I will tell you what my Dr has told me, Pure Central Sleep Apnea is a tricky thing to manage and really intresting adventure. (My translation, it sucks!) One caution, do not try to treat this one on your own. During my tiration they had to be real carefull because small adjustments to my preassures caused my Apnea's to go crazy. They had me stop breathing for a whole minuete once and the tech had to come wake me up. My AHI was up to 90+ at one time during my Cpap/Bipap Tiration.

Go to a good sleep lab, get a sleep study done, and make sure to get copy's of your tests results. When I first went in I felt awful but thought it would be mild sleep apnea. Imagine my surprise. I am normal weight, don't fit the criteria for someone with sleep apnea.. but then again I don't have OSA, I have the brain being stupid type. :-D

Let me know if you have any questions, I have been fighting this one for almost a year now, I feel a lot better then I ever did. But I am not at the magic 0 AHI number that everyone wants. And nor do I think I ever can be.

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Postby JDD » Thu May 06, 2010 11:38 am

Im still skeptical though.I mean what does your mental health have to do with your breathing.Isn't that supposed to be just automatic?You dont need to think about breathing, you just do.

Hey just wanted to answer that one.

Your Mental Health has nothing to do with centrals.

Here is what the common list for things that cause Central Sleep Apnea:

Central sleep apnea often occurs in people who have certain medical conditions. For example, it can develop in persons who have life-threatening problems with the brainstem. The brainstem controls breathing. As a result, any disease or injury affecting this area may result in problems with normal breathing during sleep or when awake.

Conditions that can cause or lead to central sleep apnea include:

•Bulbar poliomyelitis
•Complications of cervical spine surgery
•Encephalitis affecting the brainstem
•Neurodegenerative illnesses such as Parkinson's disease
•Radiation of the cervical spine
•Severe arthritis and degenerative changes in the cervical spine or the base of the skull
•Severe obesity
•Stroke affecting the brainstem
•Primary hypoventilation syndrome
•Use of certain medications such as narcotic-containing painkillers
One form of central sleep apnea commonly occurs in people with congestive heart failure. Idiopathic central sleep apnea refers to apnea that is not associated with another disease.

Now I have Asthma, which my Dr thinks contributes to my Centrals. Other than that I am listed as having Idiopathic central sleep apnea. Which means heck they don't know why I do what I do.. Maybe has to do with the Idio....t? 8-) Anyway what I have been told is becuse Central are not as common as Obstructive, and has not gotten as much reasearch.

Hope this helps let me know if you have any other questions, and don't worry there is a light at the end of the tunnel. Just need to get through the darkest part first.

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Postby CrohnieToo » Thu May 06, 2010 12:20 pm

Well, then, too, there is a situation wherein our lungs aren't functioning well for whatever reason, smoking, asthma, GERD, silent reflux, etc. and we retain CO2. The brain relies on the amount of C02 in the blood to tell it when to send the signal to breathe.
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Postby Josh V » Thu May 06, 2010 7:51 pm

Wow, thanks guys for the responses.

OK well, for my case for my work injury, they had me go in for a sleep test. I didnt even realize what exactly it was for. I never got the records for it either yet from my primary Dr. I haven't heard anything so I figured everything was normal.

I have issues with heartburn but overall was healthy during my last physical I had.I could be more "In Shape" though. I mean, I dont work out or anything and dont always eat the best. Could that be a contributing factor? I dont smoke or do any drugs and rarely drink, only socially maybe 1 night a month. I even try to avoid any legal drugs except maybe Tylenol for occasional pain for my back. JDD I see you posted "Complications of cervical spine surgery". I have two slipped discs on my lower back from my work injury, could this be related and if so, you think that is why they had me see that Dr. This was a Dr the Company Attorneys agreed upon so Im thinking that clinic may not be that good as to benifit the company.Should I seek a 2nd opinion with another DR? I have no insurance right now so this is gonna be a tuff one. But if this could be related to my work injury, they should be liable right?
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Postby Mrs Rip Van Winkle » Thu May 06, 2010 9:37 pm

Josh...the cervical spine is the neck area...your lower back is most likely the Lumbar or lower. So Central SA that is due to cervical issues would not be caused by lower back. Although, we re not medical pro's..just SA sufferers.

You will need to call your Dr or the Sleep Lab where you had the sleep study and request a copy of the full summary report from your sleep study. A Primary Dr is not always up on sleep disorders or how to treat them. If yo want, once you have your summary report (it is 5 to 7 pages of stuff..not just a DR dictation) you can post it on here and someone will hopefully comment on it...
I'm only a sufferer, not a medical pro. What I post are my thoughts as a sufferer, not that of the ASAA. As a moderator on these forums I oversee the posting rules. This is the internet, always discuss what you read with your medical team.
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Postby SleepyBobR » Fri May 07, 2010 9:15 am

Most of your concern seems to be with the breathing issues at onset of sleep. I have this from time to time as well too as do others on the Forum. There is a whole (very long) thread devoted to this topic which you may be able to locate. Apparently, these brief breathing cessations occur at the transition from stage 1 sleep to stage 2 just as you are drifting off. This has something to do with blood CO2 levels being different between the two stages so breathing stops briefly allowing the CO2 level to adjust. My sleep doc has confirmed that this is normal; it happens to everyone as they fall asleep. What is not normal is for it to wake you up. Exactly why it sometimes wakes you (and me) up but not always is a mystery but, in my case, I think it relates to stress levels and anxiety. Of course, the condition itself makes you more anxious so it can feed on itself. Bottom line, this is not central apnea and the treatment is to just ignore it and somehow eventually get by it and get to sleep. Easy to say I know but it does make it easier once you know what causing it, scary as it can be.

You also say you stop breathing once you are asleep but that could be obstructive or central apnea; only a sleep study could determine which, if any, is affecting you.
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Postby White Beard » Sun May 09, 2010 1:51 am

Josh V

I understand your concern it can be very frightening and unnerving to wake up not being able to breath or feel like you are choking! From what I gather you live alone, and that can make it even worse! I know the feeling, just the other night I woke up in the middle of the night unable to breath and felt like I was sofficating and then choking! I was even using my mask and machine, and it still happened ( I have had problems lately and I am going in to have a ASV retitration sleep study done tomorrow "actually tonight"!) Anyway it is a very scary feeling, but to find out if you really do have sleep apnea, whether it be Central Apnea or Obstructive or both, you need to have a Sleep Study done! In all honesty you probably would not know if you were having Obstructive Apneas or even Central Apneas, if your asleep you are most likely, like the rest of us, and do not know what type of problems we have when we are sleeping! Unless you have a partner or somebody in the house that hears or observes you when your sleeping, how would you even know if you snore or what you do when you sleep? It does sound like you should see a Doctor about this and have a sleep study done!
I wish you well and hope that you find your answers...........White Beard
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Ideopathic Central Sleep Apnea

Postby jasacke » Sat Aug 14, 2010 2:41 pm

People with ICSA hyperventilate. They also tend to be anxious. Scientists aren't sure which is first, the hyperventilation and anxiety or the ICSA.

As a well read sufferer of ICSA, I think there may be a cascading effect where both contribute to the development and worsening of this condition.

Who'd thunk it, strangling in your sleep might make you anxious?

To break the cycle, try exercises to retrain breathing and stop hyperventilation. ESPECIALLY: Stop breathing thru your mouth and concentrate on nasal breathing. Read about the Alt health practice of Buteyko which may help.

Also, treating the anxiety may help. Buspirone is an SSRI precribed for anxiety, for EG

The latest theory is that consolidating sleep with the hypnotic Ambien might treat ICSA, since the apnea tends to occur during transition of sleep stages.

For info Google treating "Idiopathic Central Sleep Apnea" Treatment
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The above refers to those diagnosed with ICSA only

Postby jasacke » Sat Aug 14, 2010 2:45 pm

These research directors are for those DXed with ICSA
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