I've just recently been diagnosed with OSA and received my CPAP yesterday afternoon. During the CPAP sleep study I experienced a panic attack where I felt I was not able to breathe. The technician said this was normal and managed to get me calm enough to go back to sleep. The problem is that when I attempted to go to sleep on my own last night, I once again experienced that feeling of not being able to breathe. Being single, I have no one to help calm me down. As a result, I just turned off the CPAP and slept without it.

Does anyone have a suggestion on how to handle these panic attacks? I really want to use the CPAP because I really believe it's going to do me a lot of good, but I just can't seem to get past that feeling of panic. I have a prescription for Ambien CR which I didn't fill because of the way it made me feel the next day. I'm thinking about taking that just before going to bed because it makes me fall asleep so quickly. My hope is that I can fall asleep BEFORE that feeling of panic gets to be too overwhelming.

Thanks in advance for your assistance.

I have had this happen....Its no fun....my husband has helped me through many .....there are many books on calming your self ...breathing tec..and all that ....I have read many.....lots.....one of them is the relaxation response and beyond the relaxation response by herbert Benson MD...they are ok.....  a book Don't Panic...I don't have the author( I gave the book to my sister) Is a good book...and maybe have a friend or family member to call just in case you need them...just knowing you can call someone helps......good luck ...just remember your not alone.......ps you can go on line and get the books a lot cheaper...thats how I have gotten mine.....Don't Panic is new...I don't know if you will find that cheaper...theres always the library too

You might want to check out this forum thread:

http://www.cpaptalk.com/viewtopic/t17513/essential-oils.html?sid=7f6b6528ff683bfaa936a43c3d34c67d

I've had the same thing--not so much panic but just some real irritation/claustrophobia. I used to wake up at 2am every night and want to throw my whole cpap against a wall and smash it with a hammer.

Hi Chris and Welcome!!

It is very common to have that feeling.  Here is what works for me, has worked for several others and may help you.  I think the panic comes from thinking/feeling that you are not getting enough air.  So first, try to relax and let everything go (those are great suggestions above).  It takes practice to consciously relax all of your body.  I learned through relaxation technique classes to relax by focusing on relaxing my feet and working my way up.  The other thing I tell myself is to feel myself sink onto the bed.  That "sinking" feeling is when you relax all of your muscles.

Secondly, remember you don't have to do anything special to breath, just take normal, slow deep breaths.  Visualize that you are in a favorite place with a (very) strong wind blowing on your face, riding in a convertable on a scenic road, feeling an ocean breeze, galloping on a horse, whatever calms you.  But keep making conscious efforts to relax and breath normally.  Don't hyperventilate.

if you need convincing that you are getting enough air, hold your hand to your exhaust ports and you will feel the air rushing out.

Finally, it might be helpful if you put on your mask, turn on your CPAP and do something else for awhile to take your mind off of it.  I get hooked up and then read the paper, which always puts me to sleep.  Or listen to music, just something to take your focus off of your CPAP.

Ambien is additive and it is always better if you can learn to deal with panic cognitively before taking meds.  However, better living through pharmacology is my motto.  It may be that you will need something to get you over this initial hump.  So don't feel bad about taking something if you need to.  It doesn't matter how you get to being calm and compliant, as long as you get there.

Keep us posted on your progress!!

Vicki


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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

I agree with above suggestions.

Try taking small steps: try wearing just the mask (without the hose) around the house or while watching TV to help get used to wearing it.  Then try the device when you are awake (and not trying to go to sleep) just breathing and staying calm for short periods of time.

Initially I slept on the couch for 1-2 weeks. When I woke up in an anxious state I could distract myself by watching TV. But … What worked even better for me was listening to audio-books. Lights are not needed, and the story was a good distraction from both the machine and my anxious thoughts. I kept the mask on while listening so was in compliance when I did fall back asleep. Low cost as I got the tapes at the local public library.

Adjustments to the ramp setting might be helpful - If the increasing pressure feels like it’s blasting you awake.

Breathing out bothered me the most, but eventually I, or I guess my lungs, got used to it.

Good luck!

I also had a total panic attack during sleep test and realized after searching internet that I had hyperventilation syndrome and went on a course to learn to breathe. I think it might be common with a lot of apnea sufferers due to the co2 imbalance during the night.  It really helped.  I went on a Buteyko course FYI.  The course taught me to breathe only through my nose, in quickly and out very slowly and do exercises every day to slow my breathing down.  I am very proud of myself because I tolerated the ENT doctor feeding camera tubes down my nose and into my throat while doing these exercises, something that would have given me a panic attack just to think about!
  My doctor gave me sleeping pills which helped with the awful cpap initially.  Have just had a septoplasty and turbinectomy  and am hoping I dont need the next surgery, tongue reduction as I cannot use the darn machine for ever more.

it may also help to take a lower dose of ambien about 1 hour before going to bed and to not use the ramp, ambien and all valium type meds reduce the chances of having a panic attack
start with the air at full pressure

Lynn has a good point.  I don't use the ramp because the air pressure is too low and it makes me feel like I'm suffocating.

Vicki


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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

You might also consider getting a prescription for lorazepam sublingual tablets.  The dose is very small but the effect is quick because it is absorbed through the mucous membranes of your mouth.  I use them for panicky feelings in general and find them very effective.

Are you using a mask or nasal pillows?  I do not panic with nasal pillows, but I did and still do if I try to use a regular mask.  Nasal pillows do not give you that -I CAN NOT BREATHE feeling.  Please try them-GOOD LUCK!

Nancy Kay wrote:

Are you using a mask or nasal pillows?  I do not panic with nasal pillows, but I did and still do if I try to use a regular mask.  Nasal pillows do not give you that -I CAN NOT BREATHE feeling.  Please try them-GOOD LUCK!

I'm using the nasal pillows. I did what Lynn and Vicki suggested and eliminated the ramp up period. I also took the Ambien 1 hour before sleeping. I slept the entire night without the panic attack although I did not sleep through the whole night. I'm hoping that a few night using the Ambien will help me get over the mental problem and that somewhere along the line I can start using a much milder sedative (I just can't seem to get my mind to shut off sometimes.)

Thanks for all of the advise.

JOIN THE CLUB.  IVE BEEN USING CPAP FOR 4 YEARS AND STILL GET PANIC ATTACKS AND HYPERVENTILATE.  TRY OPENING UP ALL THE WINDOWS NO MATTER HOW COLD IT IS AND THATS THAT.  I CAN SLEEP IF IM ON A BOAT SO ILL BE DAMNED IF I CANNOT SLEEP IN MY OWN BED.    JIMMY

Has anyone in this thread tried changes to the exhalation reduction setting? (EPR on ResMed devices or C-Flex on Respironics devices).

I am curious to know if that has helped anyone.

Hello,

Finding this forum string has made me realize that I am not alone in being the victim of CPAP-related panic attacks.  I am at least a bit relieved to know its not just me, but at the same time, I am sorry that others have had to endure this.

I am in my mid-30s and in overall decent health.  I have obstructive sleep apnea, and have successfully been using a CPAP on a nightly basis ever since I was diagnosed about 7 years ago.  When I use my CPAP, I typically sleep like a bear in hibernation through the night, and wake up refreshed.  Since beginning CPAP treatment, there have only been a handful of nights that I have been unable to use my CPAP (like during power outages, or when I did not have my CPAP handy because I unexpectedly had to stay away from home overnight on what was supposed to be only a day trip.  On the nights without my CPAP, attempting to sleep was futile.  When I did attempt to sleep without my CPAP, I would  awake gasping for air every few minutes all through the night.

I write today because I recently experienced an unbelievably traumatic experience with my CPAP.  Lately, I have been under a bit of stress (but not so much more than usual).  Now I have never before suffered a panic attack.  Two nights ago (Saturday night), though, I was preparing for sleep and, as is my usual routine, I put on my mask and got in bed.  I closed my eyes and, seconds later, as if compelled, I literally threw the mask off, and gasped for air.  The instant I closed my eyes, I had this indescribably claustrophobic feeling (the likes of which I have never experienced), and felt like I had to throw the mask off or I was going to suffocate.  I paced around through the night, and every time I tried to put on the mask (I also tried my less-obtrusive nasal pillow to the same effect), a few moments later I would again throw the mask off gasping for air after feeling all closed in with this sense of imminent doom (like I was going to die).  I then tried falling asleep without the CPAP, but of course I awoke every few minutes gasping for air like I always do when I try to sleep without it.  I felt I was in a catch 22 - as if I could no longer wear the mask, because it was strangling me, and I could not sleep without it, because I would suffocate.  Keep in mind that for 7 years I've been using my CPAP and NEVER had a problem (even when I just started using CPAPs, as do some new users).  But on this night, I felt that I had to consciously work to breathe - whether with or without the mask - and I felt as though my breathing would come to a stop if I fell asleep.  This feeling accelerated through the night until I felt my life would soon end because I could neither sleep with my CPAP, or wear my mask without it strangling me.

Now I'm typically a fairly grounded individual, and have never had anything remotely like this experience.  By the next morning (Sunday), I was in even worse shape - pacing around, I was trying to get my things in order as if I was preparing to die.  At my insistence, my wife took me to the emergency room by mid-morning where they first gave me an EKG to rule out a heart attack (the doc said my heart was in perfect health).  Then, diagnosing me as having had a series of severe panic attacks since the prior evening, the docs pumped me full of Atavan in order to "reboot" me.  This seemed to finally allow me to relax.  They then sent me home with a prescription for Xanax, which they told me to take regularly around the clock unit Monday, when I could see a psychiatrist.  Last night (Sunday night), when I again put the CPAP nasal pillow on (despite being dosed up on Xanax), I felt the panic returning.  But for my wife trying to relax me and massage my head until I dozed off, I believe another attack would have occurred.

Today (Monday) I saw a psychiatrist on an emergency basis.  She took a detailed history and prescribed me two daily doses of clonazepam, .5 mg each, which she believes should stop the attacks until she follows up with me in 3 weeks.  She also wants to refer me to psychotherapy to help me find ways to cope and/or prevent future attacks from occurring.  I am now completely drained, and I worry - in horror-movie-style terror - that another attack is imminent tonight, and tomorrow night, and the night after that, and so forth.  I dread the thought of the sun going down.

My CPAP has been a life saver.  I cannot imaging having been without it for the last 7 years.  In this cruel twist, now for some reason I have, in a matter of days, come to dread and fear the machine.  I don't know what has changed.

A week ago, were I have to have read these above words written by someone else, I would have laughed in disbelief.  But now it is all too real.  Have any other long-term CPAP users suddenly have something similar occur to them?  If so, were you able to discern what changed to suddenly bring about such attacks?  What kind of treatments (whether drugs, medical, or psychological) have helped you cope with these symptoms?  Have the attacks stopped?

I look forward to any input or insight anyone out there can provide.

Best regards,
Eric  

toksook, I don't know what equipment you have, with me being a newbie, I've had a terrible time getting used to this, and I've had the same problems as you (causing panic attacks) but I think I've solved it, by turning the C-Flex feature off on my machine! To better describe it, without going through the how, & why, of the story again, here's a link to my recent thread:
http://www.apneasupport.org/viewtopic.php?t=17421
Please let me know if this helps?


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