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    Old 06-30-2008, 09:17 AM   #1
    haoba1
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    waking up gasping

    I have this strange situation lately where I seem to wake up suddenly sometime between 2 and 4 in the morning, feel like I have to move (often thrashing for a few seconds) and sit up and having to catch my breath. It almost feels like your heart has stopped and you need to move to get a breath for a few seconds. I will generally feel fine again after a few moments, but sometimes it does make me uncomfortable enough to not look forward to going back to sleep. This can happen up to three or four times a night. I suspect either sleep apnea and/or panic disorder. I did have a panic attack around 6 in the morning a couple of months ago after a few of these attacks, went to the ER, all check out okay, so I suspected that the sleep problems were related, but going back to a regular dose of Lexapro (10 mg) from a much lower maintanence dosage did not stop it, though when I took some clonazepam when I upped the Lexapro that seemed to make it less severe and frequent. I have since largely come off the clonazepam, but I will take a crumb of clonazepam after an attack to try and get some sleep, but I don't like the feeling I get from it when I have to wake up. My wife tells me I snore, and so from that I also suspect sleep apnea, plus the fact that I don't seem to be having any panic symptoms during the daytime. My wife also observed that on at least one occasion before an attack I was snoring, then made a loud snort and then woke up with the attack. Oddly it does not occur when I take naps on the couch in the afternoon, though eating chocolate or having anything with caffeine within 6 or 7 hours of bedtime aggravates it.
    I think I have had something like this in the past, and it seems to come and go. I think that in the past it has been a precursor or warning that my body is getting sensitized and that panic attacks will come later on, but unless the lexapro has quit working it should have been gone by now if that was true. It is getting to me now and I find it hard to feel like I am getting a good night's sleep. I will pursue if further, maybe I need to do a sleep test (can they distinguish nocturnal panic from other things?).

     
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    Old 06-30-2008, 09:23 PM   #2
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    Re: waking up gasping

    This is what I experienced. My throat locked up and from a sleep I would bolt up to a sitting position to catch my breath. It was like someone cut off my air supply and then let go so I could breathe. I didn't have apnea. A doctor told me I had asthma and gave me an inhaler with instructions to go to the hospital when it happened. It seemed kind of silly as once it happened the event was over.
    One day another doctor told me that GERD can cause the throat closing. I started taking protonix. However, what has made the difference is eating early and lowering my fat intake. I seldom have the attacks now and usually only after I have pigged out on something

     
    Old 07-01-2008, 06:02 PM   #3
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    Re: waking up gasping

    Thanks, GERD could be a possibility or at least a contributing factor. I visited my doc today and he is referring me to an ENT who has experience with sleep disorders, I will see him in a week. Meanwhile I will stop eating earlier (I do often eat an hour or two before bedtime) and see if that helps. Plus I'll take a zantac tablet before bedtime. My doc did note that I seemed to have "a lot of tissue" in the throat and that my uvula appeared as if I had GERD at some point (which I have had in the past--but with a higher frequency of the overt heartburn/reflux symptoms than what seems to appear now). Oddly I did have some reflux last night after one of the attacks. When this waking problem became an issue earlier this spring my doc also prescribed asthma medications, I suspect that while it may have improved my breathing it (advair) also might have helped initiate a 6 in the morning short panic attack a while back due to the long acting beta agonist in it (plus not sleeping well earlier that night didn't help). I switched to a steroidal inhaler only, but I don't think the asthma meds are actually doing anything to help the waking up attacks.

     
    Old 07-02-2008, 04:42 PM   #4
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    Re: waking up gasping

    Asthma, GERD, panic attacks, and some other conditions often go hand in hand with sleep disorders. Sometimes treating the sleep disorder will alleviate/cure the asthma/GERD/panic attacks etc....

    While many docs think these conditions are causing the sleep disorder, in some cases the reverse is true. Best to treat the sleep disorder and see if the other things go away on their own. My sleep specialist was the one to inform me of the connections...in my case the acid reflux and respiratory attacks disappeared...and best of all, my blood pressure dropped into a normal range with cpap treatment.

    Bethsheba

    Last edited by bethsheba; 07-02-2008 at 04:43 PM.

     
    Old 08-25-2008, 08:44 AM   #5
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    Re: waking up gasping-update on a sleep study

    Update--I had a sleep study a couple of weeks ago, and got the results today. I should mention that the gasping episodes have lessened over the last couple of months, though I did have a couple last night (maybe b/c I had a few extra cups of tea that day?). I have no stage 4 sleep (doc mentioned meds might affect that, I take 10 mg of lexapro and .25 of clonazepam, plus lipitor), borderline sleep apnea (4 episodes per hour, not enough to get worried about), and most significantly, a lot of movements during sleep (15 per hour). He said that the movements can be related to iron levels, or rarely to kidney function, and that those should be checked out. So far its not the kind of thing that a mask would be particularly useful for, but he told me to call him back if the gasping and waking episodes get bad again. I still wonder if they are related to an imbalance in the nervous system that indicates that panic disorder could flare up again. I had a panic attack last spring (after a period of weeks dealing with the gasping awakenings) and upped the lexapro from a quarter of the dose to full dose, plus added clonazepam, so that it can't happen again. Meanwhile I try to avoid eating late in case of GERD and am slowly losing weight via exercise and watching what I eat, so maybe that will help too.

     
    Old 08-25-2008, 03:36 PM   #6
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    Re: waking up gasping-update on a sleep study

    First of all, congratulations on getting that sleep study done! Every bit of info we have helps us get appropriate treatment....

    While the info provided by your doctor is interesting, I would highly recommend getting a copy of your sleep study...your doctor's office should be able to provide you one free of charge or for a small fee. There is a tremendous amount of info on that report, and as thorough as doctors may be, often relevant info is overlooked, misinterpreted, or missed completely..so do get a copy of your report.

    Although 4 episodes of apnea an hour may seem trivial, it would help to know how long these episodes lasted and whether or not they woke you up. Your sleep report would have this information on it....oxygen saturation levels are important, perhaps more important than the number of episodes.

    I doubt very much that the tea had anything to do with anything.

    I had almost 500 movements a night during my study and my doctor had me use a cpap before trying other remedies for the movements. He told me that sometimes when oxygen levels dip (as with apnea), it can sometimes cause body movements. For that reason, he wanted me on cpap before doing anything else about my movements. Cpap treatment didn't help the movements although it stopped the apnea. He then had me try iron supplements (which did nothing) and then he prescribed mirapex...which also did nothing. I was under this specialist's care for about two years when my primary doc changed my blood pressure medication...THEN my movements stopped. I have since read that medications and nutritional imbalances (potassium, magnesium, and calcium...but especially magnesium) can cause body movements. So, I'd recommend you review our boards and the "Restless Legs" boards to find the "cures" of others with these problems. I suspect you'll see a common theme...

    The panic attacks occur when your oxygen levels drop...think about it. If someone were to cover your mouth and prevent you from breathing, how would you feel? Panicky? You bet...and sleep apnea in a sense "covers your mouth and prevents you from breathing" Apnea can cause other mental health issues as well--anxiety, depression, irritability, etc.

    In my case the one medication I was taking caused all of my noticable sleep problems. For that reason, I would encourage you to do as much reading about the side effects of the meds you are currently taking. Do not rely on only one source for this info because no one source lists all of the possible side effects.

    Take care and keep us posted!

    Bethsheba

     
    Old 09-01-2008, 12:26 PM   #7
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    Re: waking up gasping-summary report

    Thanks for the advice, a 2 page summary report has arrived and it states, among other things, that my sleep latency was 27.0 and sleep efficiency was 76%. There was 23.5% REM with REM latency of 161.5 minutes (total recording time for the study was 487.6 minutes). Stage 1 sleep was 3.7%, stage 2 71.3%, stage 3 1.5% and stage 4 zero percent. Apnea index is zero but there were 25 hypoapneas, with an apnea hypopnea index of 4.1. 63.5% of total sleep time was in supine position, with supine AHI of 6.2 vs non supine AHI of 0.5 (does this mean if I lay on my back I get more shallow breathing episodes?). REM AHI is 16.1, non REM AHI is 0.4. lowest desaturation was 89%, with 0.1 minutes of desaturations between 81 and 90%. There were 91 periodic leg movements for PLM index of 15.0.
    What I gather is that sometimes I am breathing shallowly (hypopnea) and oxygen levels then dip, though only once to below 90. Is below 95 a problem, as it is, I think, when one is awake? One of the recommendations checked off is to lose weight (BMI was 28.9), which I am doing, though I read that not having slow wave sleep does not help in this regard. Maybe the lack of slow wave sleep is b/c I was in an unfamiliar environment, I really don't know. Seems I have the most breathing issues when I am in REM (why would that be?). Another box is checked off for "consider use of pharmacological Rx for PLMS" but I don't want to add any medications to the ones I already take, considering that two of them (lexapro and clonazepam) should make me sleep more, if anything.
    I don't have too much of the gasping thing lately, esp with a low dose of the clonazepam (.25 mg before I sleep), but I do wake up at times, and feel tired most days. I had blood and urine samples taken last week to hopefully rule out anemia and kidney disorders, which the ENT doc mentioned are sometime causes of PLMS, but he did mention that most often there is no obvious cause for it. Guess I'll have to keep reading up on it, as suggested.

    Last edited by haoba1; 09-01-2008 at 12:28 PM. Reason: corrected percentage

     
    Old 09-01-2008, 05:32 PM   #8
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    Re: waking up gasping-summary report

    Hello Haoba1,

    I'm glad you got a copy of the report! Isn't it something??

    Because I over did it today, I do not have the energy to address all of your comments so I will just adddress one at this time and keep it short and simple.

    Lexapro can cause restless legs and other body tics...it can cause insomnia and somnolence...and it can cause problems with dreams but that's for starters. I would add, too, that if one wishes to discontinue lexapro, it is important to wean of as there are withdrawal problems with this med, from what I've read.

    So you might want that med at the top of your reading list...and that's not to say other things aren't causing your periodic limb movements as well. As I mentioned, I believe my 500 movements/night disappeared when I stopped taking my medication....

    Hope to discuss more items on your report later.

    Take care.

    Bethsheba

     
    Old 11-12-2009, 04:34 AM   #9
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    Re: waking up gasping

    Quote:
    Originally Posted by haoba1 View Post
    I have this strange situation lately where I seem to wake up suddenly sometime between 2 and 4 in the morning, feel like I have to move (often thrashing for a few seconds) and sit up and having to catch my breath. It almost feels like your heart has stopped and you need to move to get a breath for a few seconds.
    This problem is likely caused by the drugs you are taking. You need to do allot of personal research on this as your Doctor will likely only treat the symptom that will ultimately make it worse.
    I have had this "gasping for air"
    Your GABA receptors are likely responding incorrectly causing this as a result of the meds. Up the Klonopin and it will go away (for example). Problem is this will start to reoccur in between does as inter dose withdrawal will occur eventurally until you up the dose again. You need a doctor that understands this an gets you off these meds. It will be hard to find.
    Good luck and get better and don't dismiss this post. All this can be verified.

     
    Old 11-20-2009, 09:38 AM   #10
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    Re: waking up gasping

    New here. Wow, I can't believe how accurately people have been describing these same symptoms I have been having on and off for two years or so. they seem to be getting worse whereas before, it didn't matter how I slept. Lately I can only sleep on my back if I have any chance of fighting my way through the breathlessness into sleep. I didn't think about some of the other factors, such as being on my period, but i must say last night was the worst night by far and I started TODAY.
    My spells have been accompanied with even more disturbing symptoms as time goes on. I sometimes wake up in total confusion and panic, thinking there's someone in the room or that I'm being attacked. I am also having a strange sensation, like a cold trickle down my spine right before the spell sets in. The "falling" sensation is hapenning quicker, while completely awake. I am experiencing a foreign pain in my limbs, which is why I sleep on my back.
    I'm 24 years old and in good health, other than being a smoker. I weigh 130 lbs. I would really like to know how many with this problem are overwieght, their sex, wether or not they smoke, and if the CPAP improved the condition and quality of life.
    My experience with doctors has been disapponting. I went last February and they ran a series of tests, without even mentioning apnea. The doc prescribed me xanax for anxiety, to my disapproval. I have read that while little is known of sleep disorders, there seems to be a connection to opiate and barbituate use/abuse. This drug is dangerous and addicitive and didn't solve my problem, but may have made it worse. I'm still paying on a $4,000 doctor bill.
    Thank you so much for making me aware that there is help out there! (and that I'm not going to die!)

     
    Old 11-20-2009, 09:46 AM   #11
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    Re: waking up gasping

    --------------------------------------------------------------------------------

    New here. Wow, I can't believe how accurately people have been describing these same symptoms I have been having on and off for two years or so. they seem to be getting worse whereas before, it didn't matter how I slept. Lately I can only sleep on my back if I have any chance of fighting my way through the breathlessness into sleep. I didn't think about some of the other factors, such as being on my period, but i must say last night was the worst night by far and I started TODAY.
    My spells have been accompanied with even more disturbing symptoms as time goes on. I sometimes wake up in total confusion and panic, thinking there's someone in the room or that I'm being attacked. I am also having a strange sensation, like a cold trickle down my spine right before the spell sets in. The "falling" sensation is hapenning quicker, while completely awake. I am experiencing a foreign pain in my limbs, which is why I sleep on my back.
    I'm 24 years old and in good health, other than being a smoker. I weigh 130 lbs. I would really like to know how many with this problem are overwieght, their sex, wether or not they smoke, and if the CPAP improved the condition and quality of life.
    My experience with doctors has been disapponting. I went last February and they ran a series of tests, without even mentioning apnea. The doc prescribed me xanax for anxiety, to my disapproval. I have read that while little is known of sleep disorders, there seems to be a connection to opiate and benzodiazapine use/abuse. This drug is dangerous and addicitive and didn't solve my problem, but may have made it worse. I'm still paying on a $4,000 doctor bill.
    Thank you so much for making me aware that there is help out there! (and that I'm not going to die!) -timetraveler

    Last edited by timetraveler; 11-20-2009 at 09:48 AM.

     
    Old 11-29-2009, 12:12 AM   #12
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    Re: waking up gasping

    Quote:
    Originally Posted by haoba1 View Post
    can they distinguish nocturnal panic from other things?
    Yes, sleep studies are quite definitive. A sleep study will absolutely be able to tell you if you are having sleep apnea, or some other type of problem. Depending on who you ask, between 25-50% of people who snore have sleep apnea, so it is certainly worth looking into.

    Good luck!

     
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