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Do you think I have something else other than sleep apnea?

I'm 37 years old. Suspected sleep issues as far back as possibly my early teenage years. Not overweight and I don't fit any of the typical symptoms or stereotypes. I've had a sleep study, but results weren't that good because I just got a few hours. Low AHI just above 5 and RDI of over 18. Lots of RERAs were noted. Home sleep study showed an apnea up to 80+ seconds and most hypopneas/apneas average 20-30 seconds. When I examine my sleep results in Oscar software, I see that my average hypopneas/ apneas are like 10 seconds. Some days I see central apneas show up and others they don't show up at all.

I use APAP (Air Sense 10 Autoset for Her) with P30i nasal pillow mask. On APAP mode, minimum pressure of 7.6 and max of 12. It never really goes over 9-10 at the most. Typically the magic number for max is 9. I've tried CPAP mode on everything between 7.6 and 9. I've tried limiting from 7.6 starting to 9 max. I have tried turning the EPR completely off, on ramp only and on full-time. I always feel awful no matter what.

Some days I feel anxiety from using it. I've never been claustrophobic or anything. Over the past few months, I've had odd issues. A red, flushed/hot face on some days when I feel really tired and/or don't sleep enough. A lot of the time when I take my blood pressure, it isn't up when my race is red and my heart is beating faster than a normal heart rate (usually closer to 110). I'll feel dizzy sometimes and feel like I'm not getting enough air or could just faint or something.

There's nothing wrong with my heart or any of my blood work. Been checked a zillion times for virtually everything by ER doctors, my GP doc, Cardiologist, etc. Since using APAP, it is like anxiety came out of nowhere. My heart will start beating and I'll feel like I'm dying or something. Could this be related to the CPAP or just my UARS symptoms in general? Even when I have a test that reveals UARS and is more conclusive...what will my TREATMENT for it be? On APAP right now, I average about 0.5 AHI for apneas. How the heck do I treat the RERAs and UARS? I seem to turn over like every 15-30 minutes while sleeping. Why do I still feel so AWFUL every morning? I find that over the past few months it is like I have become a mess with health issues. Everyone got a stomach bug in the house over a week ago and now my GI tract is doing all kinds of weird stuff. The lack of sleep probably isn't helping.

So my main issues are:

Random panic attack-like symptoms with spiking heart rate/blood pressure that I haven't had until about 2 months ago. Flush red/hot face at varying times of the day. Feeling exhausted, having trouble thinking during the day. Scared to drive because I'm literally not alert enough. I probably nod off and pop awake about 15-20 times on the bus on the way home from work and it is only about a 30-minute ride total. I get these single core 'jerks' like hypnogogic jerks throughout the day. Sometimes I'll nearly drop stuff and people will stare. My body is very shaky/jerky in general.
3 Responses
Avatar universal
Short answer is yes, stress about the idea of sleep and generalized anxiety as well.  As to whether or not they are legitimate disorders no one online can say; for that you need to see a doc or counselor.  

It is likely you have significant overlap with nonmedical issues disrupting your sleep at a minimum.  For treating that the gold standard is using a full CBT sleep training system.  This enables you to comprehensively address all the common nonmedical root issues disrupting sleep, including normal stress and anxiety.
Avatar universal
Your situation reminds me a bit of my own. UARS for sure, but that is more of a description than a diagnosis, you know? That would be okay if we had awesome treatments for UARS but since we don't, then the question is, what is *causing the UARS in the first place*??!!

For me I've been on a long road of sort of informed trial and error, after finding a functional medicine doctor that has lots of ideas, who is grounded in trying things based on the best evidence and best match with my symptoms. Sleep hygiene taken up to 11, and becoming kind of a health nut, and optimizing my breathing helped (that one required surgery and also allergy treatment). One thing that wound up being a game changer for me was earplugs! Even in a quiet/white noise room! I'm so sensitive to sound that my brain just won't ever really let go and rest if I'm not wearing earplugs. (I use Mighty Plugs which don't go inside the ear canal.)

I hope this helps. Good luck and keep on problem solving; it might take a while but it's worth it!
Avatar universal
Your issue looks pretty complex but that aside can I presume that you're addressing your lifestyle, diet and mental health as a crucial basis to any other interventions? I've had chronic sleep (RERAs and other stuff) and anxiety issues (depression, panic attacks, etc.) in the past and I've slowly and steadily resolved them simply by changing my diet, optimizing my lifestyle and learning about and managing anxiety and my mental health. I'm now sleeping great, fit as a fiddle and in good mental health....medication free! The changes in diet   (I researched this and ended up following a blend of the Paleo diet and the AIP diet, check them out) and lifestyle (exercise, etc) can be difficult at first but with perseverance the dividends for me were life changing.  Hope this might be of some help.
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