"Sleep-onset central sleep apnea is not uncommon phenomenon, and is usually regarded as a normal sleep pattern."
If you're waking up because of it, it may be that the machine's response to your apnea is the culprit. The Respironics machines send a single 2cm pulse of air lasting one second after you have had an apnea for ten seconds, in order to detect if your apnea is central or obstructive. That can be enough to wake you while you're transitioning into sleep.
The Resmed machines use a different method. They send a 1cm oscillating pulse starting a 4 seconds and continuing until the apnea stops. With Resmed, if you enable a timed ramp (not an auto ramp), the pulsing won't occur at all until the ramp time is over, which can allow you to avoid the pulsing until you get to sleep. You can disable the pulsing entirely if you have a ResMed BiLevel in Bi-level mode and turn Easy-Breathe OFF. Even in Bi-Level mode, you can set the pressure to be the same, so that the machine is essentially as CPAP.
Alternatively, you could buy a cheaper machine, like the Apex XT, which I've been told doesn't do anything to try to distinguish between central and obstructive apneas.
While I agree with your statement that taking sleep medications is generally a bad idea, both my father and a friend that I've known for twenty years have taken them every night for years. My dad takes Ambien and my friend takes an OTC (antihistamine type) medicine. While taking medications does involve risks, not getting enough sleep involves significant risks as well. I've begun experimenting with melatonin, with mixed results.
Central onset events are not unusual - I see them all the time. Sometimes, as would seem to be your case, they can be worse than others. It can be a feature of normal sleep, but then so can pretty much anything. The question is more whether it is causing a problem and in your case it sounds like it is. Usually after a few months of using CPAP the onset events are less of a problem but that may not be happening for you. You said that your machine starts at 10? You may do well to start with a ramp from a lower pressure. Onset events can get worse as pressure increases, so this can usually be managed by using a ramp that starts your machine at 4 and steadily builds it up. This could reduce them impact of the onset events.
If this doesn't help then you may need ASV or even BiPAP. An in lab study may be very helpful in resolving this.
Rest assured you are not alone in this and it can be managed.
Thanks for your comment.
I don't think it's due to the machine's response to the apnea, mainly because I have been experiencing this for about 18 months now, way, way before I got the machine. This isn't a new thing for me. The machine just doesn't seem to be addressing my apneas, which happen at sleep onset rather than deep sleep, and are therefore very short but enough to stop me from falling asleep.
I've tried the ramp but that doesn't help either. The thing about my translational apneas is that they go on all night sometimes, way beyond what is considered normal and, like I say, I really don't think they are due to the machine as I've been having these type of apneas for over a year before I even got it.
This week has been another terrible week, after thinking that things may have been starting to improve the week before. Every night this week has just been a case of going to bed exhausted and then falling asleep on breathing out, then waking up to breathe in, for hour after hour.
I'm gonna keep using the CPAP every night, as I don't find it uncomfortable or invasive at all and am having no problems drifting off to sleep using it. The problem is that is isn't helping me to breathe in the way I need it too and my transitional sleep apneas are still causing me real problems, which are only going to get worse until I find a solution.
Thanks to both of you,
It might be that you are one of these people that is going to benefit from a more specialist machine than a straight forward cpcp or apap. Sleep clinics will always try (or should I say insurance companies) will always try the cheaper option first. If this does not work, they will then try the more expensive machines. This is what I have been told anyway, as I live in a country with an easier health system I have nothing to back this up with. However, this appears to be the general opinion of how it works.
@Apneadeadache: Really? Have you found anything that works?
Sorry for the late reply, the truth is that things got so bad the doctor prescribed me some sleeping pills, which Ive been using for the last 6 weeks or so. Ive been gradually bringing myself off them, and things were going ok, but now that Ive stopped them completely the exact same problems have come back.
Hope to hear from you soon,
I have the exact same issue and I have had it for several years. After years of trying to figure out what the problem is I finally narrowed it down to sleep onset apnea.
Honestly, after dealing with this almost every night since May 2010, I had a 4 month period this last year where everything was totally fine and I slept like a log all night. No issues! I thought I was cured. Then it came back.
I had just gotten married and had an amazing honeymoon. My prospects were all lined up for my future and I hadn’t a worry in the world. That’s when it went away. “Coincidentally” it came back (seemingly to stay) once things started to get a little rocky with school and finances again.
Still trying to get back to that mental state to see if that was a key but it’s been tough and I’ve been having trouble Again for a few months. There are some placebo things that seem to help for like a week then stop working randomly, adding to my theory that this is all stress/anxiety related.
I thought for awhile the issue might’ve been from Silent Reflux as treating myself for that seemed to help wonderfully with my breathing issues but it stopped helping before long and I’m back to thinking it’s all mental!
Hi Alex, Do you suffer from stress/anxiety as this can have strange affects on a lot of things in your life? Stress can have a large effect on your life that can bring on other things and if this comes along with anxiety attacks can be devastating on your well-being. It is very easy for someone to say try not to get stressed but that is not easy for some people. Count to ten and take a deep breath. I don't know of any study that has been done on Sleep Apnea sufferers concerning stress, but these studies can be picked apart due to the way they do some of them.
I would like to say the sleeping pills help you transition to sleep by making you tired enough that your body is sleeping through the events. Sleeping meds do not cure sleep apnea.
Are the apneas occurring while you are on your back? Sleeping on your side can often improve sleep onset events.
Did I read you personally adjusted the pressure on your machine? I may have misunderstood. But if you did adjust it yourself please, please have it changed back to the setting prescribed by your doctor. The number is based on objective data obtained from diagnostic equipment. The wrong setting can possibly cause an increase in central apneas
Hope things get better soon for you!
i am dealing with the same!! please help. have been 2 constantly years. every single day
i have anxiety , i have sleep apnea but i have CPAP- i went to 6 differenten sleep specialists, no one cure me of this awakeing just as falling asleep. several meds and nothing...
Please give me smoething guys..
It is anxiety related. It was for me anyway!
It stilll comes and goes but overall it’s reduced a lot since I discovered it was related to the stress in my life and my overthinking about it before I would go to bed.
It’s just like you describe sort of like forgetting to breathe just as you are falling asleep and you wake up feeling like you need to catch your breath.
You are safe and once you fall asleep your breathing will ultimately regulate.
As a second suggestion, try a round of stomach acid reducing medicine like a proton pump inhibitor (omeprazol) for a couple weeks.
If you notice a big improvement then GERD or silent reflux could be an issue.
Those are a couple things I discovered on my journey to getting better after a decade of this problem!
I think the first thing you should do is use OSCAR to capture the detail of what is happening when you go to sleep. You can download OSCAR for free, and run it as long as you have a Mac or PC and a SD card reader. The display of the data will tell you exactly what is happening when you going to sleep. Here is an example of the level it can show in the period of time when you are going to sleep. This is a ResMed AutoSet 10 machine with the Ramp time set to Auto. It detects when you go to sleep and then ramps the pressure up to the minimum set pressure. It detects sleep just before 22:55 and starts the ramp up. At 22:59 it reaches set pressure. And at this time there is a Flow Limitation detected, and a disturbance to the flow. It is not long enough to be flagged as an apnea. However a little later at 23:03 an obstructive event is flagged. So step one would be to determine if there are apnea events happening at the time you go to sleep, and if so what type they are. That will help determine if anything can be improved to prevent them. What type of machine do you have and how is the ramp set up on it?
thank you i will try. is this related still to the exact moment you are falling asleep, you joke and feels u forgot to breath? i did sleep study they didnt see it clearly.. but regards that, if you have it how do you solve it? is it stress? anxiety? or other thing related if it happned like you showed?