British Snoring & Sleep Apnoea Association

Hello everyone

I have been having terrible trouble sleeping for 18 months now ever since I woke up in the middle of the night after a vivid dream with my heart racing out of control. I was terrified and ended up having a panic attack, I thought I was having a heart attack. I had been under a lot of stress at the time which could have caused it but it started to happen night after night. I would wake up hot, sweating with my heart pounding or racing and I would often wake up struggling to breathe. I ended up with panic disorder and agoraphobia due to my terrible nights and ended up at my doctor who told me that my symptoms were probably due to anxiety. I had a thyroid test and ECG which were normal. I felt a bit better but it was short lived as my anxiety got even worse after my son became very poorly with a severe virus in November 2010 and has now been poorly with M.E. for 18 months now.

My night time racing heart and feeling of choking continued and I went back to see my doctor last year and she said that it was probably anxiety. I mentioned sleep apnea to her but she said that my husband would here me stopping breathing. My husband has heard me snoring, this is mainly when I'm lying on my back but he has not heart me gasping for breath. My doctor told me that I needed help for my anxiety and referred me for CBT which helped for my agoraphobia but not for my night time symptoms.

Fast forward 18 months since my first attack of tachycardia and I now wake up every single night with episodes of waking up in a fright with a pounding heart or a fast heart rate, a feeling like I can't breathe on waking and I have numerous nightmares every night and I often wake up with my heart pounding after these. I also get these horrible hallucinations as I am drifting off to sleep and on waking, they can be very frightening and I have only had these since my sleep has been disrupted. I often wake up with a very dry mouth too and often feel extremely hot and have to go and splash my face with cold water. I have also had a test to check for early menopause because I am 40 but the test was negative. In the morning I feel like I have not slept at all and I spend a lot of the day yawning but I don't take naps during the day because I am a carer for my son. I have read that if you have sleep apnea you keep falling asleep during the day, but I just feel really tired and keep yawning. My blood pressure is normal, around 107/75 most days and I have also read that this increased if you have sleep apnea.

I am really confused as to what is going on at night, could I have sleep apnea or are my symtoms just anxiety, like a nocturnal panic attack? I am really stressed at the moment due to my son's illness. I think I should also mention that a year before my fast heart rate at night I had two episodes of waking up gasping for air and not being able to breathe, these happened a week apart and then didn't recurr. If I had sleep apnea would it be true that I wouldn't have the nightmares because you don't sleep deeply enough for them to happen, my nightmares are prolonged but sometimes it feels like my body is creating them so that I wake up. Last night I woke up numerous times feeling like I couldn't breathe it was horrible and my husband said I was snoring. I have quite large tonsils due to so many attacks of tonsillitis, could they be causing an obstruction? I have recently checked my BMI and I am about half a stone over weight at the moment due to the fact that I have been less active since I have been caring for my son.

Do you think that I should go back to my doctor and request a sleep test just in case? I have also thought about doing a home test because I have heard that the waiting lists are very long. However, my doctor knows that I am extremely stressed due to my son's illness and I'm sure she will just say that it is anxiety again. I would really appreciate some advice as to whether I could be suffering from sleep apnea, I just want to be able to sleep properly again, I am exhausted after 18 months of this. I dread going to bed now, it is just awful. I do apologise for the long rambling post but I'm getting desperate now.

Many thanks in advance
stressed lady

WELCOME tired lady! Thank you for posting - it must have taken a lot of courage to do so. WELL DONE.

Regardless of your situation as regards OSA, I know from personal experience how horrible and frightening panic attacks can be especially at night when you wake up and it comes upon you with no warning out of the blue. I found 'Panic Attacks' by Christine Ingram, published by Thorsens an invaluable help and they no longer have the power over me they once had.

You have a very heavy load on your shoulders.

Perhaps a starting point would be to do the Epworth Sleepiness Questionnaire that you can download from this site, and see what you score. This would be helpful to show your doctor if you decide to pursue your request for a sleep study.

Please know that I'm simply a person whose sleep apnoea is being successfully managed by xPAP therapy, and not medically qualified. From what you say, I can't see obvious signs of OSA, but that is something that needs to be checked out by a competent health professional. I would suggest that you do the Epworth questionnaire (as above) and then go back to talk to your doc. Even if he or she thinks the problem is anxiety-related, that does not mean that it isn't a debilitating and real problem. You need to get to the bottom of this and then hopefully with a good diagnosis start on a method that will manage it and get you the restful sleep you need ... and deserve.

Welcome tired lady. You have been going through a lot there, with a lot of factors that all could be causing the problems. Like Alsacienne, I'm not medically qualified either but I think your doctor should really consider you for a sleep test, even if it is just to rule that factor out? It would also mean one less worry for you too.

What I did was to fill out the Epworth test and a page with associated symptoms of Apnoea and took it into my doctor's there and then, just in case they didn't have access. I had to have a thyroid test before being referred but you have already had that so it should be pretty simple if you have an understanding GP?

Please keep us updated with your progress

Thank you so much Alsacienne and Headthrob for your help and advice, I really appreciate it. I have just done the Epworth test and my score was 10 which was normal. However, I feel terribly tired and fatigued all day long after my bad nights and have little energy. I feel like I have not slept at all most of the time. I am still having bad nights, either I wake up boiling hot with my heart pounding, or I wake up feeling like I can't breathe, and most nights I will wake up at some point with a fright and my heart rate shoots up for a few seconds and then I have to fight off a panic attack and calm myself down and my heart rate goes back to normal. I am also still having numerous vivid and disturbing dreams every night and some of them are very morbid and frightening.

I was talking to my mum the other day about my symptoms and she thinks that it could be the perimenopause because the is a history of early menopause symptoms in our family and she doesn't think that anxiety would cause me to wake up feeling boiling hot. My heart pounds when I feel hot but then goes back to normal when I cool down again. My doctor said that my normal FSH result does not mean that I am not entering perimenopause because the hormones fluctuate a lot and it is difficult to catch it at first.

I really wish I could get to the bottom of what is causing my scary symptoms at night because it is making my life a misery and I have little energy to cope with the day ahead. I am just a bit concerned as to why I often wake up feeling like I can't breathe properly and today I was really tired in the afternoon and tried to have a nap but again I woke up suddenly feeling like I couldn't breathe properly, maybe my body is always on the alert now and won't let me have a proper rest. Could sleep apnoea show itself during a nap? I am getting very close to going back to the doctors again, especially as I would like to put my mind at rest that there is nothing wrong with my heart. It does not race during the day, unless I feel a panic attack coming on but something horrible happens to me at night that makes it do very strange things, it is so frightening. I am already dreading going to bed tonight and I have also contemplated not going to bed at all sometimes!

I will keep you posted on how I am getting on, I'm sure me doctor will just tell me it is anxiety again because I am extremely stressed due to my don't illness. I would just like to get an answer to my awful symptoms so that I can learn not to be frightened when it happens and end up having a panic attack!

tired lady

I don't want to sound like an alarmist - but I feel you need some advice from another perspective.

I had a very similar score to you on the self sleep test and experienced (over 20 years) very similar symptoms to you.

I had convinced myself (based on Dr's advice) that my episodes of waking with fast heart beat and no air were anxiety related. It was only after someone at work convinced me to demand a sleep test that I was diagnosed with severe sleep apnea. I am now using CPAP to improve my condition.

Bottom line: get tested and receive reassurance. Even if you have sleep apnea there are effective treatments for the condition. The risk is letting it go undiagnosed doing damage to your circultaory and neurological systems- whaih I think may have happened to me - heart arrthrymias etc

I am a newbie at all this, but if there are other symptoms then yes definitely there need to be further investigations Janet.

My Epworth score was very low because I had insomnia as well as apnoea, and fought it like mad, therefore I just rarely felt tired and could have stayed up night and day. I was running on adrenaline for ages. I now need Melatonin for at least three years and CPAP.

I hit a low, which was unusual for me.. so got sorted. Its great, and hope you find the same. Not every night is the same, few hiccups but support here is always available.

So my humble advice is to go back to your GP and take any investigations offered.

Good luck!

This strangely did cross mind, but you have a lot going on Tired Lady.
This dream you had, you may be associating it with dreams, but what is really going on.
Don't think I put that to well, oh well, read on!



This has been known not to help, if it ongoing why have they never been taken out?
I know they don't like to these days, but you can do without them.



All that means is it is in the NORMAL range, what is normal for you.
Not having been tested before, your doctor will not know.



This is a bit worrying. Hallucinations!

I am not a Dr but going by what I have come across before, I think you may be starting on the Sleep Apnoea slippery slope.

No need to answer any of these here but -

Are you a bit overweight?
Do you snore, pause breathing when sleeping?
Start breathing again with a snort?
Do your legs move around (kicking) when you are sleeping?
Hallucinate, i.e. (I think this is what you are doing rather than dreaming because you are half awake and you mind is working overtime trying to make sense of things). Then you waken up in a panic because your brain wakes you up because you are not breathing. This is maybe why you have the feeling you are chocking or can't get breath. This may also be why your heart is racing, you may be in a panic becuse you semi-realise you have stopped breathing. Your heart may also be trying to punp oxygen around but itself is starving of vital oxygen it needs.
I think it is worth having a home test, even if it is just an oxymeter, this will show up any dips in your oxygen levels, indicating you may be having Apnoeas.

Any, I am NOT a doctor, but going by experience and what I have been told by others I think you may well have mild to moderate Sleep Apnoea. Mind you I could be totally wrong

Ask your Dr for referral for at least a home test, also a visit to ENT may be required just to check there is nothing else going on.

jonesy1 was just like you according to their post, so chase it up.

Thanks for posting that jonesy1

The Epworth Scale is just a guide and it also depends how honest you are with yourself when you answer.

I think you should go back to your Dr and discuss it with her.
I know you may have other issues going on that may be hiding the OSA, you may not even have it but I think a lot points towards it.

Hope this is of some help, but do remember none of us here are doctors and we just go by what we know. We do find though that a lot of doctors dismiss OSA all to easily.
Doctors are getting better but have a long way to go.
I think they are afraid of being wrong when they send you for tests

Good luck and let us know how you get on.

S2S