Sleeping, breathing, not breathing, it's a problem...

January 10, 2018 12:32 PM

You are not my doctor, and this isn't really a medical question, but I seem to be having trouble with my breathing while I'm sleeping, and yes, I've had a sleep study done. More under the fold.

So, over the past year or so I've been having strange dreams where I'll dream that someone or something in my dream is restricting my breathing to the point where I cannot breath. For example the other day I dreamt that I was hanging out with some friends, just talking and having a good time, and all of a sudden they were holding me down and covering my mouth for no apparent reason. They weren't even being malicious about it, just casually holding my hands together and had their hands over my mouth. It was weird. but the point is, I couldn't breath. A few months ago, I dreamt I was talking with my brother, and suddenly we were wrestling (we never wrestle irl) and he had me in a choke hold and again, I couldn't breathe.

I'll wake up suddenly from these dreams gasping for air and when I wake up, my chest hurts, and my extremities (sometimes hands, sometimes feet) will be tingly and cold. You know, as if I'd been holding my breath for a very long time.

I've had a sleep study done, around a year ago when this started happening, and the study was inconclusive... They said I might or might not have sleep apnea, but they did not strongly recommend a CPAP machine. They said it wouldn't hurt to get one, but I didn't need one really. I don't have one, just so's y'all know. I did a home study, then an extended overnight study where they had me stay overnight and then most of the next day. I only mention this because I'm sure that someone will recommend that I have a sleep study done.

Here's my question though -- and it's kind of a what came first? thing, what is the greater probability... .

A - I'm subconsciously worried about dying in my sleep and that intrudes into my dreams and causes me to have these weird dreams. But I'm not actually having any difficulties breathing at all, I'm only waking up gasping because I'm dreaming about being smothered, or choked, or whatever. (Husband's theory)

B - I have asthma, COPD, and a chronic sinus infection (and yes, I've seen doctors about these, and they have seen me) and those issues are actually causing me to stop breathing or have trouble breathing, which intrudes into my dreams and tells my brain "Hey, wake up right now! or you're gonna die!" and that's why I wake up gasping for air. (my theory)

C- six of one half dozen of the other.

I'm not looking for advice about better breathing for sleep. I've had breathing issues for a long time -- though these dreams are a new thing. I'm just asking about which scenario do you think is more probable... or, like the chicken and the egg, do you think I'll never know?

posted by patheral to Health & Fitness (10 answers total)

Best answer: Your brain reacts to stimuli to a far far greater degree than it alters your body to conform to its expectations based on heavy suggestion, if I may so broadly describe the things it does in the name of the placebo and nocebo effects, for example. It's B, primarily. That's my non-medical opinion; IANAD.

I think what you're encountering is the line between "problem" and "disorder." I used to have a sleep problem, where I couldn't get enough sleep. Then I started falling asleep at work, and that was when it was a disorder, because I had lost my ability to maintain function in my life due to the problem. If these dreams are worrying you, depressing you, intruding on your daytime thoughts, it's crossing the line. Hold the line, and build a wall on it if you have to.

I have sleep apnea, treated with CPAP, and I too had some of those choking dreams before my apnea got so bad that I just couldn't stay deep enough asleep for long enough to form developed dreams. I think you should get a script for CPAP from your Sleep Doctor and rent a CPAP, and try it out. I can offer more advice to that end if you like.
posted by Sunburnt at 1:02 PM on January 10, 2018 [1 favorite]

I'd lean more towards B, as that's exactly how my night breathing problems (sleep apnea) manifested. I'd wake up violently after dreaming about drowning or being strangled. I haven't had a single one of those dreams while using a CPAP machine (though they came back when I was without it for a couple of days last summer). I do occasionally have anxiety-related dreams, but they manifest in other ways, not suffocation nightmares.
posted by lovecrafty at 1:05 PM on January 10, 2018

Best answer: I think it's super unlikely that your brain is so worried about dying that it's actually allowing your dream to impact your breathing. Your brain and your body love breathing more than anything. It priotizes breathing over everything. I just can't imagine any scenario where it says "wow what a scary situation, guess I'll actually stop breathing now." Its way way way more likely saying "Oh shit, we're not breathing for some reason, what could it be?" And your sleeping brain imagines something until it wakes itself up.
posted by bleep at 1:26 PM on January 10, 2018 [3 favorites]

Yeah, get a CPAP and the problem will go away. Speaking from experience, here. You are experiencing choking dreams because your body is not breathing, not the other way around. Also, don't ignore this or think it is manageable on your own-- every time this happens you are losing brain cells. You are actually drowning a little bit every night. You have dreams of being waterboarded because that is the exact physiological thing that is happening to your body. Would you tolerate going to an office every day and being alternately waterboarded for ten minutes every two hours when you are awake? Then don't put up with it while you are sleeping! If you don't get treatment it all adds up fast-- let me be clear here-- actual real brain damage is already happening to you. If your doctors offered you a CPAP machine, get one, and try it for at least two months before you give up on it. You honestly do get used to the feeling of straps around your head-- in time they become comforting and even needed. You can adjust to anything. When the improvement comes and your brain fog and chronic fatigue goes away it is so fantastic. The change for me was so dramatic that it feels like I have two different lives-- the 37 years before CPAP, and the 13 years after CPAP. This is just my personal experience, and obviously YMMV. But if you are anything approaching my level of sleep apnea this is something you don't want to fuck around with.
posted by seasparrow at 1:30 PM on January 10, 2018 [2 favorites]

I forgot to mention that if you were just dreaming about choking, your chest and limbs wouldn't hurt.
posted by bleep at 1:30 PM on January 10, 2018 [2 favorites]

Absolutely B. You have the physical evidence that your body is struggling to supply air to the point that your chest hurts and your limbs are tingling. Obstructive sleep apnoea is not the only kind of sleep-breathing problem ever, so although that may not be what you have, your breathing is clearly not happening the way it needs to while you sleep. The effects on your waking life will be similar.
posted by Athanassiel at 1:56 PM on January 10, 2018 [1 favorite]

I'll add to the chorus that the dreams you describe exactly mirror mine prior to treating my sleep apnea. When my son reported the same kinds of things we had a sleep study done and he too is now a CPAP user. I was also told I was "borderline" but the impact of the CPAP has been dramatic. I am effectively a different and better person with more energy, less anxiety, and a much better attitude.

Also, it's interesting to me that you have these additional factors (asthma, COPD, sinus infection) which I assume can ebb and flow. Perhaps when they're well managed you don't have apnea events but when they're peaking for one reason or another you do. In either case, aside from cost, CPAP/APAP has almost no downside and is worth a try if you can get an Rx.
posted by lucasks at 1:56 PM on January 10, 2018 [1 favorite]

I don’t have sleep apnea / trouble breathing in my sleep, but B is pretty much exactly how external things manifest in my dreams. I’ll dream about a truck backing up and wake up to my alarm beeping; I’ll dream about someone yelling and wake up to a baby yelling; I’ll dream that my arm doesn’t work and wake up to find that I was sleeping in a weird position and it’s all pins and needles. Nthing that it’s overwhelmingly likely that your body isn’t getting enough air and your brain is translating it into your dream.
posted by insectosaurus at 3:04 PM on January 10, 2018

As a data point to support B, I have acid reflux and when it gets particularly bad, I have dreams about vomiting or coughing up hairballs and wake up gagging and choking because there is acid in my throat and mouth. (Obviously different problem, but my physiology is causing the dreams.) It's horrible - I hope you figure this out soon!
posted by raspberrE at 3:48 PM on January 10, 2018

Docs ask about the kinds of dreams you’re having when they are screening for sleep apnea so it’s apparently a documented thing to dream about choking or paralysis when you stop breathing in your sleep. See a doc!
posted by bunderful at 6:58 AM on January 12, 2018