I was diagnosed with mild/moderate sleep apnea in 2005 and 2011 and have been trying to use a Respironics auto-bipap/cpap/bilevel machine with nasal pillows for the last six months. i have had little success with the 'auto' mode which is a pity (i had hoped i could self-titrate) and have found 12.5 cm cpap tolerable and comfortable. At this level my AHI apparently drops from 21 to 1 or 2 (according to the machine stats). My concern and question has to do with an unusual 'flutter' which i have developed; it began as a 'chest vibration' last March, which was the same thing that i had back in 2005. During the 2005 episode, it got quite severe to the point i could feel a 'flow murmur' rumbling throughout my cardiovascular system (all over) especially when lying down; but during the day also. An echo in 2005, 2009, and 2010 ruled out any cardiac issues of note however, i have noticed my left atrium between 2005 and 2009 dilated 0.5 cm.Regardless of what i have tried, the 'flutter' has remained for the past two months (before that, it was a 'vibration'). Unfortunately, i could not adapt to the CPAP and did not use it regularly for six months after buying it. I have no health insurance and no support for the CPAP. During the months i did not use it, i slept very fitfully and woke several times a night with a 'vibration.' I also had a lot of central apnea. Now, i wake two or three times a night, seem to have acquired some gastric reflux (especially if i eat after 8 pm); and when i am forced awake (always at 2 am, 3 am, and 5 or 6 am) i always have 'flutter' plus often a rapid heartbeat. My handheld ECG if used at the time i wake up shows 'suspected fast heartbeat 167 bpm' something like that; and my blood pressure is often 150/100 as it was this morning. The 'flutter' dissipates within a few moments. I have had about twelve years of chronic stress, during which time i faced continual emotional stress over a long-distance relationship (greatly depleting my serotonin); became homeless; was downsized; worked for five days straight until my feet swelled up (i have photos); lived in China for 28 months (most recently); and experienced the largely unexpected deaths of my Mom and Dad.Apart from the above, i have a normal life and can work full time (desk job). I can run on the treadmill for 30 minutes without issues (HR about 114 - top 135) and lift weights. I have no breathing issues but sometimes feel a bit winded (after taking Sertraline i think). I was taking propranalol for almost seven years (three of those years, dose was about 120 mg a day) prescribed for the 'palpitation' (my 'chest vibration') but ran out in July last year suddenly (at the time i had only a mild chest vibration) and that caused me to have major episodes of 'flutter' which were very frightening. I suspect that sudden loss of control in my heart caused a severe rebound effect, which i am still suffering from.I do not have night sweats. But my digestion seems to have changed; when i do not use the CPAP, and i am forced awake with sometimes significant flutter, i am forced to go and poop even if it's 2 am. This is very disconcerting; and i worries me that i have mild heart failure. Also, during the day and when i am resting/trying to sleep, i can 'feel' a 'pause' between my heartbeats, which has a 'flow murmur' quality (like a rumbling). But this has improved a lot over the past year; it is not so long in duration and soon is replaced with a normal 'lub-dub' heartbeat. Another thing, when i am forced awake (each time), i have a strong erection. This is maintained for hours and it seems to be connected directly to the flutter; once it subsides, the flutter does as well.Would an aneurysm explain the problems i have? I am able to live a normal life, except for being distracted out of my mind by the fear caused by the flutter. My fear is that it is more serious than my docs (Cardio visit last week for example, resulted in no action) think; that i have an aneurysm or significant narrowing of a major artery or possibly Pulmonary Hypertension (the values for the pulmonary valve(s) could not be detected in my last Echo my Cardio said, because they 'could not' measure the tricuspid reflux jet size/volume, which i find hard to believe); or something equally sinister.A second question: would a chronic hiatal hernia, ulcer, or IBS explain the flutter and/or cause sleep apnea? I find the diagnosis of sleep apnea hard to understand, because my breathing during the day is normal. How is it possible i just stop breathing at night (i do not seem to have significant obstructions; though my wife has said i do snore). Also, when i use the CPAP, i feel refreshed but i still get flutter. I am concerned that the CPAP will not eliminate the flutter; and that my heart will be remodelled and i will suffer more and more. What can i do to stop the flutter????? it is driving me insane!!! and costing me a fortune in trying to stop it.
Person's Gender: Male
Person's Age: 48
CPAP/BiPAP/BiLEVEL (Respironics 750 Nasal Pillows) most useful apparently at 12.5 CPAP; supplements (CQ10; Magnesium; Calcium; Potassium; Selenium; Apple Cider Vinegar; Hawthorne; Vitamin C megadoses) astorvastatin; TCM herbals; Propranalol; Nebivol; and (very recently) Sertraline.
This is Dr. Davidif your heart doctors have examined your heart and aorta and no aneurysm is found, then I don't think this vibration is from that. I think most likely the vibration is coming from a mucous plug in the lung and when you breath, air can rattle this mucous plug and cause a vibration. this is quite common. when you wake, are you coughing and clearing your throat? do you ever bring up mucous?
My last Echo was in July 2011, as far as i recall; my Cardiologist did not feel any further testing was warranted. I suspect there may be an aneurysm or narrowing; but nobody wants to help me, even though I am willing to pay for it (including any necessary treatment). I am sick of this 'flutter' feeling (it is not true flutter, as i mentioned i have a handheld ECG; when i get a strong flutter at night in particular and am woken up by it or becaue i stopped breathing or breathed too shallowly, the ECG reads 'suspected fast beat') and i worry about it constantly. Also, when i wake up with 'flutter' and take my BP, my HR is often 80+ and BP often 150/100 plus. Clearly something is not right (and it is NOT merely anxiety...it has been seven years! and i was MUCH worse a year ago, with 'dropsy.' I was falling asleep in public but could not fall asleep; because my heart would refuse to allow me to sleep and i would be jerked awake; this went on for three months and i felt exhausted. I had constant 'flutter' and even 120 mg propranalol would not dampen it much.
The only thing that really helps is 1) sleeping well with CPAP 2) taking propranalol (up to 80 mg /day). The 'flutter' is very subdued by this and i believe over time, it will disappear as my heart shrinks due to the reduction in stress of the severe sleep apnea. If i do not sleep using CPAP, i wake up several times with more aggressive 'flutter;' and the next day it turns into a deep constant 'rumbling vibration' in my chest; but doctors simply cannot diagnose it (for seven years). What type of specialist can disgnose this for me? An EP or a Vascular Cardiac specialist (what is that called?). Worried sick, because the cause of the 'flutter' is perhaps not being addressed (unless the CPAP is curing it); and that the CPAP will not cure the cause and i will suffer very badly because nobody would/could find out what is wrong.
I don't think your flutter is coming from your heart or blood vessels. if the CPAP heals, I think the flutter is coming from your breathing and your lungs. you should see a pulmonologist and get a bronchoscopy. sometimes you can have a mucous plug in your airways cause vibrations when you breath because of its close location to a bronchial openning and the breathing can cause rumbling sounds when the air passes by the mucous plug causing it to vibrate. mucous plugs are common and sometimes can be broken up by coughing or by using things like mucinex and drinking lots of water. sometimes you need a bronchoscopy to go down and break up big and thick mucous plugs.