Avoiding going to bed, panicky and fearful

[cpax]

I am newly diagnosed with severe apnea. My sleep study found I stopped breathing 56% of the time. I just got my machine 2 days ago and I'm struggling a bit with it. I'm a mouth breather and trying to get used to the nose mask is a bit of an effort. I find myself getting panicky.

Last night I finally found a good position, on my back which is weird because I've been a stomach sleeper for as long as I can remember. It worked for about 5 hours then I woke up. I found my one nostril seemed a bit restricted. I got up and sprayed it with something the Respirologist gave me called Avamys. I tired to put the mask back on but got all panicky. I got up and journalled about it on the computer for a while but couldn't bring myself to put the mask back on. I spent the rest of the night without it which means I slept poorly for the second half and woke up with the familiar headache. So now my biggest issue is anxiety about going to bed. When I think about it my heart rate increases and I feel fear. I know the sleep I get with the machine is waaaaaay better and I've seen improvement even front he bit I've got so I want to keep working since I know this is the best way but I need to overcome this fear and panic obstacle.

I would appreciate any suggestions.

[ameriken]

Welcome to the forum, you've found a great place with some really great people here who understand anything and everything CPAP.

And you're not alone, I think that fear and paranoia and claustrophobia are very very common, it's good you raised the issue to deal with it because you don't want to give up CPAP for it. I felt that fear when I did my titrations, and before I got the machine I told myself that I was not going to have that problem. I convinced myself that if I ever felt that, that it was ok, it's not going to kill me.

Some other things you can do are try to wear the mask around the house without the hose. Perhaps sit around and watch tv with it, or read. The day I got the machine, I took two naps with the mask and machine on to help me get used to it. When I went to bed, I put the mask and machine on about 30 minutes before I wanted to fall asleep and I played angry birds on my cellphone (which I still do before I go to bed ). So, it's just a matter of acclimating yourself to it.

Another thing to consider is the mind game that fear plays...and you can conquer the fear by just telling yourself that nothing wrong will come from this, no one has ever suffocated or died because they were on CPAP and you've got to train your mind that it's ok, perfectly normal, and that it's a good thing. You're already doing well and getting the benefits, so just wear the mask around, and start convincing yourself that it will all be ok and that when you get that feeling of fear, try to laugh at it and then put the mask back on. It may not all happen overnight, some of these things take time...just persevere, talk about your troubles on the forum, and never, ever give up. Like they say "One day at a time".

I hope that helps! Good luck.

[BlackSpinner]

take the machine to where the tv is and wear the whole thing while watching tv for a few hours every day. That way your body and mind get used to having it around.

Plan two rewards - one for keeping it on and one longer term. The longer term should be something really desirable to you and potentially obtainable. The best image seems to be a beach holiday so far.

When you feel anxious about the mask focus on the reward for keeping it on. Maybe the reward for a complete night is a piece of high quality chocolate, so imagine that choclate in front of you, hear it being unwrapped, smell it, taste it on your tongue. If the reward for wearing for 3 months is a beach holiday, imagine your self on the beach, smell the hot sand, the sunscreen, feel the hot sand, taste the cool drink. It is best to pick something you have experienced and really enjoyed.

And remember if you take the mask off you don't get the reward!

[FatiguedMe]

Hi,
You can try wearing the mask before you go to bed. Are you at home during the day?
Try wearing the mask when you are up to adjust to it. Ease into it, try some relaxation exercises, deep breathing.
What scares you about the mask? If you are mouth breathing you need to get a chinstrap, you are losing therapy thru your mouth.
Please try to relax and I am sure you will get used to it. Some others will come along with more suggestions.
Susan

[cpax]

Great suggestions all! Thank-you so much. Mostly it's really nice to know I'm not alone in this. This community is great!

[Carl LaFong]

During my sleep study they put on a nasal mask and I freaked out. Too claustrophobic for me. Switching to nasal pillows did the trick. They're great. After decades of apnea I actually now crave and look forward to bedtime.

Hang in there, it will get worked out. There is no single solution for everyone. It can take time and trial.

[archangle]

If you can't stand the through of sleeping with the mask, keep the mask on and get up and do something else. Read, watch TV, or get up and walk around, clean the house, whatever. If you wake up in the middle of the night and can't stand the mask, get up.

If just wearing the mask gets to you, open your mouth and breathe deeply. You can actually learn to be able to do this while the CPAP is on because you can close off your nose internally so you can open your mouth and breathe that way.

Just don't sleep without the mask. You don't want to get into the habit of taking the mask off and going back to sleep. You might start taking it off and not remembering doing it.

Maybe sleeping in a recliner with the CPAP will be different enough to make it easier.

[Janknitz]

I had those horrible panic attacks at first too. I was having daytime panic attacks too, but not to the level of a bona fide panic disorder--YET. The good news is that as you use your CPAP more, you stop that cycle of secreting adrenalin all night in the struggle to breathe, and eventually your anxieties decrease.

When I had those panic attacks in the mask I did two things:
1. Tired to slowly breathe in and out while counting to 10. I promised myself if I was still panicky at 10 I could take the mask off. Most of the time I was fine by the time I got to 10.

2. If I did take the mask off in a panic, the rule was that I MUST put it back on and try to go back to sleep, even if it was an hour later after I'd gotten out of bed to do something else.

Finally, another thought. DME's often set newbie machines with the ramp feature on--the machine starts at a lower pressure to help you get to sleep before the full pressure starts--the idea being that you won't notice it while you're asleep. The problem with that theory is that it feels like it is hard to breathe if the pressure is too low--that certainly makes me panic! So if you have the ramp feature on, try turning it off, and if the other steps don't solve the panic issue, perhaps you need to talk to your doctor about a little more pressure.

[snuginarug]

Kudos to you for making a commitment to use your cpap! You've got the right attitude, being determined to make this work.

A very smart lady on here, when I expressed my troubles with waking up after a certain number of hours, encouraged me to go through every single comfort issue. If you are not comfortable, you will not stay asleep, and that is very frustrating as it is sometimes such a struggle to relax enough to get to sleep in the first place. When you awake in the middle of the night, try to keep the mask on long enough to pin point any discomfort you might be experiencing. Inflamed, dry nose? Too much mucous? Pressure from having the straps too tight? Are the straps pulling at your hair? Trying to keep the mask on a little bit longer instead of instantly ripping it off can help resolve the anxiety problem sooner too. Your unconscious is totally freaking out, and keeping the mask on just that little bit longer helps your unconscious see that the mask is not hurting you. The unconscious starts screaming bloody murder, but the conscious mind, just for a few moments, can say See, we haven't died yet, have we? It take s awhile for the unconscious to trust the mask.

Fool around with the ramp, the humidifier, the tightness of your straps, different sleeping positions. Practice wearing the mask while not asleep. And as archangle says, don't take it off and sleep the rest of the night without it. As the others have suggested, when you awake with the complete heebie jeebies, get up, then return to bed after you have relaxed a bit and put that mask back on. Some people take a mild anti anxiety medication to ease their adjustment to the mask.

I found that getting on the computer prevented me from getting sleepy again, I think because of the light of the screen. I found I did better if I listened to quiet music or an audio book. I felt sleepy and relaxed again sooner than when I interacted with the computer.

For encouragement, you might want to check out the sticky at the top of the board entitled "Newbie would like to hear success stories"

It's not easy, but you can get through this. The rewards of treating apnea are great, and they are just around the corner for you.

[Mr Bill]

I am newly diagnosed with severe apnea. My sleep study found I stopped breathing 56% of the time. I just got my machine 2 days ago and I'm struggling a bit with it. I'm a mouth breather and trying to get used to the nose mask is a bit of an effort. I find myself getting panicky.

cpax, welcome to the board. The nasal mask will give you the best seal if you can learn to tolerate it. Your body will figure out how to let you talk, drink water, and swallow pretty quickly. I found that the small mask I was given was better than a large mask I later asked for. The large mask was much harder to seal and I went back to the small mask.

Last night I finally found a good position, on my back which is weird because I've been a stomach sleeper for as long as I can remember. It worked for about 5 hours then I woke up.

I too, found that I slept on my back the best. It may be because it requires the least effort to breath, assuming your CPAP is clearing your airway. I cannot yet sleep well on either side because it causes centrals big time. Supposedly, sleeping on your back, supline, is worst for obstructive sleep apnea. But that is if you have no CPAP. Now you have one. Sleep in whichever position makes you most comfortable.

I found my one nostril seemed a bit restricted. I got up and sprayed it with something the Respirologist gave me called Avamys.

Somebody posted here that one nostril is almost always restricted and our sinuses alternate naturally. Probably this is nothing to worry about as long as you feel you can breath well.

I tired to put the mask back on but got all panicky. I got up and journalled about it on the computer for a while but couldn't bring myself to put the mask back on. I spent the rest of the night without it which means I slept poorly for the second half and woke up with the familiar headache. So now my biggest issue is anxiety about going to bed. When I think about it my heart rate increases and I feel fear. I know the sleep I get with the machine is waaaaaay better and I've seen improvement even front he bit I've got so I want to keep working since I know this is the best way but I need to overcome this fear and panic obstacle.

I would appreciate any suggestions.

Its common to feel panic when putting on the mask. I slept with the light on for quite a long time. It will take time for you sleeping mind to make the association that the mask is a good thing and is making you better. For me, it was sleeping with a pulse oximeter and seeing that without the mask, I was desaturating badly. Night after night of seeing good numbers till I took off the mask convinced me that this was something I just HAD to do. Somehow that got through to the sleeping mind and after month 4, I began to sleep 6-8 hours instead of only 4-4.5 hours a night. I find that it helps to get as calm as you can. Read or drowse or whatever, then put on the mask. If you can breath OK without the hose, you are calm enough. Now switch on your machine and when it starts blowing, attach the hose to your mask. Now you are getting even more air and you should be good. Rinse and Repeat as Necessary.

Good luck and let us know how you are doing.

[Muse-Inc]

Ahhh, the infamous sleep dreads...no fun. Good suggestions offered, the sleep dreads, the fears are very real and can be quite challenging to deal with as many of can attest. I'd try a different mask. I have severe claustrophobia and a phobia about suffocation; as a result, there's no way I'd adjust to a nasal mask or anything covering my nose, touching my forehead, or blocking my vision. My sleep study mask was a pillow mask and that's the one I wore for almost 2 yrs, then I started mouth breathing and hadda change to a full face mask (FFM). My choice was this one, lots of us here wear it too, comfort of pillows with the security of not losing therapy air. In my case, I can barely see the mask, so it doesn't trigger my fears. Our host sells it for $119 last time I checked, if insurance buys it, price is $700 or so so I buy from our host.



Here's more images http://www.mergenet.co/hybrid/photogallery.htm

EDIT: try to avoid sleeping on your back as it typically increases the number of events...that position makes it easier for your airway tissues to collapse.

[Katagal]

You could be me posting about this very issue - I have had my mask for almost a month now and the first week was awful, I experienced everything you posted about and have been a chronic mouth breather all my life so a chin strap was a must and that is probably the hardest part for me to adjust to. A suggestion that has worked wonders for me is to take a herbal relaxation tablet (so nothing terribly strong) and I find it keeps me relaxed during the night and I don't fight the mask so to speak when I awake at night, i just surface and know the mask is on and roll over and go back to sleep. I have a routine before bed, warm shower and then sit on my bed and put the mask and chin strap on and then just quietly breathe in and out and think about how good a night sleep I will be getting thanks to the CPAP machine and then I attach the hose and relax while reading for a while and then I drift off. I have always been a side on sleeper all my life, yet now I am awaking in the morning and finding myself on my back.

Another thing is that you may need your pressure adjusted, I need to have my exhalation pressure reduced as I felt I had to push hard to breathe out and that was waking me up in a panic most night, but once that was adjusted, I have pretty much slept through the night with mask on the whole time

Good luck - persistence and perseverence is the key

Cheers Katagal

[Gaga58]

Cpax...another thing to try is aromatherapy. I had read on here where folks were having good results with relaxation by using it, so when I ordered my machine I also ordered a starter pack! It is great!! Of course, that's if "smells" don't bother you or you can find a scent that is pleasing to your system. I panicked big time during my titration, to the point I even surprised myself that I had such a quick, intense fear! The odd thing being I had already played around at home with a quitter machine and it didn't seem to bother me at all, nevertheless, I panicked there, to the point I ripped the mask off and called out!! I had to really fight that feeling all night there at the sleep center. On the way home the next morning I was "pondering" my reaction to all this, as even the thought of panicking was making me panicky!! I had to really stop and think about the whole point of this therapy...for me it's to lower my high bp, have more energy, not be so cranky and irritable all the time. I imagined myself after a few months, seeing myself as FEELING better, back out in the yard again going all day long, keeping up with the grankids...I dangled those thoughts in front of me like a well deserved carrott (or chocolate!). I am happy to say I have not had the "panics" here at home and my first night was actually my best I think so far! I am currently using a nasal mask and I find the aromatherapy actually helps keep my sinuses clear for the breathing and I have the added "smell" to enhance all that air blowing in my face! You don't have to buy the kit, you can make your own using any scented oil you might find pleasing, just make sure you put it BEHIND your machine where the air filter is and not IN the hose or humidifier or ON the filter itself. I use scents throughout my house, so for me, using them with my cpap was a double pleasure...with fall fast approaching I'm loving the spice smells right now!

You've found a great forum with an even greater group of people...they are not only helpful, but supportive! Hang in there, as one day we'll no longer be the newbies and can help someone else by sharing our experiences!!

[kempo]

cpax welcome to the forum. Just hang around this place and in a couple of months you will look forward to hooking up before you go to sleep.

Oh and by the way having OSA is nothing to be ashamed of. Tell all who will listen about your therapy. There is no telling how many of your friends and family have OSA and don't know it.

Good luck!

[carbonman]

Plan two rewards - one for keeping it on and one longer term. The longer term should be something really desirable to you and potentially obtainable. The best image seems to be a beach holiday so far.

When you feel anxious about the mask focus on the reward for keeping it on. Maybe the reward for a complete night is a piece of high quality chocolate, so imagine that choclate in front of you, hear it being unwrapped, smell it, taste it on your tongue. If the reward for wearing for 3 months is a beach holiday, imagine your self on the beach, smell the hot sand, the sunscreen, feel the hot sand, taste the cool drink. It is best to pick something you have experienced and really enjoyed.

And remember if you take the mask off you don't get the reward!

To reinforce this in your mind, put a rubber band on you wrist,
wear your watch backwards.....something that is unusual
that will remind you, throughout the day, to think these thoughts.
Remind yourself that this therapy is your new life.,
Confirm to yourself that you will prevail and be successful.

....that you are not alone, we have all been where you are,
and we are pulling for your success.

Welcome!

It's your life.
It's my life.