Hard time breathing but only intermittently, at work

Newbie post but not new to the boards. THANK YOU, everyone. Everything I know about my machine/masks/everything comes from this place. Both my resp techs balked at telling me more than "press this button." (Kaiser, which I adore, but you don't get time from them.)

I've been on cpap for 4 months, and have loved it. No problems (well, nothing that reading back posts couldn't fix). Used it all the way through every night from the very first night (sometimes uncomfortable at first, but quickly loved it, within a week). I've used Swift FX mask which I liked, but I'm too active a sleeper for it, TAP PAP (returned, nasal pillows set unadjustably too-far apart for my narrow nares or that would have been my fave), now using the AirFit P10 For Her, which I have LOVED.

The Problem: I sleep in two places, both at home, and at work (I work in a fire house, 48 hour shifts, rotating nap shifts, so sleep hygiene of going to bed at the same time every day is not possible for me). At home, I've had no problems. An occasional fish gasp through my mouth while settling down to sleep, but that's fine, and it works, and then I settle and sleep.

At work, three times now, I've had what basically felt like panic attacks while trying to breathe. One was about 3 weeks ago, and the other two times were on this last shift. All three nights it has been the same: I put the mask on, it's fine for 10 or 20 minutes (ramp time is 30) and then suddenly, it feels like I can't get enough air and I have to pull the mask off my face to breathe. They are NOT panic attacks, because as soon as I take the mask off, my breathing returns immediately to normal, no other symptoms. I relax, meditate, get my breathing nice and normal, put the mask back on and it starts immediately. Last night I must have done this 20 times, because when I get stubborn, I get STUBBORN. I wanted to use my mask (it's help me cut down on migraines, my main reason for using it -- terrified of getting a migraine if I DON'T use it). I tried both meditating and reading with it on to relax, but I couldn't do either -- not enough air.

From reading boards here, I knew to turn up my pressure. I was starting at 5, max set at 20, though I rarely go above 11. Average while asleep is 7. Ramp level was set at 4 (so stupid, I REALLY can't breathe, period, at that setting). So last night I messed around with changing the setting. Brought ramp up to 5, though I never hit that button. Brought minimum/start up to 5.5, then 6, then 7. At 5.5 and 6 it felt good for the first minute or so, and then I started having difficulty getting enough air again (wanted to do that fish gulping thing, which I did, through my mouth). At 7, it felt both like too much air (???) and not enough.

I have noticed that the mask seems more humid all of these three nights. The temp is set static at 65 in the work dorm, and I can't change it. Humidity levels are normal here, in and out of my building (we watch it for fire info stuff). On these nights, the mask seems to weep more (it rarely does at home). I have a snuggle hose on both the full length of hose and the mask hose. I'm a side sleeper, but have tried stomach and back to see if this helps, and it doesn't. Have tried putting the sheet over the hoses as well as the snuggle hose, didn't help. I've tried taking the hose off the lift thing and sleeping with it flat, no help.

On these terrible three nights, I haven't been able to get it to work, even with giving it several hours every night. I know it's only three nights, but it scares me -- I don't want this to be psychosomatic or fear-induced -- it doesn't FEEL that way. It feels like I can't breathe. I want to FIX this.

Is there any way that the mask's holes (many, and very small) are getting plugged by the extra moisture that I feel? (Humidity is pass over, set to 0.) Would that, if true, make me feel like this? Any other thoughts, oh ones-who-know-all?

(No congestion - I do the Falcon method of am neti/Flonase, pm Claritin, and that's been awesome.)

Thanks in advance.

Hi, good for you for persisting and being on top of things - it's too bad you have to split your sleep by shifts - never a good thing. My first suggestion would be to try to either go without the ramp altogether (most of us have very shortly into doing Cpap) because while it's ramping, you're not being fully treated of course. The second would be to try to do without even the passover humidity (and extra heat if you use it) altogether because of the weather at the moment.

And what are the chances some fire stn. noise is waking you at those times? Or unwanted lights?

Julie wrote:
And what are the chances some fire stn. noise is waking you at those times? Or unwanted lights?

Thank you for this, Julie! I'll try the no-ramp, no-humidifier next. Re: noise/light, no, it's silent and dark as the tomb in there.

What size nasal pillow are you using? Any chance you can move up a size?

For moisture in the nasal pillow itself caused by the condensation of the moisture in our own exhaled breaths...a heated hose would maybe help. Using passover humidity won't help if what you are getting is condensation from the moisture in your own breath.
A barrel cozy would also maybe help. Saved me from many annoying nights before I got my heated hose.
http://www.padacheek.com/PACAirFitSeries.html down at the bottom of the page.

I have a Resmed so your mileage may vary, but I went through what you are describing.

I have a setting called EPR and I think that your A-flex is the same concept. not enough air can be caused by several things:
1. pressure too low to support breathing-you have already tweaked this

2. you may have a problem exhaling into pressure-I did. What I don't know is if the A-flex is active in your first 30 minutes before the machine comes up to pressure. This issue may also be the reason you use a "get used to it" period before it comes up to pressure. If I were to bet this is where I would put my money

3. you may be having an apnea 10-20 minutes into your use, I don't know if your system will respond or not. Mine is supposed to respond, but I have not experienced it actually doing it.

4. My whole experience with humidity has change since CPAP. I used to like a steamy shower and now I can't breathe. I found that for me there is a humidity/temperature curve that when conditions are above this curve I have trouble breathing-the warmer it gets, the less humidity I can take. From what you have said, I don't think this is what you are describing

If it turns out to be an issue with exhaling into pressure, my sleep tech told me that the P10 mask would not be a good choice and I am now using the Amara View. I liked both, but must admit exhaling is easier with the Amara View.