HELP! Something has changed...

Greetings,

I have been using a CPAP successfully for almost 4 years. Almost a model patient actually - I took to it almost immediately and in all this time I have never slept without it. I am considered a "severe" OSA case at 34 events/hr. My AHI since I started therapy has never been over 1.0 and is usually in the 0.3 - 0.5. range. Sounds great, right? Not any more. Something has changed.

For the past several weeks I have had a really hard time with therapy. My usual complaint is that I feel like I am unable to get enough air, so I experience the "air hunger" and end up gasping through my mouth to breathe (I use nasal pillows - exact equipment listed below). I've tried many different breathing techniques but nothing seems to work. I end up ocusing so much on my breathing that I can't fall asleep.

I have tried changing everything from initial pressure, EPR, humidity, etc. The only thing that seems to help is if I pull the mask away from my face a bit while I am falling asleep so I am getting a bit of air outside of the CPAP. It's annoying and noisy but it helps me fall asleep.

What could have possibly happened? Everything was great until it wasn't. I am very frustrated because I'm no longer getting the therapy I used to and it's affecting my sleep and productivity during the day.

For reference:

I am using a Resmed AirSense 10 Auto Set with Resmed AirFit nasal pillows.
My current minimum pressure is 10 with a max of 20, no EPR, and "2" humidity.

Any help or guidance you can provide would be greatly appreciated!

Warm Regards,
Daniel

pixeluxe wrote: My AHI since I started therapy has never been over 1.0 and is usually in the 0.3 - 0.5. range.

What is your AHI and leak level since this "change"?

Note: You should go to User Control Panel and fill our your Equipment Profile so you never have to state it again, and it is in easy view on every post you make. You can also type your settings in that section.

pixeluxe wrote:Greetings,

I have been using a CPAP successfully for almost 4 years. Almost a model patient actually - I took to it almost immediately and in all this time I have never slept without it. I am considered a "severe" OSA case at 34 events/hr. My AHI since I started therapy has never been over 1.0 and is usually in the 0.3 - 0.5. range. Sounds great, right? Not any more. Something has changed.

For the past several weeks I have had a really hard time with therapy. My usual complaint is that I feel like I am unable to get enough air, so I experience the "air hunger" and end up gasping through my mouth to breathe (I use nasal pillows - exact equipment listed below). I've tried many different breathing techniques but nothing seems to work. I end up ocusing so much on my breathing that I can't fall asleep.

I have tried changing everything from initial pressure, EPR, humidity, etc. The only thing that seems to help is if I pull the mask away from my face a bit while I am falling asleep so I am getting a bit of air outside of the CPAP. It's annoying and noisy but it helps me fall asleep.

What could have possibly happened? Everything was great until it wasn't. I am very frustrated because I'm no longer getting the therapy I used to and it's affecting my sleep and productivity during the day.

For reference:

I am using a Resmed AirSense 10 Auto Set with Resmed AirFit nasal pillows.
My current minimum pressure is 10 with a max of 20, no EPR, and "2" humidity.

Any help or guidance you can provide would be greatly appreciated!

Warm Regards,
Daniel

Are you using software......like Sleepyhead.......to see what's happening during the night, or are you just getting those numbers off the LCD screen?

Maybe your humidity setting is higher than you need. Higher humidity settings have been reported to increase AHI numbers.


Den

.

When is the last time you replaced the nasal pillow?

Examine the nasal pillow carefully to make sure that the inside second inner cone hasn't got turned and might be occluding the opening. Have to look real close to see the 2 inner cones...one inside the other.

ChicagoGranny wrote:

pixeluxe wrote: My AHI since I started therapy has never been over 1.0 and is usually in the 0.3 - 0.5. range.

What is your AHI and leak level since this "change"?

Note: You should go to User Control Panel and fill our your Equipment Profile so you never have to state it again, and it is in easy view on every post you make. You can also type your settings in that section.

Hi there ChicagoGranny - thanks for the reply. I have updated me "equipment" profile. Thanks for the tip!

The screen on my device shows smiley faces for leaks and mask fit, and my AHI is still around the same 1.0 mark.

Wulfman... wrote:

pixeluxe wrote:Greetings,

I have been using a CPAP successfully for almost 4 years. Almost a model patient actually - I took to it almost immediately and in all this time I have never slept without it. I am considered a "severe" OSA case at 34 events/hr. My AHI since I started therapy has never been over 1.0 and is usually in the 0.3 - 0.5. range. Sounds great, right? Not any more. Something has changed.

For the past several weeks I have had a really hard time with therapy. My usual complaint is that I feel like I am unable to get enough air, so I experience the "air hunger" and end up gasping through my mouth to breathe (I use nasal pillows - exact equipment listed below). I've tried many different breathing techniques but nothing seems to work. I end up ocusing so much on my breathing that I can't fall asleep.

I have tried changing everything from initial pressure, EPR, humidity, etc. The only thing that seems to help is if I pull the mask away from my face a bit while I am falling asleep so I am getting a bit of air outside of the CPAP. It's annoying and noisy but it helps me fall asleep.

What could have possibly happened? Everything was great until it wasn't. I am very frustrated because I'm no longer getting the therapy I used to and it's affecting my sleep and productivity during the day.

For reference:

I am using a Resmed AirSense 10 Auto Set with Resmed AirFit nasal pillows.
My current minimum pressure is 10 with a max of 20, no EPR, and "2" humidity.

Any help or guidance you can provide would be greatly appreciated!

Warm Regards,
Daniel

Are you using software......like Sleepyhead.......to see what's happening during the night, or are you just getting those numbers off the LCD screen?

Maybe your humidity setting is higher than you need. Higher humidity settings have been reported to increase AHI numbers.


Den

.

Thanks for the reply Wulfman. No, I am not using external software - just the data I'm getting from the CPAP itself.

As far as humidity goes, I have shut it off completely but then I get really dry. I have it at "2" right now. Maybe I'll try a "1" tonight.

I'm wondering if it has to do with warm air vs cold air. I feel like the warmer the air the more of a smothering feeling I get. I keep my bedroom very cool (in the 60's) at night. If I turn the heat on the tube up too high I get a lot of rainout.

What's so frustrating is that everything has been great for so long - and suddenly it's not. I just can't figure it out.

Pugsy wrote:When is the last time you replaced the nasal pillow?

Examine the nasal pillow carefully to make sure that the inside second inner cone hasn't got turned and might be occluding the opening. Have to look real close to see the 2 inner cones...one inside the other.

I'll double-check. I know what you mean though - I have seen the inner "cone". I've changed out the pillow a couple of times and it doesn't seem to make any difference to this particular problem.

Get the software. It's FREE!!!

viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html


Den

.

Wulfman... wrote:Get the software. It's FREE!!!

viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html


Den

.

+2 Very well worth the cost...

Hi,
I had a similar problem of air hunger ( after 3 yrs of never having such a problem) with my P10 nasal pillows. Then I discovered that the little vent screens on both sides of the mask were discolored ( and presumably blocked?). Soaked them overnight and scrubbed with a toothbrush - no more problems. Guess the exhale vents were blocked, causing a buildup of CO2? Hope this helps.

(Old aviator pic of TapPap mask which I use when having problems with the P10)

jagzoo wrote:Hi,
I had a similar problem of air hunger ( after 3 yrs of never having such a problem) with my P10 nasal pillows. Then I discovered that the little vent screens on both sides of the mask were discolored ( and presumably blocked?). Soaked them overnight and scrubbed with a toothbrush - no more problems. Guess the exhale vents were blocked, causing a buildup of CO2? Hope this helps.
(Old aviator pic of TapPap mask which I use when having problems with the P10)

Or you could just get a new mask. Useful life of the mask is rated at 6 months. If you have insurance they will replace it for you.

Feeling air starved can be one of three things:

1. You are actually suffocating. Your body senses this as a buildup of carbon dioxide, but for normal causes (like vent blockage), there is a corresponding dip in oxygen that you could detect with a pulseoximeter. This is your most likely culprit.
2. You have become a little claustrophobic. If you have been on CPAP for three years, this is unlikely, but the symptoms are the same as for #1. Do ensure that your mask vents are not blocked because you can easily get #2 from too much experience with #1.
3. You are having cardiac issues. If you can breath through your nose without the mask, and not be starved for air, this is unlikely, but if following jagzoo's advise doesn't clear up the situation, see your doctor.

It is impossible to know all possible reasons for such symptoms but one thing to consider, and which can explain the sudden change, would be a psychological event. You don't necessarily need an obvious change in your mental state, those things can occur and be triggered by changes that are imperceptible to our consciousness. Regardless of the exact origin, if it is happening, it would be consistent with what you are observing: your data is mostly unchanged (low AHI), once you fall asleep you can sleep well, but you have hard times falling asleep. If all else (suggested by others so far) fails, I suggest one simple experiment: set the minimum pressure higher (like 13 or more), set the EPR at its maximum (for comfort exhaling) and see if it makes a difference. It's a 5-minute test but it may be your answer. You may be a candidate for switching to bi-level CPAP but at this time you could just try changing the settings and see if it helps.
McSleepy

Hi pixeluxe, See thread "Need device for cleaning stained vents on Airfit Pro 10 mask " to see if dirty mesh and cleaning them might solve the problem.

Anxiety?

Thank you all so much for your kind feedback. I am going to try all of the above - starting with cleaning the air vents (and ordering a new mask) to see if that helps along with the software so I can get a clearer picture.

I breathe fine as soon as I either pull the mask away from my face a bit or take it off entirely - so this may be the (simple) culprit. I'll post my results!

Thanks again guys -
Daniel