Feeling suffocated with CPAP

I just started using my CPAP 3 days ago, and basically failed... It was so hard to breathe that after lying in bed for more than 3 hours I had to give up and take off the mask. After taking the mask off I fell asleep pretty quickly. My nose is a bit congested so even if the mask is not hooked to the machine I felt hard to breathe. The pressure is set bewteen 4-9 cm and I tied with the ramp on and off, pressure relief on and off but none helped. I will sift through the forum to see if I can find any information, but I would really appreciate it if I can get any suggestions from you guys. Thanks!

Can you explain in more detail exactly what you were experiencing when you tried to use the mask with the machine on?
Did you feel like you were suffocating or your breathing was stifled?

Ramp and/or exhale relief don't really come into the picture with the starting pressure of 4 because 4 is as low as it will go.
Often the setting of 4 is simply uncomfortable for some people...not enough air is moving and they feel like they are suffocating.
Trying maybe a starting point of 6 cm with exhale relief of 2 might be a better thing to try to see if the breathing is more natural feeling.

With pressures as low as yours, I'm not surprised. When I started, my prescription was set 4-20 cm. I felt suffocated until my minimum pressure was adjusted to 7 cm. I'm no expert, but I would adjust your minimum to 6 or 7 cm and see what that does.

Good luck!

Not sure why your high setting's been limited to 9, as it's quite low compared to most and very many leave it 'open' at 20. I would definitely move the low setting to at least 6 or 7 as I certainly would feel suffocated at 4 or 5. And if you're using the humidifier and having 'cold' symptoms, try turning it down or off - it's dependent on local conditions, climate, etc, and if yours are relatively humid now you possibly don't need the thing at all. I never use mine!

Hello and welcome. There's so much we don't yet know that could help us help you. There is info at the top of the page regarding evaluating the data from your machine. Until you are able to do that, are you able to tell us what your AHI was when you used the machine? Just a guess at this point, but often a pressure that is too low makes it hard to go to sleep because the brain is on alert sensing the air coming in is inadequate. Your first steps will be to make sure your treatment is optimized and gear is well fitted and as comfortable as these things can be. Then it's usually a matter of using it until the new sensations become your new normal. You are so very early in this journey. Try not to be discouraged. Many of us got off to a rough start but did adapt and are able to use this treatment without major issues. The more you can tell us, the more our thoughts might be triggered on how to help.

Thanks a lot for the replies!
When I was using the machine I could breathe, but it was like I don't get enough oxygen. As a result I even got a little palpitation. I felt like I've been holding my breathe for 10 seconds even though I've been breathing... My doctor set my pressure to between 4 and 9. Maybe because I have mild apnea (AHI=11 on average but AHI=32 during REM) and I'm only 5' tall. Last night before I gave up and turned off the machine I noticed that the pressure was 8.5. Could it be the mask? My theory is that because the CO2 concentration in the exhaled air is high and because the mask has a "diffuser", CO2 concentration is high in the mask so that even if I'm breathing I don't get enough oxygen...

lilyx wrote:Thanks a lot for the replies!
When I was using the machine I could breathe, but it was like I don't get enough oxygen. As a result I even got a little palpitation. I felt like I've been holding my breathe for 10 seconds even though I've been breathing... My doctor set my pressure to between 4 and 9. Maybe because I have mild apnea (AHI=11 on average but AHI=32 during REM) and I'm only 5' tall. Last night before I gave up and turned off the machine I noticed that the pressure was 8.5. Could it be the mask? My theory is that because the CO2 concentration in the exhaled air is high and because the mask has a "diffuser", CO2 concentration is high in the mask so that even if I'm breathing I don't get enough oxygen...

I think you are not pushing enough air through the mask. The higher the pressure, the more air flow. Therefore you get better CO2 clearance is through the mask. Each mask has different specs on vent rates.

Please read my first note - you NEED a higher min. pressure and a higher (e.g. 15) max pressure. Until you try them you won't understand the diff. between what you're experiencing now and what you could have. Honestly

As everyone has said, your minimum pressure is too low. Increase it. Your maximum pressure may need to go higher but lets worry about that latter.
Every mask has a built in leak so that the CO2 is mixing with the air and leaving the mask. You have enough O2 in your mask, you just need more pressure.

Lilyx Welcome. The forum can help you get past this hurdle but it does take learning about the machine. If you don't know how to increase your minimum pressure like Pugsy and others suggested. Here is a link to the clinical manual for your machine, It shows you how to get to the clinical settings and make changes. Is also has a lot of other helpful information on your machine. https://sleep.tnet.com/home/files/resme ... -guide.pdf

If you raise your minimum pressure and turn on the EPR (exhalation pressure relief) it can make your breathing feel more normal.

Just to pile on - I too had the same feeling. I raised my starting pressure from 4 to 6.5 the feeling went away.

lilyx wrote: . . . My nose is a bit congested . . .

I use nasal pillows, and during the worst part of allergy season, I often need a higher minimum pressure than I do the rest of the year in order to feel comfortable using PAP.