Yep, time for the noob to speak up

[SuperDan]

Hi all. I was diagnosed after my (now) wife was actually scared of watching me sleep because of how often I'd stop breathing. The sleep doc says I have an AHI of 79.1 which, I don't know, sounds pretty high considering an event consists of 10 seconds or longer and (or) loss of O2 more than 3% (mine dropped to 63%).
So I have this face mask and a ResMed System One machine humming next to me and the thing I can't figure out and which is keeping me awake and only able to sleep for about 5 hours at a shot, is... how deep should I breath when using this thing. I know, That sounds like a stupid thing to be wondering and it's purely rhetorical because my body eventually figures it out. My problem, I think, is how do I figure out what breathing normal is when I have this pressure at all times. My head says I should be able to just relax and my body will get it so I try, I stop breathing all together or it's very shallow and I start thinking "this isn't normal".
I know I can get it and I want to because of how great I should feel when my sleep is straightened out.
When I try to use the ramp function, I feel like I'm suffocating which leads to panic. I've tried adjusting the resistance and the ramp amount but I can't get it right. Now my mouth gets dry so fast it keeps me up and the machine's humming up and down (it's BiPAP) is making me wonder to myself if I'm breathing "enough".
Yeah, on re-reading this it's not making much sense but I hope some of you can empathize having maybe gone through it.

[cindjo717]

You will get used to it. In the beginning I would put it on while watching tv before I went to bed, so that I could get used to it better. Everyone is different, just try and breathe normally, I find that the less you think about it the better.. Try reading a book or doing something with the mask on to take your mind off of it. It's really mind over matter. It's amazing how petrified I was when I first got mine and now I can't sleep without it.

[chunkyfrog]

I wake up now and have to touch my mask, feeling the exhaust;
otherwise I'm not sure it's on.
We get so used to these things.
You will, too.
5 hours is pretty good for a beginner.
Keep plugging away.

[Slartybartfast]

Yes, it's a little strange at first. However you have to get used to the idea that the machine isn't a ventilator; it isn't breathing for you. It takes its cues from what you do. When you inhale, pressure increases slightly. When you exhale, pressure decreases. If you feel like you're breathing into a balloon, you can add in some EPR Expiratory Pressure Relief to make it easier to exhale. The suggestion to put your mask on and run the machine while you're reading or watching TV is a good one. Everyone's different; my numbers were about like yours and I took to it like a duck to water.

Yeah, my (now) wife also goaded me into getting tested. Perhaps that's why married men live longer . . .

[RocketGirl]

Yes, distraction is your friend when you first mask up - I have that same suffocating feeling when I start the ramp (and I still have to put my hand by the vent sometimes to point out to myself that there is EXTRA air being made available ). So many people experience this that I don't know why ramps start at 4 instead of 5 or 6.

When I first started cpap, I would turn my little shortwave radio on and fiddle with it for a few minutes while the ramp increased - anything to take the mind off of breathing. (Fortunately the radio has a setting where it turns itself off after 30 minutes, because I never stay awake long enough to turn it off myself!)

[greatunclebill]

for those concerned about ramp, the ramp can be adjusted to whatever pressure you want. if you can't/don't want to do it or your dme didn't turn it on for you to adjust it, you may have to go to them to adjust it.

[IndyDave]

I actually turned off my ramp after the first night into it. It was ok when I was playing around, watching tv or reading and it built up, but it was distracting to lie there waiting to go to sleep and to have it kick on, wondering when it would happen. One interesting thing my MD did, that I already really appreciate - he gave me a 3 week prescription for valium to take at bedtime during the adaptation phase... to help with any anxiety, claustrophobia, and the plain ol psyching myself out over having this thing on my face. Plus it helps me get to sleep more quickly.

[Guest]

I agree with Indy Dave. My present machine and its predecessor have adjustable ramp feature. The first time I started the machine it was set for maybe 10 minute ramp time, I don't recall now. But I found it to be just an annoying distraction and found how to set it to zero ramp and much prefer that mode.

TheDuke

[xenablue]

Yup, what everyone else said!

I've been at this about 18 months now, and I still have to spend a few minutes before laying down acclimating myself each night. I have a routine - a dvr'd episode of Jeopardy, which takes about 20 minutes zooming through the ads - if I could ever stay awake long enough to watch a whole show to the end. I watch this as I fine tune my mask for fit and comfort.
Because I'm busy watching the show and tweaking my mask, breathing becomes as it is without the mask - natural and unforced. When I first started the same thing happened to me - I felt like the machine was trying to breathe for me so tried to keep up with it - that was all bunk! Seems more like I was fighting the machine - and the ramp was a PITA so got turned off pretty soon.
Everyone has their way of dealing with issues - it isn't natural to sleep with a mask strapped to your face so however we find a way to make it work is good.
I read so much here that has helped immensely and I tried everything suggested to come up with MY routine. They say it's not good to watch TV before going to sleep, but it works for me.

Cheers,
xena

[SuperDan]

Thanks all of you. I really appreciate the advice. That's exactly it Xena, I'm either fighting it or trying to let it breathe for me. I'll try wearing it around to get used to it and try to distract myself when getting to sleep. I like the idea of playing the radio. Good call

[mnfe]

When I first got mine I was taking big breaths because I felt like I couldn't breathe otherwise. Within a few weeks I was ditching my ramp and having to check to see if it was even still on in the morning because it felt so natural. I find that when I turn it on I breathe out and then breathe in again when I feel it kick in. After a few breaths I'm good to go and adjusted. It did take me a few weeks to get to that point though. It also helped that I switched masks, I went from a nasal mask to nasal pillows (Swift FX).

Keep trying, it'll come!

[rimrock]

What effect does setting the EPR to 3 (for example) have on the pressure during treatment? Just wondering (after 5 years). I am thinking that if during the night the EPR is set at 3 (for example) and the pressure is normally 12 (for example) am I getting an affective treatment rate of 9 for a few seconds?

[NightMonkey]

What effect does setting the EPR to 3 (for example) have on the pressure during treatment? Just wondering (after 5 years). I am thinking that if during the night the EPR is set at 3 (for example) and the pressure is normally 12 (for example) am I getting an affective treatment rate of 9 for a few seconds?

Well, this is getting the thread off topic, but yes, in the example you give the pressure drops while the machine senses you are exhaling. This works well for some people. But know that many apneas start on exhalation and the lower pressure may not prevent them.

For myself, I played around with all EPR settings and found that my apneas increased. I also did not like the pressure ramping up and down with each breathing cycle and believe it contributed to more awakenings.

If you want to play around with EPR it is best to have the software and look at the daily details report each day to see the effectiveness, or lack thereof, of your therapy.

[NightMonkey]

...try to distract myself when getting to sleep. ...

Many human activities go much better if you think about what you are doing. Sex and breathing are two exceptions - thinking about what you are doing will diminish performance.

I don't like that radio idea - it goes entirely against good sleep hygience practice.

To distract myself I think about pleasant things - surfing in snarly waves; laying on a beautiful, warm beach; making tons of money; etc.