Anxiety and hyperventilating-solved due to suggestions

[Raheel]

Hello everyone here.
I've been using CPAP since 4 months now and everything was fine. Last week I had this anxiety attack due to a dream and started hyperventilating. Since then I could not use the mask at all whether nasal pillow or the nasal mask. I am ok with out the mask but once I start the machine I start hyperventilating.my doctor told me it is all in my mind but I can't think of anything else other than concentrating on my breathing while using the mask. Without it there is no problem. How shall I get rid of this mind game.

[knothead]

I had panic attacks when first using my cpap, I was ok sitting on the bed with my mask(FF) on but as soon as the light went out I couldnt breath. I finally made a point to wear the mask sitting and watching tv till I was used to it. Later I added my machine while sitting watching tv with the light on. I went on doing this till I was comfortable with the mask & machine till I graduated to bed, that was 5 years ago, now I even take naps with my mask...give this a try, it really works to desensitize you. Good luck.

[Raheel]

Thank you for your reply Knothead. I am presently at a stage where I could use the mask with the machine on while watching YouTube videos. Your experience has given me hope that overtime I may come out of this uncomfortable episodes of heavy breathing. I welcome other members suggestions.

[Julie]

You might want to talk to your MD re getting short term help like Ambien... or very small doses of melatonin.

[Raheel]

Thank you Julie. I will ask my Doctor but first I will try the procedures what Knothead has posted.

[Raheel]

Any other comments please.

[Janknitz]

I had terrible claustrophobia at first and would rip off the mask. I made a pact with myself to count to 10 slowly and breathe deeply before I took off the mask. If I still wanted to take it off after that I could, but I had to put it back on again as soon as I could. After a while I didn't have to remove the mask at all, and eventually the panic attacks subsided.

You may want to check your data to make sure your therapy is optimized. My general levels of panic have reduced significantly because I'm not full of stress hormones all night trying to breathe. But sometimes anxiety bumps up and I can often trace it to a big leak or needing a bit more pressure.

[Julie]

Good idea Janknitz... and it's a good idea to tell yourself (while you're counting to 10) that YOU are in control, nothing terrible is actually going to happen, you can choose to not use the mask... when the 10 lousy seconds are up. And have something to be proud of. Then bump it to 15, 20, etc. etc... all the while being in control. Take a deep breath to calm yourself and think 'reasonable', not panic.

[Raheel]

Every reply here is giving me valuable tips which is boosting my confidence. This forum is a great one. I am glad to have discovered and registered my name here. One thing I realised is to have patience.

[McSleepy]

I believe I know what you are going through. After many years of using CPAP, I had my first surgery and was very afraid of it. I had all sorts of mental issues relating to sleep and the knowledge that it is all in my mind didn't seem to prevent them, but it was what ultimately helped me overcome them. One word: psychotherapy, and by that I mean anything that affects your mind in a focused, positive manner. Of course, if you can find a good therapist, go for it (CBT might help, but psychoanalysis is best). But in the absence of getting professional help, you can do quite a lot yourself. Start with the knowledge that (most likely) there isn't anything outside of your control here. You were perfectly successful in using CPAP for a while and then a thought has triggered some fear that is causing this self-priming effect. Work on your mind - talk to yourself about all that: how you know you can do it, how there is nothing preventing you from doing it, other than those thoughts, which you should be able to chase away. Start in the fully-awaken state (as already instructed) and just talk to yourself - how you will be fine, how you can do this for as long as you want (watching the videos), then how you will be able to put down the device and close your eyes (still propped up in bed), then how you WILL be able to turn the lights off (knowing, of course, that you can turn them back on at any time), then that you will be resting like this - for as long as you want - then, hey - why not allow yourself to fall asleep.

Before you do that it may help to think what your fear is. Do you feel that hyperventilation is going to poison you with excessive CO2 levels? You know, I had not even heard of hyperventilation until around the time when I started CPAP (for various reasons) and I did not fear it. Then, I read about it and I stated fearing it. It took me a while to realize that there is a good reason I wasn't aware of it - it's not really a problem; your body knows what to do, the only thing suffering is your mind. What else could you fear? That you'll suffocate? Unless you have some other medical conditions that would be much more dangerous by themselves, your body will not let you suffocate. What else? Maybe the biggest one: that you will not be able to sleep, which is where it all began (sleep apnea that needs to be treated, etc.) Well, start with the knowledge that you don't have to fall asleep and you don't have to sleep that night. There are few things more destructive to sleep than mental pressure and you need not apply any yourself. Tell yourself "I don't care if I fall asleep or not, I don't care if I think I'll be hyperventilating, I know none of that can do me any harm, I'll just power through this because I know I can". As corny as that sounds, some positive reinforcement is effective and can take you a long way.

While it is true that there are plenty of psychological issues that one cannot overcome on their own, you need to remember that there are many more that you certainly can. And there is no reason why you wouldn't try and succeed.

McSleepy

[Raheel]

Janknitz, how long did it take for you to come out of claustrophobia?

[Raheel]

Mcsleepy ,thanks for the great tips. I was doing exactly the opposite of what you have suggested and this is trying to sleep that night instead of not caring whether I sleep or not. Let me try out this night and the following nights too.

[yaconsult]

Hi Raheel,

I am sorry that you are having a hard time. It's important to remember that CPAP masks are designed with a venting system included. They have to be or the carbon dioxide we exhale wouldn't be able to escape. So even if you were to have an equipment failure or power loss or something, there is no way that you can suffocate while wearing a CPAP mask.

And the experience can change quite a bit with a different style of mask. I ran a survey here and, so far, 41% of voters used nasal pillows, 28% used a full face mask, and 24% used a nasal mask. Personally, I used a Breeze nasal pillow system and the only points of contact are the bottom of my nose, the top of my head, and the back of my head and I feel no pressure from the mask at all.

When you get used to it you will find that it's easier to breathe deeply with the machine than without it and actually look forward to using it. It's a quiet little friend watching over us all night to help us out when we need it.

[Janknitz]

Janknitz, how long did it take for you to come out of claustrophobia?

I have to admit it took a few months, but that's because my untreated apnea was very severe for many years. I think about all those nights spent "bathing" in stress hormones, and I get that it took a while to reverse all of that.

One other thing I did was inspect my masks very carefully so I understood how the anti-asphyxiation valve worked. That way I knew (in my head at least) that I wasn't going to suffocate in a FF mask and in a nasal or nasal pillow mask all you have to do is open your mouth. And knowing where the CO2 vents are helps too, so you don't accidentally block them. Those gave me peace of mind, but part of my panic issues were physiological--it just took time.

[Raheel]

Thank you all. Last night I slept for the first time in a week with my machine on, for 5 hours. As suggested I put the mask on and started relaxing by watching TV for about an hour. I then went to bed with an attitude that I don't care whether I sleep or not but I will not be removing the mask and that helped. I firmly believe that all your replies having great tips helped me to achieve this milestone.