First Night Troubles

Hi all. Finally giving my CPAP an honest, good try. Sleeping on back is my only option due to body pain. I had been awaking "choking" while breathing out, without CPAP.

Philips Respironics dreamStation and full-face mask arrived today. Is set for 5-15. Used it last night as shown, was comfortable on my back, but awoke after 1.5 hours feeling extremely scared, startled, and as thought I couldn't get air...or something. Quickly ripped off mask, I think so I could breathe, and tossed mask on floor in anger and frustration (sorry, mask).

Is this normal? (Not my behavior; my experience - lol).

Looked at the info on machine. This is what it says:

AHI: 2
Mask Fit: 100%
90% pressure: 8.0

I can sleep fine on stomach and side; no breathing issues that I'm aware of, and did so for years, maybe to "manage" sleep obstruction. But I've developed a fibromyalgia-type of body pain and side sleeping is not an option and at 50 my spine can't take much more stomach sleeping, so I have to sleep on back now. Doc says I have OSA and it's mild, but my sleep study was short and unthorough (I believe).

Anyway, what do my numbers tell you?
Is my experience common, waking up in that state?

It's 3am and I'm going to give it another try soon.

Any thoughts are appreciated. Thanks.

We hear stories like yours fairly often.

The numbers don't tell us much especially for just 1.5 hours of sleep. A few guesses about what woke you up:

~ You had an apnea event.

~ You're sensitive to pressure fluctuations -- 5 to 15 is a wide pressure range and perhaps a pressure swing woke you up.

~ Your body doesn't like low pressure -- many people feel like they're not getting enough air at those low pressures like 4 and 5. You might have been struggling with being at a low pressure at the time you woke up feeling like you couldn't get enough air.

Either tonight before you head back to bed, or tomorrow, sit awake with the mask and machine on, and see how 5 really feels. If it's uncomfortable while you're awake, chances are your asleep self won't like it either.

Tell yourself you're going to be OK, you just need some time to get adjusted and do some fine-tuning. And try, try again.

Thanks, Kaia. So this could be about me not getting enough pressure during an apnea event for the machine to do its job, or enough air altogether? Can you expand on those ideas?

Can you explain how "pressure swings" could have woken me up like that?
Thanks

One night is hardly an honest, good try. This is a complicated affliction and finding the right solution FOR YOU takes time and dedicated effort. IF this is going to work for you, you have to be patient and willing to give it time dedicated effort.

After my first week, I was ready to smash my machine with a hammer, but I got over it because I knew that I was suffocating in my sleep and suffering a lack of oxygen that made me feel like I had a hangover from too much booze. Was six weeks into it before I found adjustments that suited me, and only me. People could give me advice, but I had to make the effort to find the solutions.

I'm only 1 week in, and just now found the right mask. I still haven't let it on a full night. I felt suffocated during my exhales, my supplier didn't explain that my machine could be set so the pressure coming at me during exhiles can be adjusted. Once I called and talked to them, and they told me how to adjust that it's been so much better. Not sure if that could be one of your issues? This has all been a pain and such a learning experience. I have 3 friends who recently got machines and loved everything from the get-go, I was hating them! Have found that they are the rarity though and that helps.

blownaway wrote:One night is hardly an honest, good try. This is a complicated affliction and finding the right solution FOR YOU takes time and dedicated effort. IF this is going to work for you, you have to be patient and willing to give it time dedicated effort.

After my first week, I was ready to smash my machine with a hammer, but I got over it because I knew that I was suffocating in my sleep and suffering a lack of oxygen that made me feel like I had a hangover from too much booze. Was six weeks into it before I found adjustments that suited me, and only me. People could give me advice, but I had to make the effort to find the solutions.

Are you implying I'm "not honest" or "not good"?
One night may be an incomplete assessment, but that's about it.

I understand quite well that this is a tough illness. Maybe you could have explained the "why" of your opinion. Then maybe a lying, bad, unwilling dolt like me can understand (?)

In any event, just heard from my DME who did that (I think - understanding I have little experience up to now....)

He says what I experienced last night was probably my not being used to the pressure forced into my body by the machine as it tried to work with a breathing event I was having.

He described it like this: if you're driving down the street with your head out the window, it's going to feel stifling. But if you do it for 3 or 4 weeks, your body (breathing against the wind) will get used to it.

He's not one of us but he's done this for 20 years so I'm going to trust his explanation, which makes good sense, and keep at this, unless anyone else has anything else to add that could help.

Thanks

Michelle-OH wrote:I'm only 1 week in, and just now found the right mask. I still haven't let it on a full night. I felt suffocated during my exhales, my supplier didn't explain that my machine could be set so the pressure coming at me during exhiles can be adjusted. Once I called and talked to them, and they told me how to adjust that it's been so much better. Not sure if that could be one of your issues? This has all been a pain and such a learning experience. I have 3 friends who recently got machines and loved everything from the get-go, I was hating them! Have found that they are the rarity though and that helps.

Thanks Michelle. I wish I had seen your post before I talked to my supplier just now...I will call them back and ask if I should or can adjust that!

We do get used to the pressures. Some people take longer to make the adjustment than others.
What feels like hurricane force winds eventually become nothing but a gentle breeze and you may wake up in the middle of the night thinking your machine isn't even on and it is and still blowing those winds but they don't seem like such big winds anymore.

Give yourself some time to get adjusted to all this. Let's face it...sleeping with an alien strapped to our face and blowing winds up our nose or in our mouths just isn't a "normal" way to sleep.
It will get easier with time and experience though.
You might take some time to use the mask and machine while reading a book and watching TV...it will help speed up the adjustment process and you won't be under the gun to actually fall asleep.

Hi Pugsy

Well the odd thing is, I fell asleep like a baby, and this happened 1.5 hours into sleeping. My Resp Ther from the DME thinks it was due to the machine sensing I had a breathing event, and so the machine worked harder to compensate and do its job. Could the machine have worked too hard? And if so, should I ask for something to be adjusted?

Thanks

Hopefullady wrote: Could the machine have worked too hard? And if so, should I ask for something to be adjusted?

They don't really "work too hard" but depending on the settings chosen and what is going on the changes may have been the cause of the wake up. Meaning that whatever work the machine is doing could be disrupting sleep..or heck, maybe some sort of sleep apnea event slipped past the defenses and that's what woke you up.

This is where the software reports could maybe be useful in helping to figure out what happened both with the pressure and with the events.

It's really hard to hazard much of a guess with only 1.5 hours to work on but it might have been REM stage sleep going on. The first REM stage normally happens about 90 minutes after sleep onset and often our OSA is worse in REM sleep or maybe needs more pressure in REM sleep.
It is also common to wake up briefly at the end of a REM stage...so it might have been that normal wake up which could maybe have contributed to things.

So there could have been any number of things happening and we might not even know for sure using the software. We really need more sleep sessions to get an idea what is happening consistently.
Was it a pressure increase? Maybe..maybe not. Was it an apnea event that slipped past the defenses? Maybe...maybe not. Was it related to a normal end of REM sleep wake up? Maybe..maybe not.

There is software now so that we can see exactly what might have been happening in the time just before the wake up....but in all honesty one 90 minute sleep session is unlikely to shed a whole lot of light on things but there's always the chance it might.
You will need Encore Pro 2.17.8 (shortened to 2.18 at some places) to have any chance of figuring out what might be going on and you need more nights and hopefully longer sleep sessions to stand much chance of isolating the cause.

It could also simply have been the brain deciding to wake you up with the "hey dude, do you know there is an alien sitting on your face". I had a lot of those awakenings when I first started cpap therapy. It took quite a while (even with optimal therapy confirmed by software reports) for the brain to quit alerting me to the thing on my face.

When you feel ready for the software send me a private message...while Pro can be a bitch it can be managed and since it is the only software right now that will work with the new Dream Station machine (which I think I read that you have) it is the only game in town right now.

If I am wrong and you have something other than the new Respironics DreamStation then SleepyHead is probably a better software choice.

Pugsy:

THANK YOU.

Yes, I remember instinctively knowing it had to do with REM sleep which is why "practicing" or "getting used to" the machine today while I watch TV or read wouldn't help what happened last night.

I was very comfortable with the mask.

I was told by doc's office just now that when on my back, of course the need is stronger but not to adjust the machine; if anything elevate myself a bit (I've looked into how to do this right too).

Docs office and I will be looking at data in a few days. Until then I will keep trying and making these small changes if necessary until I get it right. And thank you for the offer of the data info...I will probably PM you about this soon. For the rest of today? I'm gonna go relax (whew!)