Still cannot breathe while sleeping

Pressure is 5-15. A few hours into sleep I have to take the mask off because I'm just not getting enough air. Both inhalation and exhalation feel difficult and like not enough air. This is happening on my stomach and side where I only have very mild OSA - if that. I mostly need CPAP when on my back.

Is this the price I have to pay to be able to sleep on my back sometimes, which is when I really need the CPAP? I do have to back-sleep sometimes for various reasons.

A friend told me yesterday that he has never had such a good night's sleep with his new CPAP. He read about it. So why am I struggling to breathe so badly? Shouldn't I love my sleep too? Shouldn't my breathing be deep and delicious and comfortable? Or is CPAP never like that?

Hopefullady wrote:Pressure is 5-15.

Anything below 7 pressure gives me the feeling that I am not getting enough air. Why not raise your minimum pressure to 7 or higher?

Hopefullady wrote:Shouldn't my breathing be deep and delicious and comfortable?

I get that feeling with pressures of 10 and up.

Is the full face mask necessary because you are a verified mouth breather? It may be claustrophobia rather than actually not getting enough breath. However, 5 is a little low, and you may do better to bump it up a little.

I use ramp-only EPR of 3 with a pressure of 8. My ramp is set to auto so it goes into therapy mode one minute after my breathing indicates I am about to fall asleep (my pressure is 9). Others may knock the ramp, but auto-ramp on my machine is extremely accurate. I find this provides very comfortable breathing while I am awake. If I have a longish awakening, and the exhalation effort starts to get hard again, I just reset the machine so the ramp starts again.

Edit:

On your machine, EPR is called Flex. Not sure if you can make it ramp only. Auto-ramp is called Smart-ramp.

ChicagoGranny wrote:

Hopefullady wrote:Pressure is 5-15.

Anything below 7 pressure gives me the feeling that I am not getting enough air. Why not raise your minimum pressure to 7 or higher?

Hopefullady wrote:Shouldn't my breathing be deep and delicious and comfortable?

I get that feeling with pressures of 10 and up.

Ah. Thanks. That's what I thought. Raising bottom number only, right?
My doctor is wonderful but his staff is unresponsive. Almost always. I also would like to change the pressure ASAP. I've seen others talk about how to do it. Are there instructions you can point me to, Granny?

WindCpap wrote:Is the full face mask necessary because you are a verified mouth breather? It may be claustrophobia rather than actually not getting enough breath. However, 5 is a little low, and you may do better to bump it up a little.

I use ramp-only EPR of 3 with a pressure of 8. My ramp is set to auto so it goes into therapy mode one minute after my breathing indicates I am about to fall asleep (my pressure is 9). Others may knock the ramp, but auto-ramp on my machine is extremely accurate. I find this provides very comfortable breathing while I am awake. If I have a longish awakening, and the exhalation effort starts to get hard again, I just reset the machine so the ramp starts again.

Edit:

On your machine, EPR is called Flex. Not sure if you can make it ramp only. Auto-ramp is called Smart-ramp.

Thanks. I'm okay with the idea of having the mask on.
I put the Flex from 2 to 3 (that's the highest it goes).
I'm not very up with all this terminology yet, but are you saying i could either do away with ramp and start higher, or maybe even tech over and hit the ramp button when I feel stifled? If I do the latter it will just happen again though.

You can go here and find the instructions for how to change the pressure (needs to be done in the clinical setup menu) on your machine.
While there you might scroll down to the bottom of the page and see how to request the provider/clinical manual for your machine via email. That manual explains how to get to the setup menu area along with a lot of other useful information that may not be in the user manual.

http://www.apneaboard.com/adjust-cpap-p ... tup-manual

I second the idea of changing the minimum pressure (leave the maximum alone) in hopes of alleviating the difficulty breathing sensation.
A long time ago I did a DIY trial with my sister to screen her for OSA with my machine and I started the pressure at 5 cm and about 30 seconds into things she yanked the mask off and said I was trying to kill her by suffocating her. It wasn't until we changed the starting pressure to 6.5 cm that she was comfortable with the breathing both inhale and exhale and lost the uncomfortable breathing feeling.

And if you are using ramp...don't unless you change the ramp starting point...default ramp starts at 4 cm and will make things worse when a person is having trouble getting comfortable with the breathing.

We gotta be comfortable to get relaxed so we can go to sleep...no comfort means no sleep to me.
No matter what is causing the discomfort.

Hopefullady wrote:I put the Flex from 2 to 3 (that's the highest it goes)

When you start at 5 cm Flex doesn't even engage at all...so it's irrelevant what you have it set to.
For Flex to engage or be turned on the pressure has to be at least 6 cm.

Flex...it's as much about timing of the reduction during inhale/exhale as it is the actual reduction.
The most reduction you can get is 2 cm at the setting of 3...I know it makes no sense but that's the way it is.
And the amount of reduction is flow based which means it's based on the force of your own breathing.
If you tend to be a rather shallow breather you won't get the full 2 cm reduction at a setting of 3.
Flex relief does not work the same as the EPR exhale relief does on the ResMed machines. It's not a direct per cm reduction per setting like ResMed machines.

What I usually suggest to people is that they try all the Flex settings and even turn it off...and you have to have the minimum pressure be set to at least 6 cm to test things. There is a demo available (explained in that manual I mentioned above) to make it easy to experiment.
Test all settings and choose the setting that seems to fit your own breathing pattern the best and is the most comfortable to you...regardless of the number of the setting.

Back years ago I tried CFlex...didn't really think it did much so I turned it off but when I got a machine that had AFlex I tried it and low and behold I discovered that AFlex setting of 2 made it feel like I wasn't even using a machine (minimum pressure was 10 cm at that time) and was amazingly comfortable.
I found that a setting of 3 made me feeling like I was breathing a bit too fast...and a setting of 1 made me feel like I was breathing slower than I wanted. That's the timing factor I mentioned...it's subtle but there.
Now your breathing force and rate may not be like mine so that's why I suggest people explore all the settings including the off setting to see what feels the best to them.

Ramp on your machine...really only useful if your starting pressure needed to be much higher.
Though one thing about ramp on the Respironics machines...in auto mode if you have an apnea warning sign or event it will increase the pressure to at least the minimum pressure and try to prevent further events.
But if the starting minimum is too low it really isn't going to go very far and may not be optimally effective.

If you are having trouble breathing at 5 cm...you sure aren't likely to be comfortable at 4 cm ramp starting point. Either don't use it or start the ramp higher (you can do that).

Play with the pressures while awake and under no stress to "get to sleep".

Wow, thanks Pugsy. You've given me some good assignments for the day

Ever since my last changes to the settings I have been sleeping like I don't have any memory of doing before. Total bliss.

Lots of changes, 2 machines, 2 sleep studies, referred to a pulmonologist and FINALLY sleeping through the night.

Suggestions:
1. play with all the comfort settings to find what you like
2. keep a journal so you remember what settings made you feel how
3. sometimes small changes are better, starting pressure for me is 5.6-5.8, it can be that sensitive
4. settings that are fine while awake and resting, may need further adjustment for when you are asleep
5. for me a headgear strap adjustment of 1/8" can cause or stop leaks

Never give up, never surrender! Own your therapy!

PoolQ wrote:Ever since my last changes to the settings I have been sleeping like I don't have any memory of doing before. Total bliss.

It might be interesting to know your before and now settings.

The therapy pressures have never changed, it was all comfort settings and ALL of those have changed from the default settings.

I am on BiLevel and it felt like my breathing was being cutoff, changed T1 to 3.4 seconds and then the machine was fine. I breathe pretty slow when asleep.

Still had problems getting and staying asleep. Turns out I have COPD (mild) on top of Sleep Apnea (moderate) and once BOTH were being treated then the bliss came

I kept a journal for weeks and some settings effected others that then had to be re-tweaked.

Pretty sure the comfort settings are quite personal as to what you feel best with, so my personal settings would not be much use to anyone else- adjust them all.

Adjust ONE thing at a time and try that change for several days.. then if that hasn't worked tweak another setting. If you start changing things too quickly, you will only frustrate yourself and make things worse. If I were to do that, I would never remember what I changed and from what to what. Keeping a journal is a very good idea, that way whenever you have the same problem further down the road, you can look back and see what you did
Good luck
Nan

Thank you all very much.
I got into clinical settings and raised that bottom pressure!!

Will start a new thread with new questions.