Newbie needs help

I just had my fourth night with my CPAP machine and I could not feel worse. I feel more worn out and exhausted now than I did before I started. I don't know if it's just an adjustment time? But I feel I am struggling with the nose pillows. When I have them on, I feel, at times, it's harder to breathe. I feel like I'm breathing through cotton. But sometmes I lie quietly and feel like I'm breathing quite normally. But at times I feel I'm struggling to breathe, and I have to open my mouth and feel I need to take a deep gulp of air before I close my mouth again. I don't understand how it can be so inconsistent? Also, last night at times I heard a knocking sound coming from my nose piece. Can't figure out what that is? And about five this morning I felt like I was jolted awake. I looked at my pressure and it was is up 11.1. I felt panicky and don't know why. I felt need to pull the mask off. I also had a headache. I have the automatic ramp that starts at four. A couple of the nights when I woke it was at 9. Was I getting too much pressure? Because I would think I would need it if it was being given to me. Well, I'm feeling confused and a little scared and unhappy. I also am feeling a great deal of anxiety about all this today.. Any suggestions?

What size nasal pillow are you using?
Try the next size larger.

I had some similar issues with the P10 in the extra small size (where sometimes I would fee suffocated and sometimes it was fine and I wasn't using ramp or lower pressures). The extra small was trying to climb up in my nostrils just a little bit (too good of a seal I guess) and the pillows were compressing/collapsing making it feel like not enough air was moving. Changed to the Small size and it never happened again.
With all the various nasal pillow masks I have used I was always able to use both the Xtra Small and the Small but with the P10 I have to use the Small and the Medium.

Also...if you are using 4 cm ramp pressure...that also can contribute to the "lack of air movement" thing. We won't suffocate at 4 cm but it can sure feel like we are. If that's what's going on with you then maybe start the ramp at 5 or 6 might be better way to start the night.

Wear the mask (with machine on) while watching TV or reading when you are under no pressure to "get to sleep". This will allow your brain to become better friends with the new guy on your face and hopefully the brain will help to minimize the anxiety issues.

Are you waking often during the night? If so, any idea why?
How many hours are you using the machine/mask each night?

Use available software to see exactly what your machine is doing during the night.

https://sleep.tnet.com/equipment

Also, what are your minimum and maximum pressures set to? Again if the minimum is 4 (the lowest), you may consider increasing it. You'll need the clinical manual to make those adjustments, someone will give you a link to it.

I agree with Pugsy. 1) raise the minimum pressure a bit; 2) try the next size up in nasal pillows. Make sure they are inflating at the edge of your nose/nares, not inside your nostrils.

I am experiencing the same symptoms after just a few weeks with my APAP. I never had headaches prior to therapy and now can't make it more than 3-4 hours with my nasal pillows/Resmed before awakening with a anxious, dull headache. Now, I can add insomnia to the my problem list ... This is hell. I'm grateful to the suggestions as well regarding the nasal pillow size. I'll go try the larger size before giving this machine back and learning to sleep on my stomach with a cervical collar... I'll post my own update if that helps.

Oh, I might add that I had to eliminate "ramp time" as i felt I was suffocating on the '4' setting so the machine now jumps right up to my range, which I believe is between 8-12. This allows me to begin my lousy 3-4 hours of sleep even sooner ...

JustinTime wrote:Oh, I might add that I had to eliminate "ramp time" as i felt I was suffocating on the '4' setting so the machine now jumps right up to my range, which I believe is between 8-12. This allows me to begin my lousy 3-4 hours of sleep even sooner ...

What machine are you using? Please add equipment to your profile. Why are you unsure of your pressures? You need to know this.
If your pressure range is 8-12, we can only tell if this needs adjusting if you make an effort to supply some data using Sleepyhead.
It can take time adjusting to CPAP and wearing a mask however, many find that it helps them to adjust by running the machine while watching TV or reading.