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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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InnerGlow
 
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Trouble breathing when I first lie down

Postby InnerGlow on Sun Dec 03, 2017 3:30 pm

I've been gradually solving the issues that have arisen with me using the CPAP, but there's one issue I can't seem to fix. When I first lie down at night with the CPAP on, I feel like I can't breathe/am short of breath/can't get enough air (to the point where I'm afraid I'll lose control of my bladder). This lasts for a couple minutes as I try to relax and slow down my breathing. Sometimes I'm able to work through it and then the rest of the night is fine. Other times I end up taking the mask off, catch my breath, and then I try again. Occasionally, I don't have this issue when I lie down, but I'm unable to figure out why those times are different.

I don't think the problem is that the starting pressure (6.5) is too low. When I first put the mask on at night, I'm sitting on the bed. I sit with it on for about 5 minutes while I get used to breathing with it before I lie down. During that time I don't have any trouble breathing, and after the initial lying down, I don't have trouble breathing.

Anyone have any suggestions?

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Goofproof
 
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Re: Trouble breathing when I first lie down

Postby Goofproof on Sun Dec 03, 2017 4:07 pm

Do you use the "Ramp" (Feature?)? If so turn it off. 6.5 is a low pressure, maybe it too low for you. Jim

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Re: Trouble breathing when I first lie down

Postby Wulfman... on Sun Dec 03, 2017 4:51 pm

Suggestion:
Increase minimum pressure.


Den

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InnerGlow
 
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Re: Trouble breathing when I first lie down

Postby InnerGlow on Sun Dec 03, 2017 4:56 pm

Do you use the "Ramp" (Feature?)?


No, haven't used the ramp feature since the first few days when I found it useless (it was set to 4!).

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Machine: DreamStation Auto CPAP Machine
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Humidifier: DreamStation Heated Humidifier
Additional Comments: Min 7 cm / Max 20 cm

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Goofproof
 
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Re: Trouble breathing when I first lie down

Postby Goofproof on Sun Dec 03, 2017 5:06 pm

InnerGlow wrote:
Do you use the "Ramp" (Feature?)?


No, haven't used the ramp feature since the first few days when I found it useless (it was set to 4!).


I never used it, I need air, in that case I'd up the air pressure, I don't know your mask, maybe if it uses has other air Prongs or pillows with it the move more air. Jim

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TedVPAP
 
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Re: Trouble breathing when I first lie down

Postby TedVPAP on Sun Dec 03, 2017 5:35 pm

I feel this way some times. What I do is to increase my breathing rate but make it shallow for about 10 seconds, then I relax and start saying my prayers. Among other benefits, praying occupies my mind so my breathing can naturally stabilize.

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Re: Trouble breathing when I first lie down

Postby lilly747 on Sun Dec 03, 2017 5:43 pm

TedVPAP wrote:I feel this way some times. What I do is to increase my breathing rate but make it shallow for about 10 seconds, then I relax and start saying my prayers. Among other benefits, praying occupies my mind so my breathing can naturally stabilize.



I had this problem when I first started using cpap and over time I learned to relax and it just went away.

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Re: Trouble breathing when I first lie down

Postby Janknitz on Sun Dec 03, 2017 6:42 pm

Is it just for the first 10 - 20 seconds or so? My machine is set with no ramp, but it doesn't come on full blast like my older PRS1. It takes 10 or 20 seconds to get to full pressure and I feel like I'm suffocating for just that little while.
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Neicy
 
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Re: Trouble breathing when I first lie down

Postby Neicy on Sun Dec 03, 2017 7:42 pm

I was suffocating when My doc started me 6-12. Try 8 minimum.
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TedVPAP
 
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Re: Trouble breathing when I first lie down

Postby TedVPAP on Sun Dec 03, 2017 8:07 pm

InnerGlow wrote:I've been gradually solving the issues that have arisen with me using the CPAP, but there's one issue I can't seem to fix. When I first lie down at night with the CPAP on, I feel like I can't breathe/am short of breath/can't get enough air (to the point where I'm afraid I'll lose control of my bladder). This lasts for a couple minutes as I try to relax and slow down my breathing. Sometimes I'm able to work through it and then the rest of the night is fine. Other times I end up taking the mask off, catch my breath, and then I try again. Occasionally, I don't have this issue when I lie down, but I'm unable to figure out why those times are different.

I don't think the problem is that the starting pressure (6.5) is too low. When I first put the mask on at night, I'm sitting on the bed. I sit with it on for about 5 minutes while I get used to breathing with it before I lie down. During that time I don't have any trouble breathing, and after the initial lying down, I don't have trouble breathing.

Anyone have any suggestions?


I am interpreting this to mean that you have the machine on so you are at pressure - correct?
When sitting there your breathing rate is slower and deeper than when you are normally awake. When falling asleep, the breathing rate needs to increase (and become more shallow). My data shows that it takes me about 4 minutes to transition from a respiratory rate from 10 to 16. I suggest laying down and being ready to sleep and then turn the machine on.

There is confusion as to whether you are uncomfortable when you first lay down, or later after you started to sleep. If the problem occurs when you are sleeping, then your pressure is likely off. Post data using the three links below would help us understand if your pressure settings are correct.

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Last edited by TedVPAP on Sun Dec 03, 2017 8:47 pm, edited 1 time in total.
Use data to maximize your xPAP treatment:
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chronic
 
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Re: Trouble breathing when I first lie down

Postby chronic on Sun Dec 03, 2017 8:23 pm

Your low is too low and the high is too high. Someone will come on here soon an get you lined about, but, my guess is you should set the low to about 11 and the high at 15. You have way, way too much swing for the machine to handle appropriately. That is NOT the way to have it set up.

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JimW159
 
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Re: Trouble breathing when I first lie down

Postby JimW159 on Mon Dec 04, 2017 2:01 pm

How frequently do you look at your actual usage pattern with SleepyHead or Encore (if that is still useful with DreamStation)? While the machine may be set at 6.5cm min to 20cm max, that doesn't show you what mask pressures are actually being produced in response to any events that call on added pressure to clear/eliminate/prevent. Until you know what actual pressures are useful in your therapy, you have no idea of what is the 'right way' to set up your pressure range.

Among the many influences contributing to discomfort and breathing restrictions when lying down is body type. Persons who have a large upper body and heavy chest but a relatively weak diaphragm muscle may well feel like they are suffocating when lying down. I know I felt that way virtually every day for more than a month while undergoing guided x ray therapy for prostate cancer where I had to lie perfectly still for a few minutes on a stiff platform - the pressure on my chest definitely made the experience uncomfortable at best.

Regarding xPAP, in my case I have set the ramp to auto and it ramps up to the starting pressure (9cm) very quickly - a matter of a few seconds or so. When I first lie down I take several deep breaths and try to clear my mind and relax. I have discovered the worst time to think about projects, tasks, problems, or anything else that requires detailed thought or visualization is when I am trying to go to sleep. This is where my wife and I are in disagreement: she likes to fall asleep listening to stories on TV, I prefer innocuous elevator music that triggers no emotion or thought. Somehow we have worked it out so we both get the sleep we need.

Good luck finding your own sleep sweet spot.

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Re: Trouble breathing when I first lie down

Postby Pugsy on Mon Dec 04, 2017 6:23 pm

I would NOT advise raising the minimum pressure to 11 as someone suggested without proof of need meaning an AHI that was too high and pointing to more pressure being needed.
Just because a machine can go to 20 doesn't necessarily mean that it will go to 20 ...for all we know your machine may never even go over 10.

Have you tried a starting minimum of 7 cm just in case it is just the lack of air movement that is sometimes causing the difficulty?
Just to try it to see???

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InnerGlow
 
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Re: Trouble breathing when I first lie down

Postby InnerGlow on Tue Dec 05, 2017 4:42 pm

I tried raising the minimum pressure to 7 for the last two nights and it helped. Thanks all for the advice about that.

As far as lowering the maximum pressure, it's my (newfound) understanding that the reason for this is sleep quality, so that you don't wake up from the pressure jumping up. Is that correct?

What is the best way to determine the correct maximum pressure? Do I just gradually lower it as long as my AHI is good? Do I set it based on my history (i.e. Sleepyhead data)?

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Pugsy
 
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Re: Trouble breathing when I first lie down

Postby Pugsy on Tue Dec 05, 2017 5:18 pm

If you are sleeping decently and don't seem to be waking because of the variations in pressure and you aren't having in air in the belly (aerophagia) issues then there isn't any urgent need to do anything with the maximum pressure.

You can use available software to see how high it is going if you want to but having a maximum higher than it ever goes hurts nothing.
Doesn't affect response or anything like that. Years ago the older machines used to chase leaks with more pressure and sometimes cause some runaway pressures but nowadays with these new machines they don't do that with large leaks and in fact will most often back off on the pressure.
Just because it can go higher doesn't mean it will.

Don't know about the software??
https://sleep.tnet.com/equipment

Sometimes I need much higher pressures in REM ...up around 16 or 18 but this is only in REM. The changing pressures don't wake me up and don't cause aerophagia issues so I just set the max at 20 and let the machine sort it out. Some nights it might hit 18...some nights maybe 12.
There's no urgent need to set the machine to 18 because it changes nothing in terms of how it responds except where it can go to.

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