Do you ever have trouble pulling in air?

Brightcrow... again, what are your settings please - the pressure ones, not the ramp.

When I had my trouble due to the nasal pillows trying to climb up into the nostrils it was in the middle of the night and not the beginning of the night. Definitely not related to the pressures being used.

Now I don't know if you are experiencing what I experienced but if it's in the middle of the night after you have been asleep..it's unlikely related to the pressure being low. Would need to use the available software and see for sure what the pressure was doing at the time right before you took the mask off when you had a problem.

What I did to help determine what was happening was while awake I played with pushing the pillows up inside my nostrils a bit just to see if I experienced a reduction in air flow and I did and it was exactly like what was happening in the middle of the night.

What size of nasal pillow are you currently using?
It sounds like you might be more of an in between size. Wonder if we could add maybe a barrel cozy to either the current size or the larger size and make it work for you?

kteague wrote: ↑

Fri Apr 06, 2018 1:13 am

Since you describe this as being soon after dozing off, I have to wonder if it was during ramp time. Are you using the ramp feature? If so, you may want to consider if your ramp pressure needs increased. Not familiar with if your machine has a ramp that responds to needs or not, but even if so, too low a starting point can make it take a while to increase where to you need. Those who fall asleep quickly can be at a disadvantage if their ramp continues after they are asleep and begin having events. If this is not during your ramp time, I would wonder if your pressure is adequate.

Although I am very new to CPAP use and don't possess anywhere near the knowledge that many on here do I want to 2nd what kteague is saying. My first few nights on CPAP I was having the same problem so I tried increasing my starting ramp pressure. Voila! After a couple of tweaks, I no longer have this problem. It may not be the solution to what you are experiencing but it is worth a try. Good luck on getting this sorted out.

My minimum pressure is 4 and maximum is 10. Initially it was set to 4-16 but the doc let me lower it to 10 because I felt too much air in the night. The vendor read my statistics and said I never went above 10. It may have been my own naïveté of what air sensations were normal and which were a leak. That change was made in my first month or so.

Last night I noticed that even when I heard the air pushing loudly, my breath was still shallow until I consciously took a deep breath. Not sure if that’s typical on Ambien. But My Air score wa 100%.

I should mention that I’ve been using this autoPAP for 2 1/2 years. Initially a face mask was a bad choice by my doc, as it caused sores on the bridge of my nose. Ever since I have used p10s. The vendor selected size small, but I liked medium better.

Again, I appreciate you sharing your knowledge with me. I do not use Sleepyhead, too much going on in my life to learn new software.

Edited to add:
Ramp time Auto
Start pressure 4
EPR on
EPR type fulltime
EPR level 3

brightcrow wrote: ↑

Sun Apr 08, 2018 7:06 pm

My minimum pressure is 4 and maximum is 10. Initially it was set to 4-16 but the doc let me lower it to 10 because I felt too much air in the night. The vendor read my statistics and said I never went above 10. It may have been my own naïveté of what air sensations were normal and which were a leak. That change was made in my first month or so.

Last night I noticed that even when I heard the air pushing loudly, my breath was still shallow until I consciously took a deep breath. Not sure if that’s typical on Ambien. But My Air score wa 100%.

I should mention that I’ve been using this autoPAP for 2 1/2 years. Initially a face mask was a bad choice by my doc, as it caused sores on the bridge of my nose. Ever since I have used p10s. The vendor selected size small, but I liked medium better.

Again, I appreciate you sharing your knowledge with me. I do not use Sleepyhead, too much going on in my life to learn new software.

Edited to add:
Ramp time Auto
Start pressure 4
EPR on
EPR type fulltime
EPR level 3

I think a minimum of 4 cm is too low for almost anybody, and will give you the "trouble pulling in air". At 4 cm all the pressure developed by the machine is lost in flow friction. If you feel 10 is the most you need for a maximum, then I would set the minimum at 6 cm, leave the Ramp in Auto, and set a Ramp Start (Pressure) at 5 cm. A 6 cm pressure is not very high, so the other option to try is simply shutting the ramp off and letting it start out at the 6 cm minimum.

RaIse the 4 to 6 or 7 (possibly even more in the future, but not yet) - no wonder you can't breathe!

brightcrow wrote: ↑

Sun Apr 08, 2018 7:06 pm

My minimum pressure is 4 and maximum is 10. Initially it was set to 4-16 but the doc let me lower it to 10 because I felt too much air in the night. The vendor read my statistics and said I never went above 10. It may have been my own naïveté of what air sensations were normal and which were a leak.

Last night I noticed that even when I heard the air pushing loudly, my breath was still shallow until I consciously took a deep breath. Not sure if that’s typical on Ambien. But My Air score wa 100%.

I should mention that I’ve been using this autoPAP for 2 1/2 years. Initially a face mask was a bad choice by my doc, as it caused sores on the bridge of my nose. Ever since I have used p10s. The vendor selected size small, but I liked medium better.

Again, I appreciate you sharing your knowledge with me. I do not use Sleepyhead, too much going on in my life to learn new software.

Edited to add:
Ramp time Auto
Start pressure 4
EPR on
EPR type fulltime
EPR level 3

With very little effort you can learn what you need to know. And this forum will help you. 2&1/2 years of PAP and still have no time to learn what you need to learn???

brightcrow wrote: ↑

Thu Apr 05, 2018 8:48 pm

I’ve had this happen a few times, again last night, no congestion or cold. Last night it was when I was just dropping off to sleep (Ambien) following a comfortable few minutes of doing puzzles while wearing my mask. I found myself having to work way too hard to get air. I repeatedly struggled to get enough breath in, then would begin to drift off, again and again until I realized something was wrong and woke up. I took off my mask, walked around and drank water, put the mask back on then fell back to sleep. No idea if it I slept through the bad breathing or if it improved.

Another oddness, I occasionally have apnea events that wake me powerfully, with near panic and pounding heart as if my autoPAP wasn’t pushing air as I would think it should.

Most of the time it works well as far as I know. Does any of this sound familiar to you?

Your minimum pressure is too low, and it sounds like you treatment is FAR from optimized. Fixing it is not hard.

brightcrow wrote: ↑

Thu Apr 05, 2018 8:48 pm

I’ve had this happen a few times, again last night, no congestion or cold. Last night it was when I was just dropping off to sleep (Ambien) following a comfortable few minutes of doing puzzles while wearing my mask. I found myself having to work way too hard to get air. I repeatedly struggled to get enough breath in, then would begin to drift off, again and again until I realized something was wrong and woke up. I took off my mask, walked around and drank water, put the mask back on then fell back to sleep. No idea if it I slept through the bad breathing or if it improved.

Another oddness, I occasionally have apnea events that wake me powerfully, with near panic and pounding heart as if my autoPAP wasn’t pushing air as I would think it should.

Most of the time it works well as far as I know. Does any of this sound familiar to you?

I tried the P10 mask and Medium pillows were recommended. I could not get enough air with Medium and I switched to Large which was more comfortable because it had larger air holes. After a few days I reverted to my Quattro FF mask.

Thank you so much for your help. Is my APAP supposed to make shallow breathing deeper? This is my main problem, shallow breathing, low oxygen. I use Ambien which contributes to that, but is necessary because it calms my severe Periodic Limb Movement Disorder at night.

Edit: I do think the difficulty pulling in air has to do with my pillows going in too deep sometimes, and it occurs only occasionally, not nightly. I'm still experimenting with using less lanolin at the edges of my nostrils so it's not unintentionally lubing the pillows.

Which of my 2 issues in the OP would increasing the pressure be helping? Or both? And should I increase the max pressure too? Does EPR fit into this?

@TedVPAP: I'd assumed my machine would compensate for my needs automatically. That's how it was presented to me. I check My Air daily and clean my equipment precisely on schedule. I spend more time on my APAP than I do with my beloved cat. I call it my other pet. I chose not to dive into the rabbit-hole of data because I don't want my machine to dominate my mental space any more than it already does. Please don't judge me.

Ron AKA wrote: ↑

Sun Apr 08, 2018 7:23 pm

I think a minimum of 4 cm is too low for almost anybody, and will give you the "trouble pulling in air". At 4 cm all the pressure developed by the machine is lost in flow friction. If you feel 10 is the most you need for a maximum, then I would set the minimum at 6 cm, leave the Ramp in Auto, and set a Ramp Start (Pressure) at 5 cm. A 6 cm pressure is not very high, so the other option to try is simply shutting the ramp off and letting it start out at the 6 cm minimum.

I will try this tonight. Thanks.

brightcrow wrote: ↑

Sun Apr 08, 2018 8:53 pm

Thank you so much for your help. Is my APAP supposed to make shallow breathing deeper? This is my main problem, shallow breathing, low oxygen. I use Ambien which contributes to that, but is necessary because it calms my severe Periodic Limb Movement Disorder at night.

Which of my 2 issues in the OP would increasing the pressure be helping? Or both? And should I increase the max pressure too? Does EPR fit into this?

How long is the ramp time? I typically do puzzles (with my mask on) for about 15 minutes before closing my eyes for sleep. Would an increased ramp minimum be uncomfortable during my awake time?

@TedVPAP: I'd assumed my machine would compensate for my needs automatically. I check My Air daily and clean my equipment precisely on schedule. I spend more time on my APAP than I do with my beloved cat. I call it my other pet. I chose not to dive into the rabbit-hole of data because I don't want my machine to dominate my mental space any more than it already does. Please don't judge me.

Not judging you. I am just trying to make it perfectly clear that your treatment is inadequate. The time you are spending caring to APAP is not helping you. A little bit of guided effort will help you. Your assumption regarding your machine is incorrect - that is why there are settings which must be adjusted based on your needs. I don't want data dominating you mental space either. Nobody is suggesting that.

brightcrow wrote: ↑

Sun Apr 08, 2018 9:23 pm

Ron AKA wrote: ↑

Sun Apr 08, 2018 7:23 pm

I think a minimum of 4 cm is too low for almost anybody, and will give you the "trouble pulling in air". At 4 cm all the pressure developed by the machine is lost in flow friction. If you feel 10 is the most you need for a maximum, then I would set the minimum at 6 cm, leave the Ramp in Auto, and set a Ramp Start (Pressure) at 5 cm. A 6 cm pressure is not very high, so the other option to try is simply shutting the ramp off and letting it start out at the 6 cm minimum.

I will try this tonight. Thanks.

Do you know how to make this change? This is not simply changing the ramp.

Your A or Cpap responds to how you breathe but does not breathe for you or change how you do it. You really need to understand what Apaps are for and you could look at the info notes at the top of the main page... it's really so basic - Cpap vs Apap. You should have been told exactly what the different machines do for you.

TedVPAP wrote: ↑

Sun Apr 08, 2018 9:32 pm

brightcrow wrote: ↑

Sun Apr 08, 2018 9:23 pm

Ron AKA wrote: ↑

Sun Apr 08, 2018 7:23 pm

I think a minimum of 4 cm is too low for almost anybody, and will give you the "trouble pulling in air". At 4 cm all the pressure developed by the machine is lost in flow friction. If you feel 10 is the most you need for a maximum, then I would set the minimum at 6 cm, leave the Ramp in Auto, and set a Ramp Start (Pressure) at 5 cm. A 6 cm pressure is not very high, so the other option to try is simply shutting the ramp off and letting it start out at the 6 cm minimum.

I will try this tonight. Thanks.

Do you know how to make this change? This is not simply changing the ramp.

To make treatment changes, access to the clinician menu is needed. I don't have your machine but I have the manual. It says to depress the knob and home button together for 3 seconds and that should unlock the machine so you can change the minimum pressure setting.