Claustrophobia and CPAP use

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Claustrophobia and CPAP use

Post by breaker » Wed Jan 19, 2011 6:37 pm

I tried to use a CPAP unit, but found that I was claustrophobic and got anxiety attacks. Anyone else have a similar reaction?

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Hueffenhardt
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Re: Claustrophobia and CPAP use

Post by Hueffenhardt » Wed Jan 19, 2011 6:50 pm

You might try wearing it during the day, with the CPAP machine on, for a little while at a time.

I am a psychologist by training, but a statistician by employment. Anyway, phobias can be treated very well through systematic desensitization. Think of your anxiety lying on a scale, where 0 is no anxiety at all and 10 is the most anxiety you can imagine. Now identify something you can do with the mask that would bring your anxiety up to about a 4, where it is somewhat uncomfortable, but still manageable. Maybe sitting with the mask in your hands raises you to a 4, or maybe it is holding the mask close to your face, or maybe it is wearing the mask loosely with the machine blowing air that would raise you to a 4. Anyway, once you have identified the thing that would raise your anxiety to a 4, then do it and remain in that position for as long as it takes for your anxiety to go down to a 1 or 2. Your anxiety will go down, it may take ten minutes or 25 minutes, but if you stay in that situation that initially illicited a 4 out of you (don't distract yourself or use relaxation techniques for this exercise; just sit with it), your anxiety will go down to a 2 or a 1. Our brains naturally do it. Anyway, after holding the mask no longer raises your anxiety to a 4, but only a 2 or 1, then take the next step (i.e., put the mask on with the machine on during the day time, etc) that raises your anxiety back to a 4, and then sit with it, until your anxiety is down to a 1 or 2. Then lay down, as if to sleep, with the mask on and machine on, and sit with it until your anxiety is a 1 or 2. Now you can do your treatment with little to no anxiety.
Last edited by Hueffenhardt on Wed Jan 19, 2011 8:33 pm, edited 2 times in total.

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Re: Claustrophobia and CPAP use

Post by snuginarug » Wed Jan 19, 2011 7:07 pm

Wearing it during the day while doing something engrossing (watching tv, reading, etc) is a good idea. I had claustrophobia problems in the beginning too. Before bed, I would gently talk to myself Sounds stupid, but it worked for me. Someone on here advised me to talk to myself like a two year old, simple, gentle, patient. I would gently explain to myself that this was good for me and would help me feel good in the morning. Then I would tell myself that I would try to keep it on for 4 hours. BUT I made a deal with myself that if things got horrible I could take it off at any time. I would put it back on after a short period of time. Repeat as necessary. I got over the claustrophobia in about a week or so. It helped to have something distracting to think about... plans for tomorrow, something I'd read, an article in the news, a friend or family member's trials and tribulations.

Good luck, and keep coming back as you need help. There are lots of great people here who have been through the same thing.

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Re: Claustrophobia and CPAP use

Post by BlackSpinner » Wed Jan 19, 2011 7:28 pm

I thought I would really be claustrophobic with the mask but unlike the lab masks or snorkle masks the cpap mask was blowing air into my face and that seemed to circumvent my issues

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Re: Claustrophobia and CPAP use

Post by Jersey Girl » Wed Jan 19, 2011 7:35 pm

The first time I ever tried to use a nasal mask was at my Titration study. The technician left me holding the mask for awhile and I would hold it up to my face and then take it away. I did this several times over about a 15 minute time period. I was assured that it had a vent and that even if the power went off, the vent would remain open and I would still be able to breathe. When the 15 minutes were up, the technician came in and helped me adjust the mask so that it fit tightly. I already had the tv on and I find that watching tv relaxed me enough to go to sleep.

Best regards,

Jersey Girl

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Re: Claustrophobia and CPAP use

Post by DocWeezy » Wed Jan 19, 2011 8:20 pm

I was EXTREMELY claustrophobic with the mask and the air blowing on my face, so much so that they could hardly get enough sleep time for the titration study. As it was, there was only about 40 minutes of uninterrupted sleep. I had never had panic attacks before in my life, but that stupid mask did it!

It took a while. I did all of the desensitization techniques mentioned here--they really do help, particularly just wearing the mask--both with and without the air going--while watching TV, reading, and for me, working (I work at home). I also took Lorazepam for about 6 weeks, a 5 mg. pill for a few weeks and then I started cutting them in half, until I was taking a quarter of a pill (I know, it was for my head's benefit and not because it was actually doing any good at that point!). I wasn't addicted to it by any means, I just wanted to take less but liked the security of knowing that I had taken it. I would wake up screaming and pulling the mask off for about a month or so, but it gradually tapered off; it was much worse without the Lorazepam. The drug made the effort tolerable and almost bearable.

Now I'm fine and my mask and machine are like a teddy bear and I can't sleep without them! I'm at about 2.5 months now and haven't had any Lorazepam for about two weeks.

Was it easy? No. Fun? Hell no. Worth it? A THOUSAND TIMES YES!

The reality is that conquering the claustrophobia takes time and effort. Mostly time. It's normal and OK to wake up pulling your mask off in a panic...over time this will dissipate as your subconscious discovers that the mask and machine are a GOOD thing and not some hideous creature sucking the life force out of you.

Weezy

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Re: Claustrophobia and CPAP use

Post by kentoboo » Thu Jan 20, 2011 8:19 am

Great post DocWeezy!

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Re: Claustrophobia and CPAP use

Post by RDawkinsPhDMPH » Thu Jan 20, 2011 8:43 am

Ditto to what Hueffenhardt said. It works very well; we use it all the time and it almost never fails unless there is something else going on. Also, as DocWeezy said, a benzodiazepine may help, but we usually don't find it necessary.

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Re: Claustrophobia and CPAP use

Post by Muse-Inc » Thu Jan 20, 2011 9:03 pm

Yeah, Weezy, great post...congrats!

I remain very claustrophic with a strong fear of suffocation. Started life as a hosehead wearing the the OptiLife mask, minimal pillow mask used in my PSG. When I started losing therapy air via loose lips and hadda move to a FFM, I spent a lot of time figuring out what to do...in my case, the Hybrid Universal FFM was and is the answer. Does not cover my nose or touch my forehead or interfere with unimpeded vision so it doesn't trigger those blasted fears of mine. At our local foum meetup when some of members bring tradtional FFMs or nasal masks and sit next to me, I can feel myself leaning away and slowly shifting my chair further away...still get the heebeejeebees being so close to 'em & I don't even wear one

Fear can be tamed, slowly persistently with a lotta patience. My theory is to outwit what triggers the fear or use de-sensitization...transformed a terrorizing phobia of snakes into something that let me actually pet a 'tame' pit viper (tame, yeah, right) once (may never again ); now it's just a fear but not the crippler it was. Took me 24 months or so of de-sensitizing myself with a local pet store's snake room...even looking at it in the beginning made me sweat and shake, so much so that I had to convince myself that my end goal was worth being in vicinity of those 'things' again, took a while to arrive at a regular schedule.

To anyone dealing with this sort of terror...keep at it, you can come to terms with it.

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Re: Claustrophobia and CPAP use

Post by DocWeezy » Thu Jan 20, 2011 9:09 pm

Sounds like we had/have a lot of the same claustrophobia and mask issues, Muse.

I think it is very interesting that a Hybrid mask works for you too! It is the ONLY one that I can use. Funny, I knew that instinctively (I had seen them online), but as a newbie (before I found this board), I let myself be talked into a Quattro....EEEEKKKKK! Freak out city! Then I tried the Liberty because the hospital DME didn't carry the Hybrid. It was a bit better, but I still felt like I was suffocating. I bought my Hybrid out of pocket just to try it and that was it. I put it on and knew immediately that it would work for me, for the same reasons that you listed. It still took time and effort to overcome the panic, but for me, the Hybrid was a key part in being able to adjust.

Weezy

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Re: Claustrophobia and CPAP use

Post by avi123 » Thu Jan 20, 2011 9:27 pm

My successful psychiatrist treats CPAP claustrophobic patients by taking a pill of 0.5 mg Xanax about an hour or two a head of time. At the same time if you are taking any other sleeping pill then start withdrawing from it (start taking half the dose).

To those "afraid" of suffocation, I suggest adding a non-rebreathing valve between the end of the air hose and the mask. This valve ensures that re-breathing of CO-2 is kept to the minimum in the event of power failure.

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Re: Claustrophobia and CPAP use

Post by Amigo » Fri Jan 21, 2011 8:12 am

I am intensely claustrophobic about anything covering my face. This issue resulted in a failed Sleep Study in the late '90's when the clinic stated my only option was a full face mask, and no ramp option. The complete covering of my nose and mouth, combined with the "hurricane" of air assaulting me non-stop quickly brought the sleep study to a halt. I left very depressed as I saw no end to my apnea and extreme sleep deprivation.

In late 2002, my physician urged me to try again as several improvements had been made in sleep therapy options. The two most important for me were nasal pillows and a ramp option.

It was still a struggle for me, but after fewer than five hours of the Sleep Study, I felt more rested than I had in years. That was all the positive reinforcement I needed to make the therapy work for me.

For whatever reason, I found that having a fan blowing on my face helped me to overcome the reduced, but still discomforting feelings of having something attached to my face. The ramp feature was also a godsend.
After only two weeks, the fan was unplugged, the ramp feature turned off, and I began my new and vastly improved life as a hose head.

Initially I used a chin strap to minimize mouth-breathing, and over time also tried taping, which for a claustrophobic is quite an accomplishment.

Today I switch back and forth, and some nights use nothing at all. My statistics stay optimal, and I always feel very well rested.

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Re: Claustrophobia and CPAP use

Post by MOTOR815 » Fri Jan 21, 2011 6:59 pm

Claustrophobic is exactly how I felt at my sleep study, and beginning my therapy a little over a month ago. At first, the anxiety was so bad that I couldn't get to sleep with the mask, then I would fall asleep a few minutes, and then immediately wake up in a panic attack and rip the mask from my face. I am, by no means, at this point a success story. But, I've had some small victories. Now, I am able to easily fall asleep with the mask on, although I still remove it during the night. The time that I am actually wearing it is increasing little by little. I've had one night that I was actually able to wear it the entire night, so I know it can be done.


Oddly enough, the first mask I chose was the Liberty Hybrid. I thought it would be the least claustrophobic of all that I had seen. Unfortunately, I just could not tolerate the nasal pillows blowing directly up my nose. I switched, just in the last week, to a nasal mask, the Mirage Activa LT, and I seem to tolerate it much better. The only thing I don;t like is the forehead support piece. It prevents me from watching TV in bed, because I can't use my glasses.

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Re: Claustrophobia and CPAP use

Post by Kahfree » Fri Jan 21, 2011 8:21 pm

I have this same problem so I have been working on resolving it. I realize that our minds are trained to believe one way, but we can retrain them to believe another. Not only am I wearing the mask at night (even if it is just 3 hours) I wear it for a short one hour nap in the daytime. I have found something interesting to this. During the day, I do not panic. Night time, I do. I think because its dark at night it makes it more scary for me. In the daytime my room is bright and I doze right off.

I talk to myself at night when I put the mask on. I do the same thing as another poster said, agree that its ok to remove the mask when I feel I can no longer cope. Then, after a short time I put it back on. In time I think I will eventually wear it for a full night. I also have a small fan blowing on my face all night long. This helps me feel like I can actually feel air in the room. Its all just a matter of me making my brain accept the mask. I cant believe this is a life long event now. I was ok with it, but now I am more upset about the fact that I am tied to this machine till I leave this earth. I almost cried while wearing it in bed last night...but stopped because I was afraid I would not stop.

One quick question. When lying still at night, I yawn a lot. But, with the mask on, I try to yawn and cant seem to complete the yawn. Its frustrating and maybe sounds trivial, but it bothers me.


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Re: Claustrophobia and CPAP use

Post by breaker » Mon Jan 24, 2011 6:50 pm

Thank you all for your thoughts and encouragement. I now plan on recontacting my doctor to see if he will issue me some equipment to get me started. Not sure...as I had failed the sleep test...unable to keep the mask on long enough to get any results. I now have some strategies to help me overcome the claustrophobia. I remain a bit skeptical, but will give it a try. Thanks again.