I am new to the cpap world and I have only used it a couple of times. My problem is I feel like I cant breath when I put the mask on. So what I have been doing is falling asleep without it on and then when I wake up I will put it on. After being asleep for a little while it is easier to fall back asleep with the mask on. I do have a ramp setting on my machine but I dont know if I should have it on? Is it the pressure that is making it hard for me to breath, in that case I should have the ramp setting on and set a high amount (ie 45 min) so that I will fall asleep before the pressure is up all the way. Or is it hard for me to breath because the ramp is causing me to not have enough air and I need the pressure up all the way right when I put it on? FYI, the night that I did the sleep study with the cpap I dont remember having this problem, dont know if I was just distracted by all that was going on with the study or what. Anyone have this same problem?

Thanks!

What is the pressure on the ramp starting at? 4 cm? Most would find that hard to feel like our breathing was being "stifled" at that low of a pressure. Just not enough air movement for some.

What therapeutic pressure is the machine set at?

Yes many find anything under 6 problematic. I don't use the ramp - just my set pressure of 9

My ramp setting starts at 4 and my normal setting is 9. I only have the ramp set for 5 min so really it gets to 9 quick.

5 minutes isn't long and yes, it will get up there fairly quickly.
Only been doing this a couple of nights? It is a bit of adjustment. Do you lay awake for quite a while feeling like you can't breathe?

ResMed machine? I think that is what is in your profile. Do you use EPR? If so, at what setting? Pressure of 9 cm is not all that much and EPR reduces pressure for exhale. If it is set for 3 that means a 3 cm drop during exhale. Brings that pressure down to 6 and that could enhance any stifling you might be experiencing.

Perhaps try some trial runs for 15 minutes or so using the machine but not trying to go to sleep to get yourself more accustomed to things and not wait till bed time.

Believe it or not but in 4 weeks you will look back on this and chuckle. It does get easier and we do get used to it and in the mornings we do wake up and have to feel for the mask and air to make sure the thing is still on our face. It becomes that much of a second nature. Though at first we wonder how in the world we can ever get adjusted to all this stuff, gale force winds blowing up our nose or on our face. It will get easier. I promise. You are already half way there when you say it doesn't bug you so much if you put it on in the middle of the night.

I struggled at first, too, and I'm still a newbie! I don't know anything about the technicalities of the machinery, but I do notice that breathing is a struggle if I'm tense. For example, the night I found out my uncle died, I was struggling for air for a couple of hours. I thought I had put my mask back together wrong after cleaning it. But it also occurred to me that it might be grief. I didn't use the machine for a couple of days, and when I went back to it, I could breathe fine.

Before the whole grief thing, I would say it took me a few days to adjust to the machine pulsing air at me on my exhale.

I didn't struggle, either, during my titration study, but I attribute that to the fact that a technician was at the controls, not a machine, and she didn't start changing the pressure until I was asleep.

A couple of things that I found comforting, and wish I had learned earlier:
1) you can still breathe if your mask is on but not hooked up to the machine.
2) your breath doesn't go back down the tube, so there's no way your germs can infect the hose, water, etc., and come back to re-infect you.

hth

I have the same problem. What I do is let the thing blow air directly into my mouth and breathe deeply until i feel like im fully oxygenated and relaxed. Then I mask up. Much Easier.

Also, I tend to read a lot before sleeping, and wait until im virtually exhausted and ready to nod off, and then mask up. Usually I drift off right away. If I wake up, I dont feel starved for oxygen at all, in fact just the opposite.

Yes I have a resmed s9 elite with epr, and I have the epr set at 3. So are you saying having it set at 3 might enhance the problem? I am trying to understand how? Less pressure when breathing out is the idea behind epr, which I would think is suppose to help.

I normally fall asleep very quickly, 10-15 min. Since starting the cpap the shortness of breath has started and I though it out for about 45 min- 1 hour, then I take it off. After taking it off I am asleep in less in 10 min.

I really do want it to work, and a think it will. You would think that there wouldnt be so many question marks, or things you have to figure out once you get the cpap. If the sleep study was linked better with your dme so you could try the machine that you were going to buy. Also having a professional there to help you while using it. That way you could have all these settings down pat, and not so much guessing.

jdsolid1 wrote:My ramp setting starts at 4 and my normal setting is 9. I only have the ramp set for 5 min so really it gets to 9 quick.

Now there's your problem. I can't breathe if the initial pressure is set below 6. Most folks turn the ramp off entirely. Just strap on, take a couple of breaths and let 'er rip. 9 isn't a lot of pressure. You ought to be able to start out with it there. But if you need the ramp, set it at 6 or 7 and see if that helps.

One problem lots of people don't consider that is apparent to those of us with automatic machines and software is that when you first lie down, your breathing will be deep and irregular. As your body relaxes your breathing will slowly become more regular and shallower. Using the ramp provides you with less air at first which is just the opposite of what you need. If anything, the ramp should provide you with MORE air when you first lie down, then ramp down to the set level. But many noobs are all weirded out by the mask and machine at first, and I won't argue that the ramp made it easy for me to adjust. For about 3 days, that is, until I turned it off.

My min pressure is 6 and ramping from lower than 6 equals suffocation. Once I realized what was up, I turned the ramp off. If I want more pressure/flow I just hold my breath for a few seconds and my ASV bumps up the flow. For a CPAP maybe you can set the ramp to start at 7 or more and ramp up from there. That would make sense. Just don't let it start from a really low pressure.

That said, it took me several months to get used to this. I found that I needed to be calm and ready to sleep before putting on my mask. If you put on your mask and start sucking hard on it, you are too worked up. Its hard but after a while you will trust your machine to deliver and you will know you can always whip that mask off in a second if needed. Once you get used to being calm enough to breath normally for a minute or so with the mask on, then turn on your machine, and when it starts blowing, attach it to your mask.

You can also try sitting out in the living room masked up with the machine on and read for awhile. That will help reduce some of the anxiety.

jdsolid1 wrote:Yes I have a resmed s9 elite with epr, and I have the epr set at 3. So are you saying having it set at 3 might enhance the problem? I am trying to understand how? Less pressure when breathing out is the idea behind epr, which I would think is suppose to help.

EPR is exhale relief. A comfort feature. You can adjust it or turn it off if you wish. A setting of 3 means a 3 cm drop so that during exhale your 9 cm of pressure drops to 6 cm. For some people that 6 cm is rather stifling. Now if you had a pressure of 12 cm and it dropped to 9 cm it wouldn't seem so stifling because there is more air moving at 9 cm.

Just an idea as to why you might be sensing that you are having trouble breathing. Maybe just not enough air moving during that portion when EPR kicks in. When we get used to higher pressures it sometimes feels awful stifling if we go down to slightly lower pressures. My APAP minimum is 10 cm. At 8 cm I feel like I am suffocating because it just does not seem like enough air. I am sure if I used it for a couple of weeks I would readjust but for a while it would be uncomfortable.

I don't use ramp (never have, never needed it) and I have no problem meeting my 10 cm pressure without exhale relief if I choose to. Everyone has different needs though.

You might try reducing EPR (or even turning it off) and see how you feel with it then.

Hello All!
I work in a sleep disorders lab AND am a CPAP user. If I have patients who are having a difficult time with their CPAP, specifically, learning to breathe in and out with it on, I tell them to take it out and use it while they are watching TV. That way they are doing something enjoyable and not feeling like they have to lay down and breathe through something foreign on their face. I tell them to work up to getting it back into the bedroom. Sometimes, CPAP takes a while to get used to and some people may think that they are going to feel better right away. This is rarely the case. CPAP takes time to get used to and time for you to feel better. I always say, give it 3-6 months of nightly usage of at least 5 hours, more if possible. You'll be feeling better in no time. Just don't give up. I know how much better I feel with my CPAP and I want others to feel better too!

Another newbie here. It will get easier! I don't use the ramp. I thought it was a great feature until I realized I needed to adjust the mask at my high pressure.. 14. My DME had set the starting ramp at 4 so by the time it got to 14 had had all kinds of leaks duh! So I started adjusting it at 14 and by the time I messed with the straps, I was used to it...no need to ramp. Now 1 month later with my mask adjusted. I just slap it on and hit the button. The blast of 14 pressure hits my face, I breathe once and then it feels natural. In fact it's a scarier feeling taking it off and feeling breathless. I remember wondering how any of this could ever work (the leaks, the noise, the face pain, etc), but now it is much better. Good luck.

another thought for you... when I was using APAP (I used a Respironics APAP), I couldn't use CFLEX as it felt like I was wheezing (I'm an asthmatic).

You might not be able to use EPR at all.

I have an S9 as well (Autoset) and I have EPR turned off - and if your pressure is only nine I doubt EPR would help you anyway. I also have my start ramp pressure set at my minimum setting of 10 and I have ramp set for 30 minutes so it doesn't count the first 30 minutes in my stats as I am going to sleep.

I would recommend setting your ramp at 9 for 30 minutes as well and turning EPR off. I also found I felt like I was gasping for air at anything below 6 and I was previously used to the S8 which didn't have a ramp feature when in autoset mode so I was well used to it when I got the S9 and I set it up to mimic the S8 settings.