CPAPtalk.com

Sorry that this is surely a totally newby question, but I just cannot understand something.

I thought that with the positive air pressure in CPAP, it would be EASIER to inhale (and hopefully not harder to exhale) than with no mask. But that is not my experience. With 2 different masks now, the effort required for me to suck in enough air so that I don't feel like I'm starving of oxygen is much, much greater while wearing a CPAP mask than without. The air I'm breathing in seems like the carbon dioxide I just breathed out. I feel like I'm getting no oxygen and have to make so much effort to breathe that it keeps me awake. When not wearing CPAP, my respirations are shallow and effortless. With CPAP, I have to suck in air hard, and since it seems to have so little oxygen, I continue breathing with a lot of effort. It is very unpleasant. In the end, I just rip the mask off so that I can get some oxygen.

My Respironics unit is set to auto, 4-20. Stats show that it never goes above 8 at night.

Am I doing something wrong?

Well, there may be something wrong wth your machine. Either that or you could be having a panic reaction to the mask being over your face. Is the hose kinked or blocked? Does your mask fit well? These machines souldn't rob you of air pressure or O2. The positive air pressure actually makes me feel like its easier to breath and obviously it's keeing my airway open during the night when I'm in REM sleep.

Have your DME check our the machine you are using.

If you feel like you are breathing in your exhaled breath, please make sure you are not covering up your exhalation holes with the covers or something. And if you are finding it hard to breath out, you will need to change your epr settings. May I make a small suggestion...if you have your pressure set at 4 to 20, you may find 4 to be too low...I know I could never get much air at that setting. If your pressure seems to top out at 8 most nights, you might set it at 6 and 15 for awhile. Then once you have been working fine at that pressure and your stat still show you are topping out at 8, you could narrow down the top pressure to 12 or 13....BUT ..do any changes slowly.... make a small change, use it for about a week..then make another small change. You do not want to make any large changes at once, slowly is the key. Welcome to the forum and good luck.

maliolani wrote:My Respironics unit is set to auto, 4-20. Stats show that it never goes above 8 at night.

Starting out at 4 cm pressure....while technically we won't suffocate at 4 cm pressure...it sure can feel like we are because there just isn't much air moving.

I suspect if you were to increase the minimum pressure to 5 or 6 you will be a lot more comfortable and find breathing much easier.

I once did a screening with my machine to test my sister and I really wanted to use the 4 cm pressure...it took about 30 seconds and she was yanking the mask off telling me that I was trying to kill her by suffocation. Ended up using a 6 cm minimum pressure and she was quite comfortable.

While some people don't have a problem with 4 cm pressure...most of us need a bit more air moving to be comfortable. Heck, even my titration study started out with 5 cm and I could barely tell there was any air moving at all.

Try 5 cm or 6 cm...and see if you feel better with it.

And also take a look at the pillows on the Swift FX.
The inner cone sometimes turns inside out--which does not help at all .

I remember when I switched to a different type of mask, (Not machine, just mask. Same settings) that I was convinced I was getting less air flow. I even called the manufacturer. Eventually, I adjusted to it. I think in my case, the new mask was so foreign to me that I became overly conscious of it. That caused me to breathe in an abnormal way.

When I first started CPAP, it was also tough. I heard CPAP described as like 'trying to breathe while sticking your head out of a moving car window'. It wasn't quite like that, but having to deal with positive air pressure for the first time made even inhaling somewhat difficult.

I cut off my ramp because I couldn't get enough air while waiting for the machine to ramp up to the full pressure. I can relate as I definitely felt like I wasn't getting enough air at the lower pressure but after starting my machine at a pressure of 10 I'm perfectly fine now.

locust78 wrote:I think in my case, the new mask was so foreign to me that I became overly conscious of it. That caused me to breathe in an abnormal way.

I agree 100%. When I first started- the mask, wind, and pressure all caused me a lot of anxiety. I panicked and ripped the mask off many times. I would be fine if I could just fall asleep. I remember walking up in the mornings with the mask on and not being certain the machine was even running because I completely acclimated to it in the night- but every night for the first week or two the anxiety would come back as soon as I strapped on and tried to fall asleep.

Hang in there. Once I got passed that initial nightly anxiety, I actually began to enjoy using the machine!

The first night the low pressure was set to 5 and I felt the way you do. Changed it to 6 and it feels only mildly restricted for the few minutes it takes to relax and begin to breathe in a slower and more even manner.

Suz

All great ideas--especially the ramp--that helped me a lot.

locust78 wrote: When I first started CPAP, it was also tough. I heard CPAP described as like 'trying to breath while sticking your head out of a moving car window'.

At least you won't get bugs in your teeth with a CPAP machine!!!

You've received some great advice.

I can only add that I had the same issues when starting out. I ditched the ramp, went up a size in nasal pillows and tried to relax.

Every night (even after 18 months at this), I sit up in bed watching a dvr'd episode of Jeopardy whilst adjusting and tweaking my mask and trying not to think about my breathing at all. Within a few short minutes the mask seems to disappear and breathing is very easy. Once your mind is on something else the panic of not getting enough air leaves you.

I also have my EPR set at 2, which works great for me.

Hang in there - this isn't always easy to adjust to - try everything suggested until something works for you.

Cheers,
xena

Thanks for all the amazing advice. Based on what I've read and choosing not to change one thing at a time, I have switched from Medium to Large nasal pillows (the medium "look" the right size, but the large are sooo much softer and more comfortable), changed the min from 4.0 to 6.0, changed the max from 20.0 to 15.0, changed the ramp start from 4.0 to 6.0, and got some Ayr gel. I'll see how that goes.

Hey I noticed if I use the white hepa filter with my machine the pressure goes down and the humidifier also makes the pressure go down. I really want to be able to use the hepa filters but I don't think there good for the machines.

I know what you mean. At first i loved the rush of air. But it can "feel" claustrophic.

One cause is humidity and the temperature of the air. Try this:

go a night with no humidity. Disconnect your humidifier.

Put an extra blanket on the bed and turn on the AC unit to 60 degrees.

I have found that its actually the warm humidified air, and not the mask, that gives the impression of oxygen deprivation.