Newbie with nasal pillow

[smoledman]

6 nights in a row I can't fall asleep. My unit is set to auto-ramp from 4 to 15 over 40 minutes once I fall asleep. The problem is even at 4.0 pressure the resistance I get is enough "bother" that I can't fall asleep. It's so disturbing to me that it just causes aggravation even from a state of near sleepiness. Once I rip off the mask, I'm asleep in minutes. this is a real problem, and I'm tired of reading posts of "once you get used to it, blah blah blah". Everyone is physiology different. Congrats to you all who immediately took to it and had no problems falling asleep, I hail you. I'm going to try a different mask with hopefully different result, but who knows.

Using the ResMed with auto-ramping, AHI 5.7.

[Julie]

You sound smart enough to realize that for those 40 mins til the pressure reaches your scripted (15) number, you're getting only suboptimal treatment... have you ever tried just not using the ramp at all, or at least shortening the time to e.g. 5 mins? You certainly don't 'need' the ramp as therapy in itself of course and most of us ditch it very quickly after starting out, though 15 is a higher number than a lot of us have to deal with immediately on masking up. You do says it's the resistance that bothers you - do you in fact mean the pressure/strength of the air coming at you, or something else?

[dcchan2]

6 nights in a row I can't fall asleep. My unit is set to auto-ramp from 4 to 15 over 40 minutes once I fall asleep. The problem is even at 4.0 pressure the resistance I get is enough "bother" that I can't fall asleep.

Did you turn on the EPR feature? It automatically reduces the pressure when you exhale.

[palerider]

6 nights in a row I can't fall asleep. My unit is set to auto-ramp from 4 to 15 over 40 minutes once I fall asleep. The problem is even at 4.0 pressure the resistance I get is enough "bother" that I can't fall asleep.

Did you turn on the EPR feature? It automatically reduces the pressure when you exhale.

EPR reduces pressure when you're not inhaling, subtle, but sometimes important distinction.

[smoledman]

Yes I'm using something called "Pressure Relief" feature which is ON. Anyways I'm going to keep practicing using the device during the day to get myself used to patterns of breathing with this thing so I don't get stressed out when I try to use it going to sleep.

[yaconsult]

Note that there are three different levels of pressure relief on most machines, but depending on the machine settings, you may need to go into the clinical menu to change or adjust them.

Using the cpap machine while you are watching tv or on the internet is an excellent way to get used to it and has helped many people.

Believe or not, despite the strange sensation, your body will quickly get used to it! Some of us even find ourselves checking to make sure it's turned on - that's how much we don't even notice the air pressure any more! I kid you not!

Please fill out the equipment section of your profile.

[dcchan2]

EPR reduces pressure when you're not inhaling, subtle, but sometimes important distinction.

According to ResMed:
How does EPR work?
When you breathe out (exhale), the flow generator device (if EPR is integrated) detects the beginning of exhalation and reduces motor speed to drop treatment pressure.

[palerider]

EPR reduces pressure when you're not inhaling, subtle, but sometimes important distinction.

According to ResMed:
How does EPR work?
When you breathe out (exhale), the flow generator device (if EPR is integrated) detects the beginning of exhalation and reduces motor speed to drop treatment pressure.

vs reality:

[Kerriboberri]

I use a Bipap machine, 14 inhale, 10 exhale. When I started June 1st my ramp was set for 30 minutes, it's now set for 10 minutes. When I first started I would have to use the ramp several times per night because I felt as if I was suffocating or chocking. I'm so used to my settings now, that if I wake up in the middle of the night I wonder if my machine is really on.

Keep it up, it may take some time but you can do it! The reward is worth it!

[dcchan2]

EPR reduces pressure when you're not inhaling, subtle, but sometimes important distinction.

Thanks for the graph. It does show the EPR behaviour more clearly than the simplistic explanation provided by ResMed. However, when you're neither inhaling nor exhaling (a pause in breathing), wouldn't it make more sense to have the full pressure rather than the reduced pressure?

[palerider]

EPR reduces pressure when you're not inhaling, subtle, but sometimes important distinction.

Thanks for the graph. It does show the EPR behaviour more clearly than the simplistic explanation provided by ResMed. However, when you're neither inhaling nor exhaling (a pause in breathing), wouldn't it make more sense to have the full pressure rather than the reduced pressure?

well, yes, yes it would. but, even though that's what is implied by the name, that's not how it works, and people need to be aware of that.

EPR reduces your therapy pressure (base pressure) by however many it's set to... and if you, for instance NEED 10cm to keep your airway open, and you set your machine to 11.... and then figure "I don't like that, I'll crank in 3 epr" then you've reduced your pressure to 8, and may very well have more events.

[MarylandCPAPer]

6 nights in a row I can't fall asleep. My unit is set to auto-ramp from 4 to 15 over 40 minutes once I fall asleep. The problem is even at 4.0 pressure the resistance I get is enough "bother" that I can't fall asleep. It's so disturbing to me that it just causes aggravation even from a state of near sleepiness. Once I rip off the mask, I'm asleep in minutes. this is a real problem, and I'm tired of reading posts of "once you get used to it, blah blah blah". Everyone is physiology different. Congrats to you all who immediately took to it and had no problems falling asleep, I hail you. I'm going to try a different mask with hopefully different result, but who knows.

Using the ResMed with auto-ramping, AHI 5.7.

A pressure change from ramp of 4 to 15 is a huge change!! I am used to starting out with a pressure range starting at 10 with no ramp, but sometimes I can't stand the pressure when it goes up just a little, to maybe the 12.5 range. I know I would have problems when the pressure hit 15 after being at 4, and I've been using CPAP for more than 5 years.

Please fill in the equipment profile under User Control Panel, using text, as it is easier to view than the pictures. I don't have a solution to offer, if your dr. prescribed a ramp of 4 and a constant pressure of 15, but I'm sure others can offer suggestions that will help improve your therapy once you've posted information about the equipment (machine, mask and humidifier) you are using.

Don't give up!! Most of us have gone through a period of adjusting to CPAP therapy. The machines have plenty of adjustments, for comfort and for treatment, that can be made so that a person can sleep well using CPAP.