Having trouble exhaling

[tom2387]

Hi, I am very new to pap therapy, and so far, haven't even been able to get through a single night with it on. The problem is that I am having trouble exhaling. I have a Devilbiss intellipap DV54, which has this smartflex feature that is supposed to make it easier to exhale. However, it seems to take a pretty forceful exhale to make it "kick in". I find I am having trouble breathing normally, and feeling like I'm having to actually concentrate on breathing in order to get oxygen. If you can't exhale, then there's no more room for new air.

As soon as I nod off, my exhale isn't forceful enough to set off the smartflex, and I wake up gasping, much like I used to when I first began to suspect I had sleep apnea. That has since essentially stopped- I haven't had that problem in many months.

Anyway, I've tried various settings to try to alleviate this problem, with no success. If someone has this particular pap machine and can offer advise for specific settings, I'd love to hear. I considered lowering the overall air pressure, but that doesn't seem to be alterable. Is that set by prescription, or something? If so, perhaps I can get my provider to alter it. How would that work? Would it have to be sent back to the manufacturer?

Another thing I've considered is maybe trying a full face mask. Right now, I'm using a nasal pillow, and I'm wondering if the full face would supply the air in such a way that it isn't forcefully blowing into my nostrils, not leaving any way to blow out. I figure with the full face, there is maybe a little more "space".

I'd appreciate any advice.

[Muse-Inc]

Check out my full-face mask, has pillows and covers the mouth (so no loss of therapy air), comes with 3 sizes of each. Click on it in my signature.

I know nothing about your machine. My post will shoot this to the top of the list.

[zonker]

hi, tom. welcome to the forum!

i too am responding to your post to get it back to the top. there is a clinicians menu that you can access. i used to have this machine, but it's been so long ago that i can't remember the combination of buttons to get you there.

what i mean to say is that, yes, you CAN do it.

i'm hoping someone will come along with the link for you to find the clinicians manual. i think it's on apneaboard.com, but i'm not entirely sure.

hang in there, someone will post the link or the instructions.....

[jim22]

What are your pressure settings, and are you using a ramp feature? Unless your pressure is really high, it's a matter of just getting used to it. You could use a ramp to start at a little less pressure formthe first few minutes.
Jim

[Holden4th]

From looking at the DeVilbiss site, I'm not sure if you have a fixed pressure or auto adjusting machine. If it is am fixed pressure machine then this is your problem, no actual relief when you exhale. If you could give us the exact model of the DV54 it will tell us if this is CPAP or APAP. What you need is APAP.

[zoocrewphoto]

From looking at the DeVilbiss site, I'm not sure if you have a fixed pressure or auto adjusting machine. If it is am fixed pressure machine then this is your problem, no actual relief when you exhale. If you could give us the exact model of the DV54 it will tell us if this is CPAP or APAP. What you need is APAP.

Actually, a cpap has one pressure for inhale all night, but there is still an option for pressure relief.

An apap has a range of pressures during the night, and also has an option for pressure relief.

You do not need an auto machine to get pressure relief. Each brand of machine does their own version of pressure relief. Somebody with this machine will be able to help with pressure settings and relief for the exhale.

[LSAT]

Check here for the DeVilbiss manual.... http://www.apneaboard.com/adjust-cpap-p ... tup-manual

[ChicagoGranny]

I have a Devilbiss intellipap DV54, which has this smartflex feature that is supposed to make it easier to exhale.

What are your pressure settings?

I find I am having trouble breathing normally, and feeling like I'm having to actually concentrate on breathing in order to get oxygen.

That is probably your problem. It's common among newbies. You are "trying" to breathe. If you can relax, distract your mind and don't think about breathing, your autonomous nervous system will take over. You will be able to breathe gently all night. (I'm a small, elderly person and have no problem breathing against pressures as high as 20 cm.) You spend most of your life breathing without thinking about it. You shouldn't try to control your breathing when using CPAP.

Do you have any health problems that make it difficult for you to breathe during the day?

[tom2387]

Thanks for all the replies.

I did find the links to access the pressure settings. It is set at 3-15 cmH20.

It's an apap. This is the actual machine: https://www.cpap.com/productpage/devilb ... chine.html

It does have pressure relief, that's the smartflex option I mentioned. My biggest problem is that is seems to need a fairly forceful exhale to detect that I am exhaling, and when I'm not concentrating, my exhale isn't strong enough for it to detect. If there was a way to make that more sensitive, that might solve the issue. Otherwise, as some have mentioned, I guess I just have to "get used to it".

It also has the delay setting, so it's only 3 cmH2O for the first half hour. Even that is difficult for me to breath with.

The reason I asked about the full face, is that with the nasal pillow, there just isn't anywhere for the exhaled air to go except through the incoming air. I'm hoping that with the full face there is at least some space between the inlet and the nostrils, or is that not the case?

[ChicagoGranny]

with the nasal pillow, there just isn't anywhere for the exhaled air to go except through the incoming air.

Tens of thousand, maybe even hundreds of thousands, of people use and like nasal pillows. The design is good. You have a mental block. This is common among newbies.

[AnarchyJane]

This was how I felt at the titration study with the nasal pillows. She put the machine on Bi-Pap and then it was easier. Even easier was a FFM.

[Pugsy]

What brand/model nasal pillow mask are you using and what size nasal pillow?
Sometimes going up a size in the nasal pillow will allow more air movement easier. Worth trying unless you are already using the largest size available in nasal pillows.