first night frustration - trouble breathing with mask on

UncleLeo · Post by **UncleLeo** » Sat Jan 27, 2007 1:32 pm

Last night was the first time with my setup, and I am now extremely disappointed and frustrated. I know it takes time, and tweaks and adjustments need to be made, and that my hopes and expectations for great sleep the first night aren't exactly reasonable, but last night was disappointing. I got fantastic sleep in the sleep study, so I thought using the same mask they used would be a good starting point, so that's what I got. I know I can always change, and I did buy the return insurance just in case.

So, anyway, last night I kept gasping for air. The best way that I can think to describe it is that my exhales and in incoming air blocked each other and stopped air from getting to me, if that makes sense. I kept having to gasp, or breathe deeply, to get enough. I thought that maybe it was all in my mind, so I tried to think of other things, and I did sleep for about 30 minutes, but woke up with the same sensation, needing more air. I used the mask for about an hour total, then gave up and took it off.

After another hour I woke up again and tried the mask again. This try lasted for about half an hour. Same thing. I don't feel claustrophobic, per se, but it does start to get to me when I focus on the feeling of lack of air and I think about it too much.

Could it be mask adjustment? It seems to be sealed pretty well around my nose and such. Is it pressure related? My machine has C-flex, and I haven't played with that, yet. Something else, maybe?

Also, this is kind of a side question... Is there supposed to be a hole in the elbow at the front of the mask blowing air out? I'm assuming it's for exhale, but it also seems like it would cause the system to lose it's pressure and effectiveness. If so, I don't recall it being there during the sleep study, but that doesn't mean it wasn't there. I was half-asleep when the person put the mask on and wasn't fully observant.

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CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX

Rabid1 · Post by **Rabid1** » Sat Jan 27, 2007 1:51 pm

Leo

It appears you are mouth-breathing, and that won't work with a nasal mask. There are many remedies for mouth breathers including chin straps, mouth taping, and full-faced masks.

What is your titrated pressure?

As for the holes in the mask, they are supposed to be there, and will not cause you to lose pressure, as the CPAP's adjust for them.

Elle · Post by **Elle** » Sat Jan 27, 2007 1:54 pm

Hi there, I am not as knowledgable as the others here but until they get here to help you out I will give my two cents. Do you have the option of starting out at a lower pressure? I have that same breathing problem if I start at my pressure of 10 but there is a button to push that starts you out at a lower pressure for about 20 minutes and then the hope is you will be asleep by then and not notice.

I have also heard others mention taking a sleep aid the first night or two. I did that for a new mask and it worked.

Some people seem to breeze through with no problems. I am fighting some mask problems right now and it is frustrating after having slept well once or twice because you find out just what a difference it makes to get a real sleep once you have things working properly....which will happen so don't give up.

CollegeGirl · Post by **CollegeGirl** » Sat Jan 27, 2007 2:01 pm

Leo,
If you're gasping for air, I have three suggestions:

1. If you're currently using the ramp feature, don't. What's your pressure?
2. Use the Cflex. It's exhale relief - it makes it easier to exhale. I had the same "gasping" problem till I turned it on. Set it on 2 - you can always adjust it higher or lower later.
3. If you try both of those things and nothing is helping, it's likely your pressure is too low. Let your doctor know you can't breathe at this pressure, and he'll probably okay a small adjustment to a pressure you CAN breathe at.

Rabid1's right in that mouth-breathing is important to stop - but if you're gasping for air, it's quite possible that gasping will stop once you get the pressure to where you can breathe, and THEN you can look at whether or not you're still mouth-breathing.

That small hole is there to allow the release of the CO2 you exhale. Without it, you'd get sick pretty quickly. Don't block it, whatever you do. And no, it doesn't affect the pressurization of the air - the CPAP machines take the "leak rate" into account, which includes the mask's "vent flow rate" (ie, how much air comes out of that little hole in the mask), and they adjust the pressure accordingly.

Good luck!

Wulfman · Post by **Wulfman** » Sat Jan 27, 2007 2:02 pm

Are you using the Ramp feature? (what are your Ramp starting pressure and time?)
What are ALL of the settings in the machine?
Do you know how to get into the Setup menu to see what the settings are?

If you're using the Ramp feature, try NOT using it.
Use the machine during the daytime this weekend and get used to it. Too many people don't do a "break-in" period with their equipment and just strap everything on as they go to bed the first night.....and then become horrified with it.
This is NOT an adversarial relationship....it's your FRIEND. You're going to be spending MANY nights together.
Get to know your equipment and settings "backwards and forwards".

Best wishes,

Den

Elle · Post by **Elle** » Sat Jan 27, 2007 2:05 pm

Can the last two posters explain the not using the ramp feature to me? thanks. I dont get how that works.

Wulfman · Post by **Wulfman** » Sat Jan 27, 2007 2:18 pm

Elle wrote:Can the last two posters explain the not using the ramp feature to me? thanks. I dont get how that works.

For some folks, the Ramp helps the user to get used to the pressure. For others, it can make you feel like you're suffocating. A pressure of 10 is NOT that much and if the Ramp is starting at a lot less than that, it could make you feel like you're not getting enough air.
If this person is not using the C-Flex feature, it could also make it harder to get their breathing/air flow in sync.

Den

Elle · Post by **Elle** » Sat Jan 27, 2007 2:23 pm

Ok, I didn't think of it that way. I feel pressure if I start at 10 but I can see that a lower pressure would give a feeling of not enough air. I forgot about the mouth breathing thing too. I had that problem in the beginning.

I would have given up if not for these boards so I'm glad the OP found the site.

UncleLeo · Post by **UncleLeo** » Sat Jan 27, 2007 2:31 pm

Just a quick follow-up as I have to run out the door in a moment...

My ramp setting starts at a 4.0 pressure, though I forget how long it lasts off the top of my head. My machine pressure setting is 10. I did not consciously turn it on. I assumed it was automatic. My machine does have a separate button for it. Do I have to hit that button each time?

I believe that I had the c-flex on, but will double-check that.

I don't believe I was mouth-breathing, but of course, that doesn't mean that I wasn't.

I feel that I should clarify something, just in case. "Gasping" for air doesn't mean consciously opening my mouth for air. It would feel forced to take large inhales through my nose and mask, which would cause a deep exhale also, of course. I probably should have worded that better. Sorry about that.

Ok, gotta go, but will check my settings and such when I get back. Thank you for all the help.

UncleLeo · Post by **UncleLeo** » Sat Jan 27, 2007 2:35 pm

Wulfman wrote:For some folks, the Ramp helps the user to get used to the pressure. For others, it can make you feel like you're suffocating. A pressure of 10 is NOT that much and if the Ramp is starting at a lot less than that, it could make you feel like you're not getting enough air.
If this person is not using the C-Flex feature, it could also make it harder to get their breathing/air flow in sync.

If I understand what you're saying right, one possible solution would be to have the ramp function turned OFF while having the c-flex function turned ON... correct?

CollegeGirl · Post by **CollegeGirl** » Sat Jan 27, 2007 2:38 pm

Uncle Leo,

There's a power button on the machine, and a ramp button. Just hit the power button, and not the ramp button.

Up your Cflex if it's not on three, and if that doesn't work - it's most likely time to up your pressure.

10 is a pretty decent pressure, though - most people can breathe at that pressure.

I'd imagine you're probably using the ramp - that would suffocate me, too.

Let us know how it goes!

ufo13 · Post by **ufo13** » Sat Jan 27, 2007 2:49 pm

UncleLeo:

Yes, what Wulf, and CollegeGirl said! Also If those fix's don't work try Shutting C/FLEX OFF, with some of us, with this feature it caused STACKED-BREATHING pattern which was caused by the c/flex pressure relief comming back to quickly to full pressure! I had to shut that c/flex feature OFF completly when I used the Remstar!

Hope this helps,

Steve,
ufo13

Wulfman · Post by **Wulfman** » Sat Jan 27, 2007 2:51 pm

UncleLeo wrote:
Wulfman wrote:For some folks, the Ramp helps the user to get used to the pressure. For others, it can make you feel like you're suffocating. A pressure of 10 is NOT that much and if the Ramp is starting at a lot less than that, it could make you feel like you're not getting enough air.
If this person is not using the C-Flex feature, it could also make it harder to get their breathing/air flow in sync.
If I understand what you're saying right, one possible solution would be to have the ramp function turned OFF while having the c-flex function turned ON... correct?

Correct. For many of us, a C-Flex setting of 2 is about right.
If there's a "Ramp Time" setting in that M Series machine you have, you could set it to Zero(s).....which should effectively turn it off.

Den

kteague · Post by **kteague** » Sat Jan 27, 2007 5:39 pm

Ditto on that ramp. A ramp pressure of 4 caused me to feel like I was suffocating. Also, masks have a minimum pressure at which the vents for the CO2 work properly. Although I have always used the ramp and settling features, I may be jumping the fence and turning mine off and see if I really need it like I think I do.

Hope you have some nights real soon that are a dream come true.

Kathy

Linda3032 · Post by **Linda3032** » Sat Jan 27, 2007 6:19 pm

Ditto on looking into the cflex. Some need it, but some don't. Some feel like it is out-of-sync with their normal breathing. Some try to adapt their exhales to time with the machines. It drives me nuts, so I turned mine off. But my pressure is very low and I don't swallow air.

first night frustration - trouble breathing with mask on

first night frustration - trouble breathing with mask on

Try!

Can't get enough air