just got equipment. need help.

[xiola]

i just got my equipment.. kinda.. they didn't have the remstar pro yet so they sent me home with a plus and said they'd call within a week for me to trade for the pro

it's set to 13. i can push the ramp button to put it down to 7

so im sitting here with it on trying to get used to it.. it's been half an hour and i still feel like i can't breathe. i know im whining. and you guys probably hear it all the time. but how am i supposed to do this?

i don't remember the settings being this high at the sleep lab. i didn't have the feeling that i couldn't catch up.
so i feel like im breathing faster to try to compensate and im worried im going to start hyperventiliating and should i just stop this and take some ativan and try again later..

wow. freaking out. but i don't know what to do and i don't have anyone else i can talk to about this. it's really really hard to breathe with it set this high.

[cflame1]

Did they set the CFLEX on? If so, what to?

[xiola]

it's set to 3

[cflame1]

What's the length in time of the ramp?

[jweeks]

Hi,

Can you tell me exactly what you are feeling? Are you being overwhelmed breathing in? Or is it breathing out? Or is the machine forcing you to breathe? Or do you not get enough air breathing in?

There is some adjustment period. My first experience with CPAP felt like I was breathing out of the back end of a jet aircraft. It took me a while to convince myself that I wasn't going to inflate like a balloon or be overwhelmed by the air. Part of it was timing. I found that if I could hold the mask and control it myself, I could bail out if things got dicey. After a little while, I no longer had that feeling.

13 is a relatively high pressure for straight CPAP. Is it OK when you are on the ramp up? 14 is sometimes used as a dividing line where people feel better with a bi-level machine. Some insurance companies, however, want you to fail on CPAP before they will go with BiPAP since the machines cost more.

Please fill in a few more details, and I'll check back a little later.

-john-

[xiola]

the ramp is set to 20 minutes

im feeling overwhelmed when i try to breathe out. and that im having to take much shorter breathes on breathing in or else it's too much so im breathing faster

i know it wasn't set this high at first at the sleep lab when i was awake. the lady at the equipment place said they probably turned it up during the night.


so they're setting me up to fail? cause im feeling pretty fail right now. i know it's only been 45 minutes. but... failing. maybe my mistake is trying this when im wide awake and thinking about it.. maybe i should just wait until im in bed.

[mattman]

Here is what I can offer, from my perspective as a CPAP user who also started out on 13cm with a ramp on a Remstar Plus.

First off and I know this may sound silly or superfluous, but relax. Sit back and try not to focus so much on what's going on and just let yourself go as much as possible. Don't try to pattern your breathing after anything other than your normal inhale and exhale pattern.

Try not to focus on the mask and the machine. Close your eyes and really try to shut out what's going on around you. You might even try headphones and your favourite music to help cover the noise of the machine itself.

Believe me, I know this is a whole lot to suddenly find yourself dealing with.

For what it's worth - I *promise* you this gets easier and better.

I really think the biggest obstacle for you right now will just be your own nerves.

The only other tip I can offer is that for me, the ramp was actually making things worse. When it was first starting up I felt like there wasn't enough air coming through and of course the first day I was using it by the time it ramped up to 13 I was like 'Wow! This is a lot of air!' so I had both extremes. I shut off the ramp and just went with straight 13cm and after a day or two I was used to it.

I honestly don't even notice it now. I have been known to put my hand over the vent just to make sure it's actually blowing. THAT is how used to it you can (And will!) become.

mattman

[mattman]

the ramp is set to 20 minutes

im feeling overwhelmed when i try to breathe out. and that im having to take much shorter breathes on breathing in or else it's too much so im breathing faster

i know it wasn't set this high at first at the sleep lab when i was awake. the lady at the equipment place said they probably turned it up during the night.


so they're setting me up to fail? cause im feeling pretty fail right now. i know it's only been 45 minutes. but... failing. maybe my mistake is trying this when im wide awake and thinking about it.. maybe i should just wait until im in bed.

I certainly wouldn't say anyone is setting you up to fail. It's just that this is a tough therapy to get used to right away. It does require some patience on our ends to help make this work.

You will get there!

[falvesjr]

I just started OSA treatment about a week ago myself, so I know what you're saying. However, for me it came naturally after the first two or three breaths (and after my brain kicked in) after they put a mask on me during my sleep study. I think the trick is to mentally prepare yourself and to just relax. As soon as you relax and start breathing normally, the "drowning" feeling goes away. I'm lucky to have a bi-level machine (M-Series BiPAP Auto with Bi-Flex) because my pressure is pretty darn high (22 IPAP / 17 EPAP) and exhaling is not easy at 22!

My newbie advice is to stick with it and relax. You'll get the hang of it and the benefits are pretty significant. I must confess that I felt better immediately, even after the sleep study night! I'm definitely not as sleepy during the day as I was in recent memory, so I'm very optimistic about the treatment.

My only problem right now is finding the (all elusive and non-existent) "perfect" mask... For the moment I'm "making-do" with a Respironics ComfortGel Nasal mask and a chin-strap as I have not yet been able to find a full-face mask that works well for me, though I really should have one as I tend to breathe through my mouth a lot. My DME has been really great and has let me try lots of masks, but alas, my search continues... I'm wanting to try the RespCare Hybrid to see if it's any better than the ResMed Mirage Liberty which didn't work for me, though it was really close! I'm also prepared to live with a nasal only mask with the chin-strap if I can't find a FF that works, so I'm getting ready to try the F&P Opus 360 and a Respironics ComfortLite -- we'll see what happens... Heck, I might even try to "build my own" mask as per instructions here on the site using an anesthesia mask and some CPAP mask parts. We'll see!

Anyway, this post is getting way too long, especially for my first post here!

Cheers,
F

[SnoozyWoozyCat]

I've only been using my equipment for 4 nights and I'm still getting used to having the mask on when I first go to bed. I get frustrated because I'm sleepy when I go to bed, but by the time I check the humidifier, put on the headgear and mask and turn on the machine I'm not as sleepy. And then when the pressure starts up, I also feel like I can't breath and that gets my adrenaline going. So instead of dropping off to sleep quickly, it takes a while. But I also have lessened my anxiety by asking questions on this board and realizing that I'm not doing something wrong and it's kind of common to feel a little short of breath at first. Over the last 4 nights, it has become easier for me -- hopefully it will for you too!

[Scarlet834]

I didn't need to do this, as my pressure was set lower than yours and was comfortable for me, but when I got my equipment I was encouraged to go ahead and start the ramp over again if necessary (as in, it's reaching full pressure and you haven't fallen asleep yet and you're uncomfortable). Eventually you won't need to do that, but it might help in the transition. I'm assuming you have the ability to do this at the touch of a button with the REMStar Plus. You definitely will be able to with the Pro.

The results are really, really worth it. I encourage you to keep at it and just try to spend more and more time with the machine. If you're not lying down, try that. My breathing patterns slow way down from when I first slip the unit on (seated) and when I lie down to sleep.

[KatieW]

When I had my sleep study, I had a wonderful woman as my respiratory tech. After trying on several masks, and settling on the most comfortable one, she set it for 5 cmH2O, and told me to sit back and relax. She said that actually the body adapts to cpap quite readily. Its the *brain* that has difficulty adapting. For some reason, that really helped me. Hope it helps you.

[Birdy45]

I started full face mask with machine in september it does take time getting use to. My advice is to lay down and relax listen to music. I have a t.v. in my bedroom so I laid down and watched t.v. that way I concentrated on watching that and less on my breathing... My DME told me to start out earlier before I went to bed to get use to it..So I put it on about 4 or 5 hours before I went to sleep and watched television that helped me get use to it...I like others now have to check the air that comes out in front to make sure it is on. Just relax and keep working with it your brain tries to trick you since you have something on your face that don't feel like it should be there, soon u wont even bother you. Good Luck.

[ozij]

You've got two different issues going on there, xiola.
One is getting used to exhaling against the pressure. It takes time, time as in "nights" not as in "minuters". Relaxing will help.

The other issure is CFLEX. CFLEX works great is making exhale easier for a majority of people. But for somem, it just doesn't work. Some of us feel CFLEX drops the pressure before we've finished inhaling, brings it back in before we've finished exhaling - and then we get into a vicious cycle of trying to breath faster. CFLEX however always drops its pressure in response how much we breathe in or out -- it doesn't respond to the speed of our breathing at all.

The first thing I'd do is try to drop CFLEX from 3 to 1, and if it doesn't help, then I'd stop it entirely, put it at 0.

I agree, nobody is setting you up to fail, and relaxation will go a long way. However, you should also know that if you do fail to adjust to fixed pressure cpap, the next step is BIPAP is which the machine is set up to give you two different pressures for each breath: one for inhale, another for exhale.

Remember also: the most primitive part of your brain, the one reponsible for the most basic physical reactions, has been spending many nights jolting you awake from near choking, and it is hypersensitive to anything that reminds it of breathing difficulties. You have to use the more evolved part of you brain to communicate with the primitive part. Try to maintain a dialogue that sounds something like this: "I know you terrified of choking. Thank you for alerting me all those times when I was too deeply asleep to breathe naturally. This thing here is supposed to help both of us, it will keep my airway open and you won't have to wake me up. Let's try this slowly, OK?"

It takes time, xiola. We've been there, and we'll help you.

O.

[brain_cloud]

i know it wasn't set this high at first at the sleep lab when i was awake. the lady at the equipment place said they probably turned it up during the night.

so they're setting me up to fail?

I also had the sense on the first night at home on the machine (just six days ago) that the pressure seemed much higher than during the titration night. And so they must have been up to some tricks during the titration to bring the pressure down whenever I came to. I also felt a bit cheated by that, since I had assumed by the comfort level of the titration that cpap would be easy-peasy. Not quite.

If you have a sleeping pill or even a xanax or something along those lines, that can help for the first night or two. I took an ambien from an old prescription of my wife's and that made the first night fairly easy (straight cpap at 14). From then on, that initial feeling didn't come back.