Wake up feeling like I'm suffocating

[rested gal]

What bad influences we've been on you, btesterman!

(I'm counting you in with me on this, DreamOn!! )

All the way from 6 to 6.6 - now, that's daring! Hey, I'm chuckling, but really I'm proud of you.

If I were you, I'd not hesitate to set it at any pressure up to 10. Really.

Easy for me to say, though. I'm not a doctor.

[DreamOn]

All the way from 6 to 6.6 - now, that's daring! Hey, I'm chuckling, but really I'm proud of you.

If I were you, I'd not hesitate to set it at any pressure up to 10. Really.

I'm proud of you too, btesterman! It took me a month and a half before I changed my pressure at all. And that was the "big move" from 6 to 7! And I'm still at 7 a month and a half later! One of these days I'll reach 10 -- just you wait and see, rested gal! Dang, I wish I had an APAP!

[btesterman]

Well, good news and bad news - I set the machine at 6.6 pressure and lowered EPR to 2. I did not have the suffocating feeling at all. HOWEVER leak rate was 0.8 and AHI was 12.6. So, things are still not "right." The DME had not included the medium pillows so I still had the small but at least I felt I was getting enough air and actually got in over 8 hours on the machine. Actually, I THOUGHT I'd done well. I was surprised at the AHI. It was 6.4 the night before when I'd wakened and yanked the thing off. I did spend quite a bit of time awake last night - on the machine, but awake. How would that enter into the mix? One thing I've noticed is that my breathing (when I'm awake and noticing) is not always a regular rhythm - sometimes there is like a longer pause before I inhale. What is that about?

[ozij]

Well, good news and bad news - I set the machine at 6.6 pressure and lowered EPR to 2. I did not have the suffocating feeling at all. HOWEVER leak rate was 0.8 and AHI was 12.6. So, things are still not "right." The DME had not included the medium pillows so I still had the small but at least I felt I was getting enough air and actually got in over 8 hours on the machine. Actually, I THOUGHT I'd done well. I was surprised at the AHI. It was 6.4 the night before when I'd wakened and yanked the thing off. I did spend quite a bit of time awake last night - on the machine, but awake. How would that enter into the mix? One thing I've noticed is that my breathing (when I'm awake and noticing) is not always a regular rhythm - sometimes there is like a longer pause before I inhale. What is that about?

The machine needs your rythmic, sleep breathing in order to figure out what's going on. If you're awake it can't interpret your breathing and gives you AHI results that are really not valid -- you can ignore them.

Your leak rate on the other hand, is disconcerting. Is that really 0.8 Liters per second? Much too high -- unless you left the machine running a few time with your mask off.

I can understand how a move from 6 to 6.6 feels dramatic -- slight changes felt very large to me too when I started -- but you should know that formally, EPR is a comfort feature, which patients can adjust on their own. Not so the pressure. So - if you're into pressure changing, you really shouldn't worry about changing your EPR.

[DreamOn]

If your leak rate was 0.8 L/s, then that's double the maximum "acceptable" leak rate of 0.4 L/s -- very high. With a leak rate like that, your other numbers are not going to be accurate, so I wouldn't be concerned about the reported AHI from last night. So now, the task is to determine where the leaks are coming from. Here are the things to troubleshoot:

(1) You're removing your mask and leaving the machine running (it will report all that lost air as "leaks"!),

(2) Your mask is leaking air, and/or

(3) You're losing therapy air from your mouth, either by mouth breathing or from your mouth dropping open (most likely during deep REM sleep, when all muscles in the body completely relax, including jaw and tongue). You could be sleeping right through this. If this is your problem, you could try a chinstrap and/or mouth taping. Or you may need to use a full face mask, which covers both nose and mouth.

Once your get the leaks figured out, I suspect you'll see your AHI come down quite a bit. The machine can't compensate for high leaks, so as a result you aren't getting the benefit of the pressure and your airway isn't being stented open.

You'll get it all worked out! You are making progress, especially using the machine for over 8 hours. And you didn't have the suffocating feeling!

[peppi]

My fellow Orlando-ian.
I will gaurantee that after 1-2 weeks of using the same pillows you will have problems both exhaling and inhaling, regardless of setting. Been there , done that.
I read earlier in this thread where ResMed knows there is a problem with their nasal pillows but refuses to fix it because people get new pillows every month anyway.
Hog wash. I DONT. I PAY FOR MY OWN.
Shame on Res-Med or any company knowingly making a defective product.

I bought a set of Breeze pillows and I will be moding my swift LT mask to make it like it should be... a working, reliable product that does'nt put peoples health in harms way. I have read where some have used the same Breeze pillows for YEARS not weeks.

BTW, Res-Med never even responded to me even after I told them I had a grand -mal seizure due to their defective nasal pillows.

Thats a shameful company and I will never buy a product from them again.

[btesterman]

My fellow Orlando-ian.
I will gaurantee that after 1-2 weeks of using the same pillows you will have problems both exhaling and inhaling, regardless of setting. Been there , done that.
I read earlier in this thread where ResMed knows there is a problem with their nasal pillows but refuses to fix it because people get new pillows every month anyway.
Hog wash. I DONT. I PAY FOR MY OWN.
Shame on Res-Med or any company knowingly making a defective product.

I bought a set of Breeze pillows and I will be moding my swift LT mask to make it like it should be... a working, reliable product that does'nt put peoples health in harms way. I have read where some have used the same Breeze pillows for YEARS not weeks.

BTW, Res-Med never even responded to me even after I told them I had a grand -mal seizure due to their defective nasal pillows.

Thats a shameful company and I will never buy a product from them again.

I pay 10% BUT I doubt that they will deliver the 2 pillows each two weeks - the DME is 1/2 hour from me so guess I will have to trek out there twice a month to get pillows. I may try modifying also - if I can get up the nerve. I could try it on a "worn out" set first to "experiment" I guess. OR, I am still seriously considering just switching to a different mask as the girl said I could exchange within 30 days. I'm seeing too many negatives about these pillows.

And - I did leave the machine on to automatically shut off when I got up twice during the night. I didn't realize that would count as leaks! Oops! Live and learn!!! I'll keep working at this - my titration went so totally smoothly I was thinking this would be a piece of cake. Silly me!

[DreamOn]

And - I did leave the machine on to automatically shut off when I got up twice during the night. I didn't realize that would count as leaks! Oops! Live and learn!!!

Well, don't feel bad. I didn't know that when I first started either! And I'm sure we're not the only ones. I haven't had to get up for a bathroom break since a month after starting CPAP, but when I did, I learned to turn off my machine first and then disconnect the mask. It gets to be second nature after a very short time.

I'll keep working at this - my titration went so totally smoothly I was thinking this would be a piece of cake. Silly me!

You're very fortunate that your titration went so well. Mine didn't go well at all, despite having a positive attitude about it, and I felt ill the entire next day. It made me wonder how things were going to go at home. But it's actually gone quite well. There have been little challenges (mainly with masks and mouth leaking--now solved), but my results have been very good and I feel great. It's worth it! Soon you will hardly realize that you have a mask on your face.

Sweet dreams.

[Sleepseeker]

I am relatively new to CPAP too (sleep studies in Oct 2009) and had the same problem (woke up feeling that I was suffocating with a full face quattro mask at 12 cm with EPR on a Resmed S8 Elite II). I switched to the "sleepweaver" by circadience all cloth nasal mask and have never had that sensation since! The mask is like a small cloth balloon over your nose. I hope this helps.

[letchworth]

but I still wake up after about 5 or 6 hours of sleep and feel like I can't breathe (in or out). I adjust the pillows but it is a scary feeling and I end up taking it off so I can go back to sleep.......... Is this a common thing or are these little pillows actually closing up (it's what I feel like has happened). I'm using the Small pillows - may try medium and see if that helps.

I use the Respironics OptiLife, so the pillows are slightly different- but one thing I noticed is that if the pillows are too large it feels like it is stretching my nose by morning (it feels uncomfortable). If they are too small they go too far up my nose and/or leak too much (and in my case I end up tightening the headgear and that can crush/compress the pillows, cutting down air). The combination of proper size and air pressure should seal them to you quite comfortably.

Good luck- you are asking some good questions (& these people can help you through the process)
letchworth

[btesterman]

" but you should know that formally, EPR is a comfort feature, which patients can adjust on their own. Not so the pressure...".

I don't have a "moral" (ha,ha) issue with changing the pressure. I think the titration is one night and that pressure is a good starting place but bottom line is we need to find the settings that make using CPAP as comfortable as possible while (most importantly) giving the best results. I'm just a bit timid messing with technical equipment. But - I'm getting there!! Will raise it to 7 tonight! Baby steps.

[Czech Daughter]

i feel like i struggle to get enough air in, and to exhale. it is like labored breathing. it starts when i start my cpap therapy, and resolves pretty much after about 20-30 minutes. then, i awaken i awaken often, struggling to get air, again. using zyrtec, but, actually have not felt nasal congestion.
ResMed AirSense 10 autoset, order is 7 and 20. humidifier set at 1 (default is 4)... hoping to relieve the rainout. Resmed P10 nasal pillows. no ramp.

[OkyDoky]

i feel like i struggle to get enough air in, and to exhale. it is like labored breathing. it starts when i start my cpap therapy, and resolves pretty much after about 20-30 minutes. then, i awaken i awaken often, struggling to get air, again. using zyrtec, but, actually have not felt nasal congestion.
ResMed AirSense 10 autoset, order is 7 and 20. humidifier set at 1 (default is 4)... hoping to relieve the rainout. Resmed P10 nasal pillows. no ramp.

Do you use EPR (Exhalation Pressure Relief)? You might try a larger nasal pillow size and see if that makes it easier to get more air. Here is a copy of the Clinical manual for your machine. https://sleep.tnet.com/home/files/resme ... -guide.pdf

Here is a link to a site that will help you download the free software SleepyHead so you can read your Data from the SD card. https://sleep.tnet.com/resources/sleepyhead
Once you have that done, we can tell you how to post screen shots if you would like us to look at them.

To get the most help please register and then register your equipment so it will show up in your post like ours does at the bottom of our post. This will show you how. wiki/index.php/Registering_Equipment_in_User_Profile

I know I have given you a lot but I wanted you to have what you need to get started. I would also start a new thread of your own, since this is an old one, and stay with us until we can see if someone can help you.

[Julie]

Try raising the low pressure setting by 1-2 cms for a couple of nights and see how you feel... 7 may be too low for you and 8-9 more realistic (and very common).

[Ferdz]

What if i turn the EPR off? What would be the effect?