My ears and face are killing me!

[Lauren168]

In my sleep study, I had 101 events per hour. Min duration 18 second, Max duration 56 seconds. RX for AHI is pressure of 25/17.

Got my BiPAP machine yesterday and last night was awful. Going to sleep was a piece of cake. Staying there was a different story. I wound up ingesting more air than breathing it and I have been burping and passing gas throughout the night and most of today. Once my Bipap was in full swing, I felt like an octopus trying to fix the gaping in my full face mask by tightening it every which way. By about 4:00 am (6.9 hours later) my face, particularly the bridge of my nose, hurt so bad I had to stop.

When I laid on my back, under full pressure 25/17, it feels like I am trying to blow up a very large uncooperative balloon. My ears are still throbbing. If I allow my mouth to open it feels as though G forces are blowing my mouth wide open. Should it be this violent?

The thought of going to sleep makes me want to just cry.

I don't want to seem like a whiner, but I seriously think the pressure setting is too high. What do I do until Tuesday?

[nosleepingforyou]

I haven't started yet so I can't answer the question. But I am not looking forward to the octopus.
Did you have any problems when you went back for the second visit with the machine? I am sure it's just a matter of setting it up and getting used to it.
Don't tell my wife it will increase the exhaust pressure. I will be sleeping in a tent.

[Lauren168]

I am supposed to just get used to it? Somehow I don't think so.

Users of CPAPs, please read my post - should the machine pressure be so violent?

If so, I will turn the whole thing back in and go back to snoring at 86 decibels.

[rlyndecker]

I am NOT an expert but NO that's not the way it should work. I have had a REALLY hard time finding a mask to fit me (the space between my nose & mouth is small; same with my nose to my eyes!). You need to find a mask that fits better, my understanding is if it works properly you really shouldn't feel any air. My #1 suggestion is DO NOT wait. I made the mistake of trying to get used to it & then found out that I can't switch masks for 90 days!

Read through some other posts here and you might get some better suggestions, just don't give up!

[LSAT]

When you first start CPAP therapy you will notice the air pressure and it may seem severe...however...after using it for a while you may begin to wonder if the CPAP is even working. At a setting of 12 I can not even feel the air blowing. I suggest that you sit with the mask and CPAP while you watch TV or read several times during the day.

[MaxDarkside]

How you tolerate pressures above 15 cm H2O probably has to do with your physiology (structure of your body). I cannot tolerate above 15. I went to 20 cm H2O one time on the recommendation of a respiratory therapist when I was sleeping on my back and the machine was not resolving significant events. I could not handle it. I felt like I was being jammed with air, air blown down into my stomach, gopher cheeks exploding, etc.. I found a way to sleep on my tummy where I had lower AHI scores during the study anyway and now I can operate with limits between 5 and 15 cm, rarely going outside 6-12 and I sleep like a kitten. Wonderful. I hardly notice the machine other than I feel better.

[Julie]

Loosen the straps - the more you tighten them beyond the minimum needed to keep the mask on, the more micro gaps are created between you and the seal as the air looks for places to squeeze out, but if the mask is seated properly, you shouldn't have as many problems (minor leaks aren't always terrible in relation to therapy) with it.

[jamiswolf]

Lauren,
Those are pretty high pressures and I'm not surprised you're having difficulties. The ASV people often have to deal with high pressures and many use mask "gaskets" and anti-leak straps.

Any way you can stay off your back? That's the worst position. My back pressures are around 17cm while on my side, it's only 6cm or 7cm. Major difference. (not everyone is so positional) Also do whatever you can to improve your health status. Lose weight if that's an issue. Monitor your D3 level and supplement as needed. Exercise your face and throat muscles (I use the Didgeridoo to do that) Anything that can improve your situation so that pressures can be reduced. In short, take a holistic approach. That's what I'm trying to do. I still need bipap but my pressures are manageable and things are going smoothly.
Good luck,
Jamis

[Lauren168]

Thank you to everyone who responded. I do have 30 days to find the right mask, but not still not convinced the mask is the problem.

I set the ramp to 45 minutes last night. I laid in bed awake, but relaxed and let the machine go to see where I was having trouble.

I really can barely tell the machine is on at an Exhale of 8 and Inhale of 13, with the exception that the machine "breathes" about 5 seconds faster than my natural breath.

At about 13E and 21 I, I am breathing with the machine and it is still comfortable and we are one. I wish I could stop the machine right there, but my machine is not an automatic and is set by the RN.

Once up to 14E and 22I the mask makes a funny flub noise when I exhale. Distracting enough to wake me up.

After the pressure goes above 16E and 23I, the mask is leaking everywhere and it is no longer comfortable. Above this the pressure in my ears brings me to tears.

So come Tuesday, hopefully the RN will convince my doc to dial the damn thing down.

[jamiswolf]

Lauren,
I understand that you're new here. But the general feeling and philosophy here is to take charge of your own therapy. Even though your sleep study may have dictated those pressures, you aren't tolerating them. Change the damn pressures yourself. Get the Clinician manual and learn how to do it. Also, you need to get the software to read the data chip to see how effective your therapy is. You needn't be a victim of the system.
J

[RocketGirl]

Lauren168, when you go in on Tuesday, tell them exactly what you told us - that the top pressures hurt your ears to the point of tears, that you can't sleep with the current setup and that something must be changed. By all means you can ask for the pressure to be lowered, but if your sleep study results indicate that you really need those pressures to quell your apneas, then the doc could possibly get very stubborn about that.

I guess I'm saying to be open to other solutions - if you point out that overall, it's not working, you can't be compliant because of the severe pain and the leaks, then even if they don't feel that it's wise to lower the pressure, the onus is on them to work with you on your mask, sleeping position, or other things.

[Lauren168]

Looking for a full nights sleep tonight. Doctor agreed to turn it all down so tonight I am set to 13 Exhale and 21 Inhale. Have also cranked the humidity up to 5. Wish me luck!