CPAP is working - sometimes wake up fighting to exhale

[5thumbs]

Been using for 10 days. some minor leak issues (a few days close to 24), AHI averaging around 2 (25 before CPAP). Resmed S9 set at auto with 17 as the upper limit. Machine rarely goes over 15 (sleepyhead software and Resmed software). A few times during the night i wake up fighting to exhale. I check seals, and try to fight thru it hoping that the auto setting will calibrate to the lesser pressure. I end up turning off the machine and restarting and going thru the ramp cycle. Is there a way to decrease the pressure and/or breath in such a way for the S9 to lower the pressure? Many thanks

[chunkyfrog]

You didn't mention your lower pressure setting.
When mine was too low, I would be awakened by runaway pressure that would not subside,
and I had to stop it the same way you did.
I believe this is the machine 'chasing' an event,
but the pressure cannot rise quickly enough to stop the apnea; but it keeps trying.
If your low pressure is set too low, this may be the cause.

[rjezuit]

Try setting your EPR higher also.

[archangle]

Try to not panic and study the situation. (Easier said than done, I know.)

Consciously try to inhale and exhale. Figure out if the pressure is so high that you are "mechanically" unable to exhale. Sometimes apnea is being unable to exhale because your throat is closed off. Feel the air flowing in and out.

Without disconnecting anything, try to read the pressure on the display of your machine.

If necessary, pull the mask partly or completely off your face and check the machine before turning it off or pressing any buttons.

You can ask to have your maximum pressure reduced, at least for a while until you adjust.

[5thumbs]

Thanks for all of your responses. Ive read more from this site, and this is what I think is happening.

Mask starts to leak, auto machine increases pressure, I wake up due to the leak and adjust mask, pressure is now too high for me to deal with (like a leaf blower in my face). I have a hybrid mask, auto set from 8-17, AHI is now 1.8 average over 30 days (down from 23 at sleep study). I only sleep 6 hours/day. So far no boost in energy, but I am not waking up as much during the evening.

When I wake up and the pressure is unbearable, I end up stopping and starting the machine. I have tried to adjust the mask, then take slow breaths to let the machine auto adjust lower, but after 5-10 breaths it does not stop, so I flip the machine off.

THanks for your help and opinions. I have learned a lot from this site.

5thumbs

[Pugsy]

When I wake up and the pressure is unbearable, I end up stopping and starting the machine. I have tried to adjust the mask, then take slow breaths to let the machine auto adjust lower, but after 5-10 breaths it does not stop, so I flip the machine off.

5 or 10 breaths isn't enough time. The machine doesn't respond that quickly.
Either use EPR or do as you are doing and restart the machine. It just won't drop from 15 down to 5 in the time frame you are wanting.

[robysue]

Been using for 10 days. some minor leak issues (a few days close to 24), AHI averaging around 2 (25 before CPAP). Resmed S9 set at auto with 17 as the upper limit.

What's the APAP range set for? In other words, do you know what the minimum pressure setting is?

What's the beginning ramp pressure set too? (Most likely the ramp pressure starts at 4cm.)

If your minimum pressure setting is larger than 4cm and you can tolerate the machine starting at your minimum pressure setting, then turn the ramp feature off entirely. That way when you turn the machine off and back on, it will be blowing at your minimum APAP pressure and not at 4cm.

Machine rarely goes over 15 (sleepyhead software and Resmed software). A few times during the night i wake up fighting to exhale. I check seals, and try to fight thru it hoping that the auto setting will calibrate to the lesser pressure.

Unfortunately WAKE breathing is much more irregular than normal SLEEP breathing. And because of this fact, it's not uncommon for machines to score "events" when we are wide awake but breathing with the mask on. And so while you are "trying to fight thru it", the machine is more than likely interpreting parts of your more irregular WAKE breathing as "potential apnea flags like Flow Limitations!" and hence maintaining or even possibly increasing the pressure all in an attempt to prevent apneas.