Please help! Panic when putting mask on, can't sleep!

[beth2507]

Hi everyone, I know this has been covered some on here but I really need help.

I stopped using CPAP for 3-4 months after faithfully using it for two years. I saw the doctor and got a new mask and an auto titration unit to get back on track. I started last night. I am using a DreamWear Nasal CPAP Mask, which is a pretty small nasal pillow one. I put it on my face at night and immediately panicked and couldn't calm myself down. I felt like I couldn't breathe, I had an upset stomach and ended up vomiting, and I was so panicked. I only left it on for 5 mins or so and ended up being so upset i hardly slept the rest of the night.

I want to use CPAP. I'm so frustrated. I only have the titrating unit for two weeks. What if I can't even use it? I am going to try the "desensitization protocol" and wear it during the day. I sleep better with CPAP, I want to wear it, but my body is reacting this way.

Please, if anyone can offer any encouragement or advice, I really need it.

[Pugsy]

What pressure did you start out with last night?
What pressure were you using back when you were using the cpap machine?

[beth2507]

She said that because it was auto titrating it started at 4- my pressure in the past was 9. The respiratory therapist said not to worry because it would automatically know what I needed?

[Oltremare]

after faithfully using it for two years.

In the past what type of mask you used?
With the new form, what has changed?

[Pugsy]

That starting point of 4 cm is often too low for most people to be comfortable with. They tend to feel like they are suffocating or not moving enough air.
The default for the auto titrating machines is 4 cm to 20 cm. Probably not the best especially for someone who has used 9 cm in the past.

I think maybe a higher starting point than 4 cm would be more comfortable and less likely to create issues.
What brand of apap did they give you? Is it like your S9 Escape or a different brand.

If it were me I would change that starting point of 4 cm to something a little higher to see if perhaps that help things. Maybe 5 or 6 cm starting point and don't use the ramp because that also defaults to 4 cm.

[beth2507]

Thank you both.

I apologize I"m in a bit of a panic because I don't know what to do.

My old mask was a swift Fx nano, but i thought that was too claustrophobic for me and am now trying the Dreamwear nasal mask.

The auto machine they gave me is a Fisher and Paykel Icon Novo auto. Thank you for the suggestion of increasing the pressure. That makes sense. I will see if I can figure out how to do that.

Thanks again for your help.

[Pugsy]

I don't have the manual for that machine handy but you can request it here and how to change the minimum pressure is explained in it.
Just make sure to request the correct manual. Instructions down near the bottom of the page.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
Or the short version might be there and enough to get you to where you can change that minimum pressure.

[lindalrc]

Sounds like two things are going on at once - not always a good idea when you are trying to develop information. You are learning a new mask AND doing a titration. The best suggestion is, of course, upping the lowest pressure. But you might also want to use your old mask or talk to the titration machine supplier to find out if there are other ones available. Finding the "right" mask is often the hardest part of CPAP adjustment.

[Thatgirl]

Increase your starting pressure- probably to at least 6. Turn off ramp. Make sure your machine is set for a nasal mask. When you put the mask on, play around with the angle the air hole sits on your nose at. I had problems feeling like I was suffocating with this make. Turned out I just had to angle the opening toward my nostrils more, and I got much more air. When you feel panicked, let yourself breath through your mouth, but try not to take the mask off.

[beth2507]

Thanks for all of the information. I have been reading multiple success stories on the board and am encouraged that most people get through this.

Thank you for the information on where to get the manual. I've emailed them for this. That makes sense that I may need more pressure to start.

I will play around with the angle of the mask too. It felt akward and i wasn't sure if it was an adjustment thing or what. I'm not sure if this is the mask for me anyway and am considering going back to my old one, I thought the old one made me feel more claustrophobic but I felt a little less air pressure and am wondering if it is a better one for me. I think ultimately I may just have to pick one and try to desensitize myself to it.

[Sleeprider]

Remember, with a nasal mask, all you have to do is open your mouth. If you could replace a panic reaction with just opening your mouth until it passes, it might help.

A higher minimum pressure should help, and be sure you turn on the machine before panic sets in. You might want to do some repetitive practice of masking up and starting the machine to desensitize yourself.

The DreamWear has a fair amount of headgear and those tubes coming along the side of your face. If I was looking for something truly minimalist, I'd take a look at the Resmed Airfit P10 nasal pillows. There are no buckles, snaps or Velcro, so it goes on and off in one simple movement. Adjustment is just a matter of spreading the split strap.

[Lucyhere]

The DreamWear has a fair amount of headgear and those tubes coming along the side of your face. If I was looking for something truly minimalist, I'd take a look at the Resmed Airfit P10 nasal pillows. There are no buckles, snaps or Velcro, so it goes on and off in one simple movement. Adjustment is just a matter of spreading the split strap.

I agree with Sleeprider. Too much headgear on the face with the DreamWear. Went back to my Airfit P10 the same night. So much more comfortable and less on the face. If it were me, I would up your pressure to 6. Try to keep telling yourself it's only air and can't possibly hurt you. I know you mentioned this but do sit with the mask and machine (with higher pressure) on while watching TV or reading.

[beth2507]

Thanks again. Sounds like I should just go back to the old mask for now and/or talk to my DME about getting a new one like you mentioned. I will find out how to increase the pressure. I need to talk myself down. This anxiety reaction I am having is ridiculous. Its just air!!! I am not sure how to break it. I think I just have to talk myself down. I think I'll spend a few days wearing it with air on while watching TV with increased minimumm pressure. Then I"ll just have to jump in to wearing it at night. I keep disturbing my husband so maybe I need to go in the spare room for a few nights. That might be less pressure for me. I'll have to put it on and talk myself down and just not sleep without it - eventually I have to get tired enough and sleep.

I am considering taking Ambien for a few days to get over the hump (I have a few) but know that is a plan with mixed reviews.

THanks again everyone. I am really bent out of shape about this which is not like me.

[codinqueen]

Pick up some Sleepytime or chamomile tea at the grocery store, made by Celestial Seasonings I think. Drink it about 20 minutes before you want to go to sleep. It might help you to relax enough to go to sleep with the mask on, or try some melatonin or Benadryl before bed if you are not allergic to it- they are less sedating & have less side effects than Ambien.

[kteague]

If it takes a while to be able to use it most of the time but the doctor knows you are working towards it, they can add another week onto the trial period. They had to do that with me.