3rd night, can't do it!!!

[Cudos]

I'm only 3 nights in and just now loading sleepyhead so I have no info. My RRT set me up on a Resmed10 auotset on Thursday night, set to auto 6-9, no ramp. I had trouble trying to breath but managed at least a few hours on the thing. She notified me I had 11 AI's and was switching me to straight CPAP for Friday and Saturday.

I cannot fall asleep with the mask, sorry Airfit F10. I am having anxiety attacks and ripping the mask of after a period of trying to breath in it. I can breath in but the exhale is brutal. Exhale assist is on and set to high setting. I have not fallen asleep. As soon as I even start to drift my breathing becomes very shallow and then of course I have take a deep breath in and now I have to blow out and I find the back pressure too much and I can't catch my breath so I start panicking from the oxygen starved sensation in my gut.

I try to battle through but after an hour I come up having to rip off that mask, get out of bed and settle down. Mask pressure was set to 5.2, I tried higher and lower to no avail. I'm already at my wits ends, actually afraid to put it on now.

How can i possibly make the mask work if I can't get past the exhale problem. Maybe I'm just too shallow a breather as I get close to dozing off. I really find the exhale extremely hard, bad lungs maybe. I'm typically a mouth breather but am wondering If a nasal mask or pillows would be better.

I will try to get some sleepyhead info up but I think it might not be accurate because I'm awake most of the time fighting for air.

Any thoughts????

[Diamondminek]

Have you tried wearing the mask with the machine on during the day to get used to it? Relaxation techniques can help too. paying attention to your breathing wont help, your bosy will do it automatically if you can switch off to let it.
Sleepyhead might be worth looking at, depending on how your pressure was arrived at - 6 is quite low, which can be weird to get used to. 9 might not be high enough, depending on whats happening. it might be that having a short ramp would actually be helpful.
a different mask might help, but if you are a mouth breather, switching to a nasal mask brings a whole new set of challenges.
you will get past these problems but it all just takes a bit of time and figuring out.

[Wulfman...]

Maybe your humidity setting is too high. That can contribute to the claustrophobic feeling. Also, a pressure too low could be a contributor.

You're already at a pretty low pressure, but is EPR (exhale relief) configured on your machine?


Den

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[ChicagoGranny]

set to auto 6-9

I can breath in but the exhale is brutal.

It's in your mind. I am a small, elderly woman who uses a pressure range of 12 - 20 with an average of 16 and a typical max of 18, occasionally 20. I breathe comfortably and slowly against those pressures.

You are concentrating on breathing and obsessing about it. You need to distract your mind away from breathing and let your autonomous system control breathing. Try to think of a pleasant, relaxing situation and get your mind totally off breathing and CPAP.

Do you have any other health problems?

[Julie]

You have a feature on your machine (EPR - exhale pressure relief) that you can set to 1,2,3 etc. and find exhaling easier. You might find that when set on the high side your AHI is also a bit higher than it might otherwise be, but generally people find a balance. And if it makes you feel better and work your treatment, it's not important right now if it is 'in your mind', though I'm not sure why that even came up. Of course you're anxious, but it doesn't mean you don't have a valid issue either!

[Cudos]

Hi all, exhale relief is on, humidity was set to auto and 23c on the hose, humidity not the problem. If the mask pressure is increased does that not increase exhale pressure requirements? If I'm struggling breathing out with a mask pressure of 5.2 won't a pressure of 8 or 9 make it worse?.

Trying to load a screenshot but not having much luck, coming out very tiny. I have tried wearing the mask before hand to get used to it and had some success but its "when I start to doze off" that I end up gasping or taking in a deep breath because my breathing is so shallow and that big gulp in requires a decent exhale which is where the problem lies, its as if I can't blow out freely enough without causing another deep inhale and on it goes. It's as if I'm exhaling in to a blanket pressed against my mouth.

I don't know, I will talk to my RRT tomorrow

Thanks everyone

[Cudos]

set to auto 6-9

I can breath in but the exhale is brutal.

It's in your mind. I am a small, elderly woman who uses a pressure range of 12 - 20 with an average of 16 and a typical max of 18, occasionally 20. I breathe comfortably and slowly against those pressures.

You are concentrating on breathing and obsessing about it. You need to distract your mind away from breathing and let your autonomous system control breathing. Try to think of a pleasant, relaxing situation and get your mind totally off breathing and CPAP.

Do you have any other health problems?

Granny, easy to say its all in my head, I wish it was that easy. Other health problems?? not sure, I know I was subject to 2nd hand smoke till 14 years of age then decided to smoke for 20 of my own years before quitting at age age 36 so maybe there's a problem there. Hold your breath for as long as you can or until you get that horrible feeling in the pit of your stomach, that's the sensation that drives me to rip off the mask. Not so easy to just push through that feeling.

Thanks

[BlackSpinner]

Get the clinician manual, unhook the modem and set the pressure to what is comfortable for you. Ignore the therapy for now and just spend a week getting comfortable with the equipment. Wear it while watching tv or playing computer games to get you subconscious used to it.

After a week or so slowly increase the pressure a bit every few day until you achieve a good pressure that reduces your AHI to under 5.

Like riding a bicycle some people need training wheels at first. You don't enter a race the first day.

[lilly747]

Trying to load a screenshot but not having much luck, coming out very tiny. I have tried wearing the mask before hand to get used to it and had some success but its "when I start to doze off" that I end up gasping or taking in a deep breath because my breathing is so shallow and that big gulp in requires a decent exhale which is where the problem lies, its as if I can't blow out freely enough without causing another deep inhale and on it goes. It's as if I'm exhaling in to a blanket pressed against my mouth.

I don't know, I will talk to my RRT tomorrow

Here is some links that might help: and of course maybe your RT can help, if not we will still be here

Here, in order, will show you how to take sleephead images and post them tof Captalk.com:

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/resources/sleepy ... screenshot
https://sleep.tnet.com/reference/tips/imgur

[Huh?]

set to auto 6-9,

These are low pressures. Count me as one who also thinks it's mental. It's also common for newbies.

You don't say what kind of physical shape you are in, but there should not be a physical problem in exhaling. Somehow, you need to muster up the confidence to overcome the mental aspect. This has to do with telling yourself your body can do it and getting your mind out of it.

Maybe as suggested, you could sit quietly on the sofa wearing the mask and running the machine. Practice this long before bedtime.

[Guest]

Thanks everyone, and thanks for the links. I will give it another college try tonight, seeing as most seem to think its in my head I'll go in with that in mind and see how it goes. As long as I can make baby steps, I knew going in it wouldn't be a cake walk.

Cheers

[Janknitz]

Here's something you might try:

Set your machine up next to the comfy chair/Couch where you watch TV

Put on a favorite movie or TV show--great time to binge watch if your TV permits that (I'm watching the FX series The Americans right now).

Set the ramp feature on your machine to "auto".

Watch the movie, and about 15 minutes in, put on the mask, noting the time. When you get panicky, don't remove the mask right away. Take 10, deep slow breaths, promising yourself you may remove the mask at the end of 10 deep slow breaths if you still need to. It takes some fortitude to overcome the fear and get through those 10 deep, slow breaths, but you can do it. Be kind and patient with yourself.

If you need to take the mask off after 10 deep slow breaths, then do it, but jot down how long you kept the mask on.

Watch the movie for a while, and repeat, with a goal of trying to increase the time you keep the mask on. Use the 10 deep breaths every time before you remove the mask, until you find you don't really need to remove the mask anymore--you can calm yourself down in the mask. Always return to the movie, to get your mind off trying to match or control your breathing.

Don't worry about sleeping with it until you feel like you can wear the mask for more than an hour or so comfortably.

You might try something at night to distract you from feeling like you must control your breathing--I listen to podcasts.

It IS hard to breathe out against pressure at first. It takes a week or two to get used to that. And the claustrophobia is real, too. I would sometimes wake in a panic, rip the mask off, and throw it across the room. But then I started using the 10 breath technique. At first I would rip it off immediately after the 10 breaths, but then I began to feel calm enough to leave the mask on for longer and longer periods.

I have pretty severe apnea, so sleeping without the mask was not an option. I'd always put it back on and keep trying. The podcasts helped, and eventually my periods of sleep grew longer and longer. But if you feel you can't hack that yet, try the distracted awake time first. When you can watch a few hours of TV with the mask on, it's time to try it for sleeping again. Be sure to let your doctor and DME know of your struggles so you can get extra time to meet the compliance requirement.

Good luck.

PS, I was having panic attacks in other aspects of my life, too. After I got used to sleeping all night with the CPAP mask, my overall panic reduced significantly, too. I think the apnea is part of the reason I had the panic attacks in the first place--spending all night marinating in my own stress hormones!

[RogerSC]

I had a rough time the first night of cpap as well. Ended up not getting to sleep after an hour, and had to go to work the next day so just gave up that night. The next day, gave my sleep doctor a call, and had him send a prescription for Ambien over to the local pharmacy. Took Ambien for a week, and then stopped. After that week of getting my body used to cpap while taking a sleep aid, that was it, from then on I was good to go.

Ear plugs are also helpful for me, although I've found them somewhat controversial around here...it's a personal choice. For me, they shut out most of the external noise, and I just hear the rhythm of my own breathing, which is fine, kind of soothing for me, actually.

Other thoughts are whether you really need to use a full face mask. Nasal pillow masks are much less intrusive and claustrophobia-inducing than full face masks. With a full beard, when I tried a full face mask I felt like a dog in a car with its head out the window, hard to kill the leaks. On the other hand, a lot of people do fine with full face masks, it's a personal preference. The Swift FX worked well for me for several years...that was the one that I used during my first week (with Ambien, as well *smile*). Right now I need a soft mask, at least temporarily, so the Sleepweaver Elan is working fine for me. Not sure I would have been ready to start using cpap with that mask, the Swift FX was much easier to fit and put on and take off.

I agree with the idea of using cpap when you're not sleeping, that also helps your body get used to cpap, and can help you forget about trying to control your breathing. My pressures are 11-15, and EPR is set to 3. The only problem that I've with breathing was the ramp. The DME had my cpap set up with a ramp when I got it, and that started at a pressure of 4. I felt like I wasn't getting enough air at that pressure, so as soon as I figured out how, I turned off the ramp. That was also a step forward.

Over time you figure out how to make this work for you. You do sound like you're in it for the long term, which is a healthy point of view, so keep reading and trying different things to get the right combination of comfort and therapy *smile*.

[Cudos]

Thank-You Janknitz and Roger,

Some really good advice there, I will take note of your ideas. Question though, which EPR setting gives the best exhale relief 1 or 3? also what does the "auto" ramp vs a set time do. Janknitz suggested to go with "auto" does that detect and adjust for my breathing pattern. And finally, does the higher pressure you choose relate directly to exhale difficulty?? higher is harder?

Thanks so much.

[Gasper62]

Buy a bag of party balloons. Blow a few of them up several times during the day. Your exhale prowess will improve. A lot.