Is the Machine Breathing Me?

[Duncan117]

I'm having trouble using CPAP. I started with a nose mask and now have the full mask. I have managed to fall asleep only 2 or 3 times in the past few weeks. The full mask is fine. I can breath well with it but as I fall off to sleep I can feel myself unintentionally pausing before taking the next breath, as if I was waiting for the machine to breath for me. This pausing oddly continues for a minute or two after I stop the machine. I tried for an hour last night. I kept drifting off to sleep and then waking feeling myself having to remember to breath. Seems a bit nuts. Any advice?

[Sir NoddinOff]

Nope, unless your machine is an ASV model... which I presume it isn't. It'll take a little while for your brain to get used to the pressure changes when drifting off to sleep.

[BlackSpinner]

It doesn't breathe for you but if you have exhale pressure relief on then it can feel like it.

Practice wearing it while watching a movie so you are distracted from the machine and you body/mind gets used to having it on.

[Pugsy]

What are your settings?
Are you using the ramp? If so for how long?
Are you using EPR? If so at what setting?
Do you have the software so you can see exactly what is happening when you are experiencing these difficulties?

For us to be able to offer anything other than wild ass guesses we need more information and we need to see those detailed reports.

See here for software options...Sleepyhead will work fine with your machine.
https://sleep.tnet.com/equipment

How to post images so we can see what you are seeing
https://sleep.tnet.com/reference/tips/imgur

How to organize things for optimal review
https://sleep.tnet.com/resources/sleepyhead/shorganize
there's 3 pages in total..be sure to read all of them

and for some examples of what we like to see ...see this thread
viewtopic/t103468/Need-help-with-screen-shots.html

These machines (like you have) don't/can't "breathe for you"...they are designed to hold the airway open to prevent apnea events that are caused by airway tissues collapsing.

Now there is a situation where there is a type of apnea event happen when a person is transitioning to sleep and your machine can't do much about that type of event (you would need a different machine) except report that it happened.
We don't know if that is what is happening here..let's evaluate your software reports so we aren't guessing.

[D.H.]

I did turn off the C-Flex (a form of exhalation relief), as I found it annoying.

[LSAT]

I did turn off the C-Flex (a form of exhalation relief), as I found it annoying.

Can I turn you off?....I found you annoying

[chunkyfrog]

Duncan, when you fall asleep or otherwise stop thinking about how you are breathing,
your body does what it is supposed to do. When you think too much, that is when you scare yourself.
Read, or watch TV, until you fall asleep. It will get better.

[Goofproof]

I did turn off the C-Flex (a form of exhalation relief), as I found it annoying.

We find a lot of things pointless and annoying, but he keeps posting anyway! Jim

[Duncan117]

My settings are 5- 12.
My EPR is on Full time set to 3
My Ramp is on set to Auto.

I am uploading the screenshot from the sleepy time software.

The first I actually fell asleep for two hours or so.

http://imgur.com/a/XDbkn

The second one I had a nap during the day and then tried to fall asleep at night:
http://imgur.com/a/uGu7S

THanks for any help you can give.

[Julie]

Hi, I suggest you a) turn off the ramp, b) turn off EPR (for now), and c) raise your low pressure to 7 or 8. You're just not being adequately treated and I doubt if EPR is necessary as it's meant to make exhaling easier if you have trouble with that, but it's not something likely to affect you at your present setting of 5, which is just 1 cm above the machine's default low of 4! Ramp delays treatment for as long as you've set it to take to 'reach' 5. It's meant to make initial start-up easier for those who can't handle much higher settings but in your case isn't helping anything (most of us turn it off forever after the first week). And most people find 4 or 5 difficult at best to inhale at and it's not usually therapeutic... so raising it by at least a couple of cms should make things easier.

[Pugsy]

There's no proof the your minimum pressure needs to be raise because it isn't doing a good job because there's not enough cpap use to really see if it is working or not.
There's really not enough of anything on the reports you posted to know what's going on at all except there was a massive leak for a while.
So far there's not a large number of any events pointing to the pressure you are using allowing a bunch of apnea events to happen which would indicate you need more pressure.

The one report where the minimum was 6 you included graphs that weren't helpful and omitted the graphs we needed.
Did you look at the links I provided and showed what we need to see and how to organize the graphs?
Respiration rate, tidal volume and minute volume aren't particularly useful.

The report where you say you slept 2 hours...you omitted the leak rate and included the 2 mask pressure graphs(don't need 2 pressure graphs) and that report you had massive large leak flags showing on the events graph.

You may or may not need to change some settings but right now the main problem is sleeping through the night with the mask and not have it leak.
Are you comfortable at these current settings? Some people might not be so comfortable at these lower settings but others are just fine with them.

I was wondering if you were having sleep onset centrals based on your description...if you are having them it's just a normal one...not a truck load of them showing up on the report. Your events are about half central and half OA but AHI of 2ish is far from bad.
So I don't think sleep onset centrals are a likely suspect in your problem.

[Julie]

The graphs show that while your pressure starts off low, it consistently rises and stays at a higher level, which is why I suggested you try starting there... it won't do serious damage for a few nights, it's not inordinantly high and in fact very many of us seem to end up at around 10, though I'm not suggesting you do that now.

[Pugsy]

This is the only graph showing pressure
http://imgur.com/a/XDbkn
and yes it does increase after a period of time and stay up there...BUT when it stays up there we see pretty much a solid block of Large Leak flagging seen on the Events graph and it is quite prolonged.
Just how bad the large leak is we don't know because we don't see a leak graph but the max was around 40 L/min and that's bad enough to seriously impact the machine's ability to do anything accurately.
When faced with large leak the machine's ability to sense and record and respond are brought into question so we don't know if the increase in pressure seen on the graphs really means much or not because there's such a large leak going on at the same time.

The pressure graph may point to the machine fighting something (the flow limitation graph is also missing and that might help explain the pressure increase) but when we see so much large leak we don't know just how valid the data recorded is.

So without seeing a pressure graph go up and stay up when not so much large leak is flagged or not see the flow limitations graph we can't really say much definitively about the real reason for the pressure to go up and stay up.
I don't trust the data when big prolonged large leaks are present especially in view of the fact that there is limited sleep and this is the only graph seen or available.

More sleep is needed without big leak potentially messing with the data for any sort of pressure needs evaluation one way or the other.

[robysue]

This is the only graph showing pressure
http://imgur.com/a/XDbkn
and yes it does increase after a period of time and stay up there...BUT when it stays up there we see pretty much a solid block of Large Leak flagging seen on the Events graph and it is quite prolonged.
...
So without seeing a pressure graph go up and stay up when not so much large leak is flagged or not see the flow limitations graph we can't really say much definitively about the real reason for the pressure to go up and stay up.
I don't trust the data when big prolonged large leaks are present especially in view of the fact that there is limited sleep and this is the only graph seen or available.

My thoughts exactly.

More sleep is needed without big leak potentially messing with the data for any sort of pressure needs evaluation one way or the other.

I agree completely. The data that is reliable does not scream: You need to increase the pressure NOW.

The data does scream: You need to figure out why the leaks were so LARGE for so LONG.

The usual suspect is mouth breathing. Duncan, what mask are you using?

[Duncan117]

I've got a full face mask. My technician helped me get rid of the leaks, at least when testing it during the day. I have been practicing the last few hours trying to use it at a higher pressure. I am really struggling to breath out against the incoming pressure. I can feel my chest tightening which I assume is an anxiety reaction. Even when the pressure is at 5 I find it hard to breath out. What am I doing wrong?