After one night - HELP!!!

TheHawg · Post by **TheHawg** » Tue Nov 07, 2006 8:21 am

Well, last night was my first night with the CPAP. I don't know if I can do this. I couldn't sleep at all. I finally gave up and took it off.
My problem is that I feel like I'm smothering. I feel like I'm breating into a paper bag, and that I'll die if I don't breath through my mouth or take the mask off. Discomfort and/or leakage is not the issue.

HELP!!!!

Thanks,
TheHawg

DreamStalker · Post by **DreamStalker** » Tue Nov 07, 2006 8:27 am

More detailed help will be easier to provide if you list some more info about your situation.

What mask are you using?

What machine are you using?

What pressure is your machine set to?

Best of luck and not give up so easily.

- roberto

inacpapfog · Post by **inacpapfog** » Tue Nov 07, 2006 8:35 am

Like Dreamstalker says, post your info on equipment and such so that people here can help you discover what might be holding you back!
Without the info that I learned here, I would have never discovered that the DME made a gross error on setting my mom's machine. He set it on 4 when her prescription called for a 10!
Just never know!!!!!

TheHawg · Post by **TheHawg** » Tue Nov 07, 2006 8:53 am

OK, I've added the machine details. Pressure is 8.
Thanks,
TheHawg

Guest · Post by **Guest** » Tue Nov 07, 2006 8:57 am

You have listed an auto machine, but note that the pressure is set at 8. Is that the 95% pressure that the machine runs at or are you running the machine as a straight CPAP instead of in APAP mode with a range?

TM

snufflepgs · Post by **snufflepgs** » Tue Nov 07, 2006 9:04 am

I'm brand new at this (still waiting for my machine to get here), so I may not know at all what I'm talking about, but I do have some experience with anxiety and claustrophobia.

You might try wearing the mask for a while during the day when you're awake to get used to it. Once you develop some familiarity with the sensation of having the mask on and some confidence that it is safe to wear, it might be easier to sleep with it on. Practice wearing it in the presence of someone you trust who can reassure you.

Of course, also check into the other suggestions being given here (machine settings, etc.) to make sure it really isn't a problem with your therapy. Good luck.

TheHawg · Post by **TheHawg** » Tue Nov 07, 2006 9:10 am

[quote="Anonymous"]You have listed an auto machine, but note that the pressure is set at 8. Is that the 95% pressure that the machine runs at or are you running the machine as a straight CPAP instead of in APAP mode with a range?

TM

oldgearhead · Post by **oldgearhead** » Tue Nov 07, 2006 9:18 am

My problem is that I feel like I'm smothering. I feel like I'm breating into a paper bag, and that I'll die if I don't breath through my mouth

If you are having trouble during inhalation, try a BreatheRite strip. If you are having trouble during exhalation, try a machine with either EPR (yours may have it) or C-Flex (RemStar units). If you normally breath through your mouth, get a full-face mask (Hybrid, Ultra Mirage, HC432, or etc.).

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Tue Nov 07, 2006 9:53 am

TheHawg wrote:I'm not familiar with how to set it, but the guy at the medical equipment place preset it to 8 with a warmup period starting at 4, according to my perscription.

Your "warmup" period is called "RAMP" meaning it Ramps the pressure up over time to your prescribed setting. I, and many others, can not tolerate the RAMP. It creates the sensations for me that you described so well. I do not have your machine so I do not know how to turn RAMP off but it should not require a tech to do it. I would try turning RAMP off and starting directly at 8cm H2O and see if that feels better.

I was like you - I hated it at first. I was given a crummy (to me at least) nasal interface, no instructions and told to use RAMP. It gave me the screaming meemies and I took it off and did not return to using it for almost 2 years. When I returned I went to a lab where they tried several interfaces, I tried the Swift and really liked it. There was none of that claustrophobic feeling. Based on things I heard here I also turned off RAMP and it helped a lot.

Good Luck

David

inacpapfog · Post by **inacpapfog** » Tue Nov 07, 2006 9:54 am

be sure to check the settings yourself to confirm they are set correctly.

curtcurt46 · Post by **curtcurt46** » Tue Nov 07, 2006 10:41 am

The Hawg,
You have got a lot going on here. The ramp set at 4cm is to low and like other comments above, a ramp for many is not comfortable. Also at 4 cm many masks are marginal at clearing out the CO2.
To start, you probably need to find out what your titration pressure from your therapeutic PSG was determined to be. Then find out what the doctor prescribed and finally what the DME set on your machine. The titration pressure from the PSG is a good start point and a general rule of thumb is to set your automatic for +/- 3cm of you titration pressure. the lowest should be 5 or 6 cm.
How serious was your apnea?
Your comment about your first night is quite common. I too had the same feelings. It took me a while before I got used to the pressure. There is one thing for sure and that is many folks have problems at first, but with determination everyone can be successful.
Here is my recommendation:
-determine that you have a correct pressure setting on you machine
-adjust the ramp to 5 or 6 cm as a start or better
- don't use the ramp
- read everything you can on the subject; start with our collective wisdom - yellow light bulb at the top of the web page.
-make sure you are controlling any mouth leaks.
-set a personal goal for each week and each day.
-reassess you goals weekly
-discuss you problems with you doctor
-seek out help until you have solved or made manageable your problems.
Good luck....Keep us updated.

DreamStalker · Post by **DreamStalker** » Tue Nov 07, 2006 12:32 pm

TheHawg wrote:I'm not familiar with how to set it, but the guy at the medical equipment place preset it to 8 with a warmup period starting at 4, according to my perscription.

Many folks have a have a suffocating/smothering feeling with pressures below 5 or 6 ... depends upon the mask type being used. Looks like your ramp start pressure of 4 is too low. Try changing that first and see if that takes care of your primary issue (yes, there may be others laying in wait).

To determine how to make changes to your machine settings, try this link and skip to about half way down the page ... be sure to write down what everything is set to before making any changes in case you change something by accident ... you can go back and reset as needed.

- r

snoregirl · Post by **snoregirl** » Tue Nov 07, 2006 12:53 pm

I think the obvious has been said.

Ditto on 4 being too low. I for one like about 7 for min, others here can tolerate 5 or 6.

I suggest no ramp and if you are using it in CPAP mode you can use the exhale relief. If you make it a range and use the AUTO capability of the machine then no exhale relief is available on you machine. Your pressure of 8 is low enough that many wouldn't need exhale relief so very much.

I suggest following the people's suggestions above and either making the machine a cpap at 8 (your titration pressure) and if you want a ramp maybe 6.

Or

Setting it as Auto maybe 6-10 or so or 6 - 9 to be conservative.

I am guessing that just the change from 4 to 6 will help you enormously.

RachelM · Post by **RachelM** » Tue Nov 07, 2006 1:05 pm

It was rough going at the very first for me also. For the first week or so, I took a bedroom separate from my spouse so all the night commotion wouldn't wake him. During sleep study I was so claustrophobic about the mask and felt like suffocating that they discontinued it after about 10 minutes. At home I was able to relax, as suggested above I wore the equipment during the day to get used to it. Use of CL2 nasal pillow system finally worked for me to where I could get to sleep and stay asleep for a while. The lighter weight helped. Still have problems with a heavier mask on the face. Getting to sleep the first week was terrible. Ramp was changed to beginning at 5 instead of 4 and to take longer to get up so I was asleep before higher pressure began. That helped some.

When it all finally got together, the great wake-up feeling was awesome!

littlebaddow · Post by **littlebaddow** » Tue Nov 07, 2006 1:07 pm

Lots of good advice given already, but I think the important thing to add is that what you are experiencing is perfectly normal and many (if not all) of us have been through the same sort of thing.

You are having to get used to a new and very strange way of sleeping, with strange equipment and a big plastic mask strapped to your face, all at a time when you are probably feeling lousy and low because of lack of good sleep.

Please do not lose hope, please do not give up. Your health is worth the effort. Stick with it and it will get better. Don't hesitate to ask questions here. You'll find lots of supportive people and good advice freely offered.

Good luck.

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