Question about blocked expirations

[Country4ever]

This is curious. I've been using a Swift nasal mask and taping my mouth for about 12 years. I use a Resmed S9 machine. Recently, I've woken up at night, feeling like I can't exhale. I take a couple breaths in, then I can start to exhale.
Maybe this is just a weird sleep state occurrence, but it seems really strange. I'm on 10cm pressure. Would there be some reason why I can inhale, but not exhale? Could it be that there's more pressure pushing the air in, but less pressure bringing the air out? I think the taping of my mouth has gotten weird, since the air fills my cheeks and stays there.
Sorry if this doesn't make sense. My mind has been a bit strange recently. Is there a setting on the machine that might leave more air in for the pressure on expiration?
Any ideas? Thanks.
Thanks.

[palerider]

This is curious. I've been using a Swift nasal mask and taping my mouth for about 12 years. I use a Resmed S9 machine. Recently, I've woken up at night, feeling like I can't exhale. I take a couple breaths in, then I can start to exhale.
Maybe this is just a weird sleep state occurrence, but it seems really strange. I'm on 10cm pressure. Would there be some reason why I can inhale, but not exhale?

Nope.

Could it be that there's more pressure pushing the air in, but less pressure bringing the air out?

Nope.

I think the taping of my mouth has gotten weird, since the air fills my cheeks and stays there.
Sorry if this doesn't make sense. My mind has been a bit strange recently. Is there a setting on the machine that might leave more air in for the pressure on expiration?[/quote]
Nope.

Any ideas? Thanks.
Thanks.

How does it feel when you put the mask on to go to sleep?

If it feels fine, then "Maybe this is just a weird sleep state occurrence" is the most likely explanation.

[LSAT]

Are you using the EPR feature on your S9? Setting?

[Country4ever]

Sorry, but I haven't made any real changes since I started cpap long ago. My guess is that it's not turned on. How would that affect things? I don't have much else turned on except the pressure, a small amount of time to build up to that pressure and not many other "bells and whistles". Without searching for my booklet, I'm thinking EPR means Expiratory Pressure some-thing-or other?

[DreamDiver]

Sorry, but I haven't made any real changes since I started cpap long ago. My guess is that it's not turned on. How would that affect things? I don't have much else turned on except the pressure, a small amount of time to build up to that pressure and not many other "bells and whistles". Without searching for my booklet, I'm thinking EPR means Expiratory Pressure some-thing-or other?

If your machine turns off, the anti-asphyxiation valve(s) (AAV's) should open, you'll notice there's no regular pressure on inhale or exhale. It will just feel like regular unsupported breathing when you're awake. It's often a wake trigger if your machine turns off suddenly, such as in a power failure.

Have you tried just the mask, disconnected from your tube, breathing in and out with your finger over the AAV? (I don't know how many anti-asphyxiation valves your mask has, so you'll have to experiment. There may be one or two. It varies by mask. I don't have a Swift, so I'm unable to say.) With many masks, it feels like there is something keeping your breath from releasing properly because the AAV is blocked by your fingers. Remove your fingers from the AAV and your normal breathing capacity should be restored.

This can be tested on a number of ResMed masks. It may or may not be the case with your mask.

Look closely at your AAV. Is there anything lodged in there that may be intermittently blocking your AAV while at normal machine pressure?

Chris

[LSAT]

EPR (Exhale Pressure Relief)....reduces pressure upon exhale to make it easier. Often it's hard to exhale against your set pressure...however, you have been using your S9 foe quite a few years the was it is currently set. Are you using the Smart start feature where you don't have to press the on/off button? How often does this exhale problem occur?

[jimbud]

If you have sleepyhead/Oscar have you checked your charts lately.
Could be your therapy needs have changed.

I know when I have an OA it will wake me up (confused) and I feel like I can't breath in or out for a few seconds.

Just a thought.

JPB

[palerider]

If your machine turns off, the anti-asphyxiation valve(s) (AAV's) should open, you'll notice there's no regular pressure on inhale or exhale. It will just feel like regular unsupported breathing when you're awake. It's often a wake trigger if your machine turns off suddenly, such as in a power failure.

How would the machine being *OFF* cause a feeling of "Recently, I've woken up at night, feeling like I can't exhale"?

If the machine were OFF, it would be much easier to exhale.

[DreamDiver]

How would the machine being *OFF* cause a feeling of "Recently, I've woken up at night, feeling like I can't exhale"?

If the machine were OFF, it would be much easier to exhale.

Under normal circumstances, yes. If there is some tiny object randomly causing a blockage of the AAV, it might be worth tracking down as a possibility.

Chris

[palerider]

How would the machine being *OFF* cause a feeling of "Recently, I've woken up at night, feeling like I can't exhale"?

If the machine were OFF, it would be much easier to exhale.

Under normal circumstances, yes. If there is some tiny object randomly causing a blockage of the AAV, it might be worth tracking down as a possibility.

Chris

It would STILL be easier to exhale with the machine off than with it on, even if the AA valve(s) were completely blocked.

[DreamDiver]

It would STILL be easier to exhale with the machine off than with it on, even if the AA valve(s) were completely blocked.

I realize this is off topic now. We could debate this, but we're not helping Country4ever. Thanks palerider.

Chris

[palerider]

It would STILL be easier to exhale with the machine off than with it on, even if the AA valve(s) were completely blocked.

I realize this is off topic now. We could debate this, but we're not helping Country4ever. Thanks palerider.

Chris

No, what doesn't help people are foolish ideas that waste their time.

Before you hork up something dumb, why don't you TRY it and see if it makes any sense at all?

It's easier to exhale against NO pressure than it is to exhale against whatever pressure the machine makes while running.

Anyone with any common sense can see that, the OP complains of just the OPPOSITE effect.

[DreamDiver]

It would STILL be easier to exhale with the machine off than with it on, even if the AA valve(s) were completely blocked.

I realize this is off topic now. We could debate this, but we're not helping Country4ever. Thanks palerider.

Chris

No, what doesn't help people are foolish ideas that waste their time.

Before you hork up something dumb, why don't you TRY it and see if it makes any sense at all?

It's easier to exhale against NO pressure than it is to exhale against whatever pressure the machine makes while running.

Anyone with any common sense can see that, the OP complains of just the OPPOSITE effect.

If your machine turns off, the anti-asphyxiation valve(s) (AAV's) should open, you'll notice there's no regular pressure on inhale or exhale. It will just feel like regular unsupported breathing when you're awake. It's often a wake trigger if your machine turns off suddenly, such as in a power failure. ...

Thanks palerider

[Country4ever]

Thanks everyone.
Chris.....I did appreciate you telling me to check my ventilation ports. That would be the obvious first step. They were all unobstructed.

I have woken up 3 nights in a row with this problem, of not being able to exhale through my nose. It's very bizarre. What I did last night, was take off the tape covering my mouth, and the air could then come out my mouth. I also noticed that my position could change the my ability to exhale out of my nose.

I'm going through a rough time mentally, to think things through very well, but I'm starting to think that maybe I have some swelling in my nasopharynx.......maybe from allergies (which I've never had before). My AHI is also higher than usual (according to my machine info) and my symptoms during the day of not sleeping well are present. I just don't understand how the air can come out my mouth on exhalation, but not my nose. I just can't visualize how that could happen.

I should get a full face mask to get around this problem, but dang, I hate the local Lincare. Plus, I hate changes. Plus, so much is closed due to the virus.
So......my immediate plan is to take Mucinex, in case my mucous is too thick from maybe allergies? (which I've never had). If that doesn't help, I'll buy something like Flonase nasal spray.
Who knows....maybe I have something like a nasal polyp.
No, I don't havethe Sleepy Head or Oscar program. It's hard for me to understand how to get those programs set up, and my DH doesn't have time to help.
And I know now that I'm not just confused, since when I wake up from this, I'm totally alert. It's a very curious things.
Thanks for all your suggestions!

[DreamDiver]

Thanks everyone.
Chris.....I did appreciate you telling me to check my ventilation ports. That would be the obvious first step. They were all unobstructed.

I have woken up 3 nights in a row with this problem, of not being able to exhale through my nose. It's very bizarre. What I did last night, was take off the tape covering my mouth, and the air could then come out my mouth. I also noticed that my position could change the my ability to exhale out of my nose.

I'm going through a rough time mentally, to think things through very well, but I'm starting to think that maybe I have some swelling in my nasopharynx.......maybe from allergies (which I've never had before). My AHI is also higher than usual (according to my machine info) and my symptoms during the day of not sleeping well are present. I just don't understand how the air can come out my mouth on exhalation, but not my nose. I just can't visualize how that could happen.

I should get a full face mask to get around this problem, but dang, I hate the local Lincare. Plus, I hate changes. Plus, so much is closed due to the virus.
So......my immediate plan is to take Mucinex, in case my mucous is too thick from maybe allergies? (which I've never had). If that doesn't help, I'll buy something like Flonase nasal spray.
Who knows....maybe I have something like a nasal polyp.
No, I don't havethe Sleepy Head or Oscar program. It's hard for me to understand how to get those programs set up, and my DH doesn't have time to help.
And I know now that I'm not just confused, since when I wake up from this, I'm totally alert. It's a very curious things.
Thanks for all your suggestions!

I'm glad you've eliminated the AAV consideration.

I've had nasal polyps. It was going to be my next suggestion when you said you could breathe out your mouth but not your nose, and then I saw you arrived at the same possible conclusion! I got mine removed even before I was tested for sleep apnea. Whether it might be polyps or some new/abnormal swelling due to new allergies, if you're able to set it up, why not see an Ear Nose Throat doc? There may be a window of opportunity at this point in the pandemic. That said, don't be surprised if your ENT says there are no polyps and that what you're experiencing is inflammation of your sinuses, possibly due to a stress or environmental factor. It may be enough that they'll offer an allergy med compatible with your sleep therapy. If they do find a polyp or two, hopefully something can be scheduled to get you through the removal process and on to better breathing during sleep.

DME's like LinCare are a topic of frustration for many forum members here, so you're in good company.

In the meantime, if positional sleeping gives you better nasal breathing capacity, why not see what sleep hygiene methods you can use to keep yourself in the most advantageous positions for now? I'll bet others will come along with recommendations for what OTC allergy meds and sleeping positions that have been useful for them, and which medications to avoid (like Afrin).

OSCAR may be a little tricky to install. You can check out the link in my signature below for download and install directions. And don't be afraid to ask your nerd-tastic niece or nephew, significant other or other friend or family member to help you install the program on your machine. Reach out if you can.

The thing is, Country4ever, you're taking the situation into your own hands. Take your time. Do what you can as energy allows. Keep notes in a notebook if you have to. Just don't doubt that you can master this new hurdle.

Chris