Newbie questions

[Sylvanas]

I’ve been trying to fall asleep with CPAP for the last couple of days without much success and have some questions about the experience
Machine: AirSense 10 for Her, humidity 4, pressure at 7-10, auto ramp, epr 3. Mask: p30i
- I started with the lowest pressure of 4, inhaling seems ok at this pressure, but exhaling is hard! I feel like I keep trying to blow up a balloon with my nose. I have to really concentrate on exhaling hard and if I ever forget, I momentarily feel like suffocating. Is it something I just have to get used to, or is there a trick to exhaling easier? My nasal passages are narrow, could this be making exhalation harder?
- When machine decided it’s done with the ramp and upped the pressure to 7, my nostrils started to “blow up” on inhale. The sensation is worse at the end of inhale (when I already inhaled what I need, but machine is still blowing extra). I’ve read that subtle movements like this can eventually damage cartilage, leading to easily collapsible nostrils, so it’s not something I want to get used to. How do I prevent this “blowing up”?
- The p30i is very comfortable, but geesh it stinks! I tried soaking it in vinegar and then leaving it with the machine on for several hours, but the smell is still strong.
What exactly is it made of? PVC? Is it easy to get materials information out of manufacturers, or do they pull the proprietary bs card?
Anyone else has this mask? How long does it take to offgas?

[Sheriff Buford]

Please go to the profile section and fill out your equipment.
- Your upper number.... 10, is too low. Raise it to 20. That way, when an apnea event occurs, your machine can go as high as it needs to go to treat the apnea event. After treating the event, it will back down.
- Are the mask and hose new? Are you cleaning the mask every morning? I prefer wiping my mask with a baby wipe in the morning.... after I awake. The oils are "fresh" and easier to wipe off than they are at night. Plus, I'm too tired at night to mess with my equipment. I prefer to plop in bed and start snoring.
- does the mask and nose smell used... or do they smell like plastic? What do they smell like?
- you have your EPR maxed out, so you can't dropped the pressure any lower when you exhale.

Sheriff

[Sylvanas]

Please go to the profile section and fill out your equipment.
- Your upper number.... 10, is too low. Raise it to 20. That way, when an apnea event occurs, your machine can go as high as it needs to go to treat the apnea event. After treating the event, it will back down.
- Are the mask and hose new? Are you cleaning the mask every morning? I prefer wiping my mask with a baby wipe in the morning.... after I awake. The oils are "fresh" and easier to wipe off than they are at night. Plus, I'm too tired at night to mess with my equipment. I prefer to plop in bed and start snoring.
- does the mask and nose smell used... or do they smell like plastic? What do they smell like?
- you have your EPR maxed out, so you can't dropped the pressure any lower when you exhale.

Sheriff

Yes, the mask and the hose are new, they smell like new plastic. The hose isn’t too bad, but the mask smell is overwhelming! I keep thinking of all the nasty chemicals I’m inhaling, which isn’t conductive to falling asleep.

[Sylvanas]

Yesterday, I again couldn’t fall asleep with my CPAP. Two times I started dozing off, but the pressure increased to 7 and started ‘blowing up’ my nostrils, which woke me up.
What should I do? Lower the min pressure? Or set manual ramp to max maybe?

[Norma45]

What is the machine like when you are sitting up wide awake? Do you still struggle to breath out at the lower pressures?
I also struggled to breath out - sitting up wide awake, but at a higher pressure than you (still lower than I needed it to be set at).
And the struggle continued when I used the cpap to try and sleep as well as having my mouth blown open (using a full face mask).
I switched to a bi-pap pretty quickly and instantly it was lots better, but tweaking some numbers made things even better.

If you can tolerate the pressure better sitting up (than laying down), I suggest you try different positions to see if you can tolerate the pressure better on your side vs your back. And check your chin tilt when you are on your back - is it better if it is raised high toward the ceiling (opens your throat) vs tucked down to your chest. For me, laying on my side gives a more open airway so the pressure can stay much lower.

[Sylvanas]

What is the machine like when you are sitting up wide awake? Do you still struggle to breath out at the lower pressures?
I also struggled to breath out - sitting up wide awake, but at a higher pressure than you (still lower than I needed it to be set at).
And the struggle continued when I used the cpap to try and sleep as well as having my mouth blown open (using a full face mask).
I switched to a bi-pap pretty quickly and instantly it was lots better, but tweaking some numbers made things even better.

If you can tolerate the pressure better sitting up (than laying down), I suggest you try different positions to see if you can tolerate the pressure better on your side vs your back. And check your chin tilt when you are on your back - is it better if it is raised high toward the ceiling (opens your throat) vs tucked down to your chest. For me, laying on my side gives a more open airway so the pressure can stay much lower.

Thank you! I’ll try different positions tonight. I’m trying to adjust to the lowest pressure right now, can BiPap go lower than 4 on exhale?

[Norma45]

Bipap also has 4 as the lowest setting.
But there are several other settings that might make you tolerate a higher pressure much better.

[Miss Emerita]

Sylvanas, you're describing both the feeling that your nasal passages are inflated when you breathe in and the feeling that you have to work hard when you breathe out. My guess is that before long, you won't find inhaling or exhaling bothersome. It's a new set of sensations, and it can take some time to get used to.

If you want to adapt faster, you might try setting the machine up during the day somewhere other than your bedroom and using it for a few hours while you do something you enjoy, like watching TV, reading, or using your devices. This can in essence tell your brain, "It's OK, don't worry about this, see, you're doing the breathing thing just fine."

But one question does occur to me. Are you using the "For Her" mode? I ask because here is a description of it from forum member palerider:

Reduced rate of pressure increments designed to help prevent arousals.
 Slower pressure decays.
 Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to 20 cm H 2 O.
 Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:
If two apneas occur within a minute, the pressure reached in response to the second apnea will become the new minimum treatment pressure until the next treatment session.

If you're using it, the slower pressure decay may feel to you as though you aren't being allowed to exhale normally. If you're not using it, you might just want to experiment to see whether for some reason it feels better. People react very differently to little differences in the algorithms their machines use, so it can be a good idea to experiment.

[Sylvanas]

Sylvanas, you're describing both the feeling that your nasal passages are inflated when you breathe in and the feeling that you have to work hard when you breathe out. My guess is that before long, you won't find inhaling or exhaling bothersome. It's a new set of sensations, and it can take some time to get used to.

If you want to adapt faster, you might try setting the machine up during the day somewhere other than your bedroom and using it for a few hours while you do something you enjoy, like watching TV, reading, or using your devices. This can in essence tell your brain, "It's OK, don't worry about this, see, you're doing the breathing thing just fine."

But one question does occur to me. Are you using the "For Her" mode? I ask because here is a description of it from forum member palerider:

Reduced rate of pressure increments designed to help prevent arousals.
 Slower pressure decays.
 Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to 20 cm H 2 O.
 Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:
If two apneas occur within a minute, the pressure reached in response to the second apnea will become the new minimum treatment pressure until the next treatment session.

If you're using it, the slower pressure decay may feel to you as though you aren't being allowed to exhale normally. If you're not using it, you might just want to experiment to see whether for some reason it feels better. People react very differently to little differences in the algorithms their machines use, so it can be a good idea to experiment.

Thank you, i'll try turning off the For Her mode.
Does it mean inflating nostrils are to be expected? The possibility of weakened cartilage worries me, as I already have pretty narrow nasal passages. Does it happen with all masks, or just with nasal pillows? May be I should make this a separate post...

[Pugsy]

Does it mean inflating nostrils are to be expected? The possibility of weakened cartilage worries me, as I already have pretty narrow nasal passages. Does it happen with all masks, or just with nasal pillows?

I have been on cpap over 11 years now....pretty much all of those years with a nasal pillow mask.

Put your fears about the slight inflation of the nostrils with any cpap pressure altering anything inside your nose totally to bed and don't worry about it. My nose is now exactly like it was in May 2009 when I started cpap. Nostril size is the same...everything is the same.
It's physically impossible for the very minor cpap pressure to change the cartilage...heck, even at 20 cm it won't even blow up a balloon.

[Norma45]

While I am relatively a newer xPap user, I find the inflating (for me mouth) happens when my xPap is kicking up pressure trying to do "fix" something - and the pressure increase is not working (so it just kept raising it trying to get things working). Now I have everything adjusted correctly for me (it took a bit), if the pressure gets high enough it is uncomfortable (shortly before it is at that level of blowing open my mouth, I just turn the machine off and back on again and the pressure lowers to something fine for me and stays there. Sometimes I need to get into a better position for this to happen. But sometimes it was just that I wasn't taking my "normal" breaths when it got turned on (busy arranging things preparing to sleep) and once I am in a good position and relaxed the machine is not increasing pressure to where it blows open my mouth. For me the quickest way to get the pressure to reset back is to turn the machine off and back on (playing with breaths to get it to change doesn't work as quickly/or not at all).

[Sylvanas]

Does it mean inflating nostrils are to be expected? The possibility of weakened cartilage worries me, as I already have pretty narrow nasal passages. Does it happen with all masks, or just with nasal pillows?

I have been on cpap over 11 years now....pretty much all of those years with a nasal pillow mask.

Put your fears about the slight inflation of the nostrils with any cpap pressure altering anything inside your nose totally to bed and don't worry about it. My nose is now exactly like it was in May 2009 when I started cpap. Nostril size is the same...everything is the same.
It's physically impossible for the very minor cpap pressure to change the cartilage...heck, even at 20 cm it won't even blow up a balloon.

Sounds reassuring!
When you look in the mirror and inhale, do the sides of your nose move inside at all? Or do they stay firm/expand?

[Sylvanas]

I spend some hours watching TV with the mask on, and looking at Oscar, looks like I was able to doze off for about 30 min the last two nights, yey! But the pressure in my nose keeps waking me up. I tried turning off the "for her mode" but didn't notice any difference.

[Pugsy]

When you look in the mirror and inhale, do the sides of your nose move inside at all? Or do they stay firm/expand?

I don't know...I can't see inside my nostrils to measure movement.
But outside...yes...I can see a little expansion of the nostril. Not a lot...not as much as it would maybe expand if I was to be blowing up a balloon kind of expansion. I assume you can blow up a balloon without damaging your nose??????

If this worry is keeping you up at night...it's an unfounded worry and you need to get past it or change to a full face mask which comes with a whole new set of potential issues.

[Sylvanas]

When you look in the mirror and inhale, do the sides of your nose move inside at all? Or do they stay firm/expand?

I don't know...I can't see inside my nostrils to measure movement.
But outside...yes...I can see a little expansion of the nostril. Not a lot...not as much as it would maybe expand if I was to be blowing up a balloon kind of expansion. I assume you can blow up a balloon without damaging your nose??????

If this worry is keeping you up at night...it's an unfounded worry and you need to get past it or change to a full face mask which comes with a whole new set of potential issues.

So they are expanding? That's great, that's what they are supposed to do. (Damaged nostrils collapse instead, that's what I meant by 'move in') Thanks, this really helps:)