Keep waking up due to massive pressure up my nose

[JLynnScov]

Hello! I saw that another person posted something similar, but I knew I shouldn't jump on their post.
My info is in my signature. I have tons of health issues and my doctor thinks a lot are due to my awful sleep apnea. I haven't used the machine in a couple months because of the air pressure of my nose and I'm getting migraines upon waking again. So, I read the threads about posting here to get help. The end time is when I woke up with the pressure ... I immediately took the mask off.

I see the other person who just posted recently was just an issue with leak. What's a person to do in that case? I had already bought a new mask because I was getting leaks. Would I just keep trying different masks until I find one that doesn't leak? I have a hard time since I have severe anxiety and when I get a mask that's more like an oxygen mask, I start having a panic attack - pull it off hyperventalating.

Here is my report.
https://imgur.com/a/09a0LKf

I can't figure out how to post just the image - I've tried for 20 minutes and I need to put my kids to bed. So sorry.

Thank you so much.

[JLynnScov]

When I woke up the last week of using the mask that's in my signature and the pressure was high - I was so gassy - waking up having to walk around, it was awful. It felt so awful - and was scary to me. As stupid as that sounds for a 46 year old!

Also, the mask I used when I started with the machine on 7/27 was a AirFit P10 Nasal Pillow Mask - That Mask just became too stretchy.

The mask I was wearing in the above report (and that in my signature) felt like it was tight and would work great.

Also, I never felt any different on any nights I used the cpap from 7/27 to 8/24.

[Julie]

If you meant you only wanted to post the graphs but not the left side with the info on them, you don't want to do that - the left side is important - it needs to be there. You also don't have a leak problem, so maybe try loosening the mask just a bit - not supposed to be too tight at all. As far as the rest goes - there are important things experts here will see and comment on better than I can, so just wait a bit and they'll be around......

[LSAT]

According to the data you posted, your pressure never got any higher than 11 all night. Your average pressure for the night was 9.64. I would not consider the pressures as "massive". Your AHI is good and your leaks (Aside from 1 spike) are good.

[JLynnScov]

According to the data you posted, your pressure never got any higher than 11 all night. Your average pressure for the night was 9.64. I would not consider the pressures as "massive". Your AHI is good and your leaks (Aside from 1 spike) are good.

I 100% see what you guys are seeing and I’m at a loss. I feel like an idiot. But, I for several night I felt like I was drowning in pressure. But, that doesn’t show at all.
If it was you - would you just push through and keep wearing, even when it feels like that?
Thank you, both of you, for taking a look.

[D.H.]

While the AHI is good, the patient is still bothered. This is like the classic example of the doctor reporting excellent health, but that patient reporting that (s)he feels lousy!

First of all, the patient only used the machine for two hours, so this is problematic. The insurance companies want you to use it for at least four, but really you should use it the entire time you're asleep.

It seems that the problem here is that the patient is bothered by the higher pressures, and perhaps also by the fluctuations.

I would try raising the minimum pressure to seven and lowering the max to 10. Those are only guesses, so you might need to fiddle further if that doesn't work well.

[Okie bipap]

I have found nasal pillows and nasal masks to be uncomfortable. I dislike the pressure they exert on the inside of my nose, So far, the most comfortable mask I have found is the F&P Evora.

[JLynnScov]

While the AHI is good, the patient is still bothered. This is like the classic example of the doctor reporting excellent health, but that patient reporting that (s)he feels lousy!

First of all, the patient only used the machine for two hours, so this is problematic. The insurance companies want you to use it for at least four, but really you should use it the entire time you're asleep.

It seems that the problem here is that the patient is bothered by the higher pressures, and perhaps also by the fluctuations.

I would try raising the minimum pressure to seven and lowering the max to 10. Those are only guesses, so you might need to fiddle further if that doesn't work well.

Thank you! After the air pressure was up my nose so bad for several nights and the machine said there were no leaks, I felt done. So, as soon as it happened (the night of the graph), I threw it off.

I’ll have to look at my manual to find how to change my pressures.

[ChicagoGranny]

I’ll have to look at my manual to find how to change my pressures.

You won't find it in the users manual. It's plenty of places on youtube, for instance, https://www.youtube.com/watch?v=fcPp1i0XuYU

I see the other person who just posted recently was just an issue with leak. What's a person to do in that case? I had already bought a new mask because I was getting leaks. Would I just keep trying different masks until I find one that doesn't leak?

No, find your mask on youtube and carefully watch some videos on fitting and adjusting.

Here is my report.
https://imgur.com/a/09a0LKf

I can't figure out how to post just the image

What you did is fine.

My info is in my signature.

You have the wrong machine in your equipment profile. Scroll down until you can edit for the correct one.

[Dog Slobber]

The OSCAR graph you posted is from August 24.

It can't be representative of a recent experience.

[robysue1]

According to the data you posted, your pressure never got any higher than 11 all night. Your average pressure for the night was 9.64. I would not consider the pressures as "massive". Your AHI is good and your leaks (Aside from 1 spike) are good.

I 100% see what you guys are seeing and I’m at a loss. I feel like an idiot. But, I for several night I felt like I was drowning in pressure. But, that doesn’t show at all.
If it was you - would you just push through and keep wearing, even when it feels like that?
Thank you, both of you, for taking a look.

I want to start by saying that yes, I understand exactly how you feel when you say you're drowning in pressure. I had a an absolutely horrible beginning to cpap therapy that even included a nightmare where I was an intelligent goose being fattened up for fois gras by being forced to breathe in more and more and more air until I thought I would pop like an overfull balloon. I even wrote about that horrible dream here at cpaptalk.

At the beginning even reasonably low pressures can seem like a hurricane because you are not yet acclimated to having air blown through a mask and at your nose/face all night long. The exhaust flow can amplify that feeling of lots of wind and make it subjectively feel like the machine is raising pressure when its not.

As for what to do when "you feel like that":

Since you describe the problem as too much air, there are two things to try, but both will require that you get into the clinical menu.

First, your data also shows that EPR is currently turned OFF. Turning EPR on and setting it to 3 will provide you with a 3cm drop in pressure when you are exhaling. This goes a long, long way in making it easier to breathe out against the pressure that you are not used to having to deal with. For many people this one change is enough to make xPAP go from intolerable to tolerable.

Second, you could consider getting into the clinical menu and reducing the max pressure setting and see if that helps you tolerate the mask any better. Yes, this could lead to suboptimal treatment of your OSA, but you can always increase the pressure back up if your treated AHI is too high when you lower your maximum pressure setting.

You may find trying to use the machine while you are not actually trying to get to sleep may help you get used to the feeling of the mask on your face and the air being blown into the mask. Many people do find that using the machine while reading or watching tv helps them get used to how things feel and that in turn helps them learn to get to sleep with the mask on their face.

And you do need to realize that using the machine for only 2 hours in a typical 6-8 hour "sleep time" is not getting you much therapy. But just as important. Ripping the mask off your face and going back to sleep without the mask is rewarding the resistant part of your brain and body for bad behavior: You are, in effect, encouraging the part of your brain that dislikes the mask to keep you awake long enough to get fed up and rip the mask off. Please note, there are many of us who went through this same problem of finding xPAP so uncomfortable that eventually ripping the mask off and (in some cases) throwing it across the room was a regular or semi-regular occurrence during our early xPAPing nights.


As for your question: "If it was you - would you just push through and keep wearing, even when it feels like that?" Many of us did in fact have to force ourselves to just "push through" and "keep wearing" even though we were just as miserable as you currently are.

In my case, I did have to turn the max pressure down. I did have to turn EPR on. And eventually, I was put on a bi-level machine instead of an APAP.

One trick that helped me during the early, really depressing nights, was to only worry about one night at a time. I would tell myself that just for tonight I would do whatever I could to not go back to sleep after removing the mask. If I had to remove the mask, I'd get out of bed for a few minutes to regroup and calm my nerves down and then try, try again with the mask on my nose.

It was a long, slow haul. But eventually my oversensitive stomach, my oversensitive nose, and my insomniac-rattled brain finally all accepted the dang mask and I started to get some really decent quality sleep. And once that started, I noticed that I was no longer waking up with some hand and foot pain that had been "normal" for me for years before I started xPAPing. And once that hand & foot pain disappeared, I was doubly motivated to continue making this crazy therapy work for me.

[chunkyfrog]

When starting out, I worked to add more time every night.
Working my way up, it seemed normal in a reasonable time.
Now, it feels weird to lie down with it off.

[Janknitz]

You might try a different style nasal mask like the one that fits under the nose with a wide slit (e.g. the DreamWear mask) or a nasal mask--it looks like a miniature oxygen mask that just fits over your nose) to see if less direct flow makes you perceive less pressure. The nasal masks can be uncomfortable and cause pressure on the top of your nose, however.

Also, make sure the mask you are using is fit properly. The nasal pillows should rest lightly against your nostrils, not crammed up in them.

[ozij]

If you click on the arrow, it will take to robysue's post. Pleas re-read it!

Remember: sleep apnea primes us to be anxious, since our body and brain have been used to choking and waking many times a night with nothing on our faces. So having a mask and air blowing in make it even more terrifying than our "normal" , that is, disrupted, choked up sleep.

One trick that helped me during the early, really depressing nights, was to only worry about one night at a time. I would tell myself that just for tonight I would do whatever I could to not go back to sleep after removing the mask. If I had to remove the mask, I'd get out of bed for a few minutes to regroup and calm my nerves down and then try, try again with the mask on my nose.

Do that when you wake up in a panic. Use your grown up mind to tell the primitive, life-saving part of your brain that yes, the choking feels the same, but actually you won't choke - that this supposedly bizarre system is there to help you.

And we're here to help you too - we've been through those terrifying first nights, we've struggled, been helped by forum members are now doing so much better thanks to the therapy.

[ozij]

The OSCAR graph you posted is from August 24.

It can't be representative of a recent experience.

But it is. That was August, this is October and the OP is asking for help

I haven't used the machine in a couple months because of the air pressure of my nose and I'm getting migraines upon waking again.