Not breathing with CPAP on!

[dseturam]

Hi All,

I have been reading the posts for the last day or so trying to find an answer to my problem but in vain.

I am a new user - started about 4 days ago. My equipment details are given below. My current setting is 8cm (gradually to be increased to 10 cm - as per my doctor's prescription).

I have been using the CPAP machine for about 2-3 hours a day and when I get up, I am not able to sleep again so I take off the mask and go back to sleep without it.

Before I started using CPAP, I used to be a sound sleeper (or so I thought) and can continually sleep for 8 hours or more without any interruption. But despite this, I used to feel tired and sleepy through out the day, hence my visit to the sleep clinic and subsequent diagnosis of sleep apnea (I apparently don't breathe between 25-42 times per hour - which my doctor said was in the 'moderate' range.

The last two nights I noticed that when I wake up, I do so because I am not breathing - despite the airflow from CPAP.
My machine has a ramp up feature which ramps up from 4 cms to 8 cms in about 30 minutes. In the ramp up period, I have to take deep breaths and generally feel that there is not enough air to breathe.

Is this normal? How do I make my CPAP machine work so that I don't stop breathing (which is what I thought it is supposed to prevent). Do I need to change my mask (though I don't think it is uncomfortable - except for the plastic odour) or airflow?

Please help.

PS: Just wanted to add: I do have pollen allergies during this time of the year and take Reactine regularly during the allergy season. Other than that I don't have any breathing ailments like asthma, etc.

[Slinky]

Well, I would suggest you have your RRT turn the Ramp starting pressure up. Not many of use can breathe comfortably at only 4 cms of pressure. I'd have the starting Ramp pressure set at least at 6 cms. And you may find that you don't need it at all and can do just fine starting out at 8 cms w/o Ramp.

The longer we sleep the deeper our sleep, the slower and shallower our breathing. Since you were titrated at 10 cms, 10 cms is the pressure you NEED to avoid the apneas. As you said, your doctor started you out at 8 cms to be gradually raised to 10 cms. You may well be ready for the 10 cms already.

[nosbig17]

The sensation of not getting enough air, when using the ramp feature, is something that I experienced when I started using CPAP several years ago. My solution was NOT to use the ramp feature. Some users find the ramp feature to be a life saver and feel that they couldn't tolerate the therapy without it. But there are some of us who seem to need the full treatment pressure right away. This is the case for me even though my treatment pressure has gone up several times. So, what's normal????

Let's consider the basics; What happens when you don't breath? The saturated oxygen level in your blood goes down, which leads to gradual deterioration of your organs, illness, and premature death. This happened to my neighbor about 13 years ago. His death certificate listed sleep apnea as one of the causes for his death. Soon there after I was diagnosed and since then I haven't even taken a nap without therapy.

At some point you may join many of us here, who are on a quest to find the perfect interface system.

Keep breathing and good luck!!!

[BlackSpinner]

The last two nights I noticed that when I wake up, I do so because I am not breathing - despite the airflow from CPAP.

Do you actually know from checking the machine that you were not breathing or did it just feel like that?

A lot of people have anxiety attacks when they first try to sleep with a CPAP machine and to me it sounds like that - especially as you seem to be unable to put the mask back on. An anxiety attack makes you feel like you can't breath. Your sleeping mind is like a toddler - it either says "whoopee what fun, a mask" or it says "get that f...ing thing of my face!!!!" with a loud scream at which point you wake up feeling breathless. I suggest that when you wake up you take your mask off and take a few deep breaths and repeat to your self how this thing will help you get better. Then put the mask back on and keep trying.

When I got my CPAP I slept like a log for about a week and then I suddenly started to wake up feeling breathless too in the middle of the night. I took my mask off , took a few deep breathes and put it back on and did my relaxation routines. The problem disappeared after a few nights.

[dseturam]

Thank you all for your supportive posts and also your suggestions. I will try them tonight

BlackSpinner - what happens is that I slowly wake up and realise that I am not breathing. It could be anxiety attacks - I don't know - but I don't seem to get up breathless rather 'Hey, I am not breathing!'. But if I will definitely try out what you have stated.

Thanks again.

[twasbrillig]

dseturam, the stopped breathing may be an adjustment thing. I noticed that happened to me frequently at first. It was one of the things that changed pretty quickly with regular CPAP use.

What kind of mask are you using? For example, if it's a nasal only interface, you may be waking because the air is taking a short cut (out through your mouth) and this tricks your mind into thinking you are breathing, at least temporarily. Can you add your equipment to your profile?

[sleepless in florida]

Welcome to CPAP Land my friend. I woke up last night unable to breathe - almost suffocating. I tore off the mask and then this morning decided to check the machine. My water tank was empty!!! Duh. I hope that is what the problem was. Be sure and check your little water tank and level.
It appears that you shouldn't have a ramp and even your setting of 8 is low. I wonder if your setting should be higher. Anyway I have only been with this for two weeks but sometimes a newbies thoughts are good too.

Good luck!

[SouthSideHope]

This is my first post on the site.. but looking at all the other comments, it looks like i just fit in pretty well...

When I went to my first sleep study, I was an extreme (68% blood oxygen level, not breathing over 100 times and hour) case so they woke me up only two hours later and slapped a nose mask on me. I couldnt sleep well the rest of the night. I felt like I couldnt breath.

The next day I came in and got a loaner machine and tested 2 different masks. The diff masks made all the difference in the world. I now have a full face mask that covers nose and mouth and it feels much better.

If you still have issue, a mask may be the issue.

[dseturam]

As promised - here's the update.

I raised the minimum ramp to 5.6 and the airflow to 8.8. I think it was better but I did get up twice and the second time, I took of the mask.

Tonight I will change the ramp setting to 7 and the airflow to 9.4 (the doctor said 'gradually increase' didn't he???) and let us see what happens.

twasbrillig: Actually the equipment I use is in my profile - I had displayed it as an image but I changed it to text now. I do use the nasal mask with headgear. I was given the nose mask and felt claustrophobic - not sure how I may be feel in a full mask. But if increasing the pressure does not work, I may have no choice.

sleepless in florida: I don't know if running out of water would cause the suffocation (mine had water - but I set the temperature to mid-low, since anything above that makes me feel that the devil is breathing down on me!!!). Apparently, using the humidifier is optional but recommended.

southsidehope: I may have to change the mask if the higher setting does not work - but I will keep the mask replacement to the last (I still have time to change the mask).

More updates tomorrow.

[Marineman2]

This sounds a lot like the cpap is inducing central apnea which happened to me! I still don't know what the answer is but my doctor wants to do an oximetry test to do while using the cpap. I am wondering though, even if they decide to add oxygen to my therapy, the fact remains that I still won't be exhauling if I am having too many centrals. Which will in turn raise blood co2.. not sure why this isn't recognized while using these machines..