New Cpap user with problem, HELP!

[snyderm]

I am a 32 year old male who just started using CPAP. I have had my machine for 2 days now (Sleepstyle 200 series) and I have found using the machine to be impossible (thus far). I have tried now for two nights to fall asleep with it, and basically I use it until about 2:30am in the morning and give up on it, because I haven't slept a wink and I have to work in the morning.

My problem seems to be that I can't successfully fight the pressure that is shooting into my lungs. I can't exhale properly, and it feels like my lungs hurt, so I have to take the mask off in order to breathe properly.

Is this a common problem? How might I deal with it? I have some bad health problems setting in, which I believe may be due to sleep apnea, so I really need to use this machine, but thus far I just can't.

My machine starts at 6 cmH2o and sometimes goes up to 10. at 10, I just feel like I have no hope of exhaling without difficulty. Is there anything I can do?

[DBoone]

The first few nights are definitely the worst. For most of us it gets better over the next week or two. I know you don't want to hear "Just stick with it" but... just stick with it. You should be able to adjust your ramp settings to help (many of us end up turning it off 'cause we don't like it). What pressure (or range) is your machine set for?

[snyderm]

I think its an APAP that is set for 4-20. I don't know what pressure I need, as I have never successfully used a mask before.

Most people seem to have a problem breathing because there isn't enough pressure. My problem seems to be that I sense so much pressure I can't exhale without difficulty. Even at a pressure of 6 cmH20, Exhaling is laborus.

[jdm2857]

Rather than waiting for bedtime, you might try using the machine while you are watching TV earlier in the evening . This way you can try to adapt while you are being distracted instead of lying in the dark and focusing on the machine.

[snyderm]

Unfortunetly I wear glasses, so I cant wear them and the mask at the same time. I am still trying. I can't try all night, because I won't sleep a wink and then I can't work in the morning. Maybe I can make a breakthrough this weekend.

[Pugsy]

Could you please check the exact model number of your machine. Confirm if it is an APAP or not?

http://www.fphcare.com/osa/cpapi.asp

http://www.fphcare.com/osa/cpapauto.asp

It does take a bit of practice to get used to exhaling against the pressure. I start out at 11 cm, no ramp, no exhalation relief and I adjust in maybe 5 breaths. Have you tried getting used to it when not in bed? When not under the stress of trying to rest?

What mask are you using?

Can you update your user profile to include your equipment in text format so we can see what you are using?

[snyderm]

Okay, I have updated my profile with the Cpap machine that I use. I don't know which mask or humidifier that I have. My mask is a full face mask with just straps, thats all I know, I will post what it is later if it matters.

Well, I have tried sleeping with my machine for a third night and once again got 0 minutes of sleep with it. I feel like maybe I am making a little progress, it is just difficult to get to sleep when I have to work in the morning and I know I won't be able to get to sleep in time to be rested in the morning. I tried until 2 AM and at that point I have to give up so that I can get some sleep to go to work. On the plus side, tommorrow is a weekend that I don't have to work, so I can try sleeping without the sense that I am on a timer.

I think I have lost the sensation of lung pain that I was experiencing, it is now just uncomfortableness. I would say that is a step in the right direction, but it remains to be seen if I will ever be able to fall asleep with it. Which adds to my stress because I think I really need this machine, if nothing else to rule out Sleep apnea as a major problem in my life. I definetely have it, it is just a question of how much better I will feel.

A question now, if I may: What about using a sleep aid? For instance, melatonin or tylenol PM? Might that be a good way to make it easier to sleep with this?

[Pugsy]

A question now, if I may: What about using a sleep aid? For instance, melatonin or tylenol PM? Might that be a good way to make it easier to sleep with this?

Many people use the melatonin with good results. Tylenol PM has benadryl in it to make you sleepy, it can make the OSA worse. Talk to your doctor and see what he suggests. Ambien can be used because it doesn't make the OSA worse.

Try to figure out which mask you are using. Did you get any sort of paperwork that might give you a clue?

What pressure is your machine set at?

[snyderm]

I will post what mask I have when I get home, I am at work right now. I am still not sure there was any paperwork about the mask. I didn't even get manuals for anything.

I wish I knew what pressure my machine is set at. I just know that when I start it up and place the mask on my face, it starts at 5, quickly goes to 6, and goes up to more than that after I use it for awhile. The highest I have seen is 10.

Does anyone know what the minimum pressure that a CPAP/APAP mask can run safely at?

[Pugsy]

Does anyone know what the minimum pressure that a CPAP/APAP mask can run safely at?

A lot higher than 10 cm..

That information is usually provided in the literature that comes with the masks but every mask I have shows above 20 cm.

[snyderm]

Actually I meant the Mininum pressure, not the maximum. My problem is that I feel like exhaling is difficult.

[spacetoast]

snyderm, did you get your manual with the machine? I bet you can adjust the ramp pressure and time so it doesn't feel so abrupt.

Did you get a sleep study done? Do you have any of the numbers or prescribed pressure?

[snyderm]

I didn't get a manual with the machine, but I found it online and downloaded it. I don't believe that I can set the ramp time at all, I think it is built into the machine. However, it does have a feature called sense-awake that supposedly keeps the pressure low while it senses you are awake. I don't know if it is already enabled or not. I have a sleep care company that gave me the machine, but didn't mention this feature, so I need to check whether it is on or off when I get home.

I had a sleep study, which they said I have a rather severe case of OSA. This is odd because I didn't get any sleep the entire night during my sleep study. I guess that for about 50 minutes I started to doze off into a very shallow depth of sleep, which was enough to get diagnosed with OSA. I have never used a CPAP machine in a study like this, so I have no knowledge of what pressure I need.

[jdm2857]

Most machines have a minimum pressure of 4 cm H20. But if the pressure supplied is less than what is required to keep your airway open, it is not helping.

Your machine is an automatic CPAP (APAP) so it increases the pressure when it senses that you need it. A pressure of 10 is not that high. Most CPAPs have a maximum pressure of 20; bilevel machines go higher.

Some people have taken an old pair of glasses, or a cheap pair of reading glasses, and cut the nose bridge. They then reconnected the halves with a rubber band and were able to use them while wearing a full-face mask. Not the height of fashion, but ....

[Pugsy]

Actually I meant the Mininum pressure, not the maximum. My problem is that I feel like exhaling is difficult.

Exhalation against pressure does take some adjusting to get used to. Sounds like your machine starts lower and works its way up to 10 cm of pressure. Maybe if it took longer you could be asleep before it hit the 10 cm. You need the 10 cm to get the events prevented.

Maybe taking longer to get to the 10 cm will help you adjust.

If it is any consolation, you will get used to the 10 cm and there will come a time when you won't be bothered by it.
Many people who used to need and use the ramp feature, now turn the ramp off and go start to their pressure.

There are some machines that have exhalation relief built in after the titrated pressure setting is reached (your 10 cm example). I am not familiar with your machine at all. It may not offer this feature.
In the ResMed product line it is called EPR, in the Respironics it it called AFlex or CFlex. Check with whomever supplied the machine to you to see if your machine offers this feature. It would make the 10 cm pressure easier to bear once you attain that pressure.

Oh, I just noticed you have Sensa Awake.... sort of a ramp feature I guess... I have no idea if it offers any exhalation relief.