cant fall asleep with CPAP

[Guest]

Hi everyone!! I have had my machine for less than a week and am very frustrated with it/myself. I cant seem to fall asleep while I am using the machine. I am using nasal pillows, which I can tolerate pretty well (at least when I am not trying to sleep). When I do lay down at night and start using it I feel like I am suffocating and all I can do is focus on my breathing to the point where I cant fall asleep. I'm not sure if I am scared of not being able to breathe in my sleep or what. Any words of wisdom would be greatly appreciated.

Thanks

[rehpotsirhc21]

I guess I didn't log in when I posted this...

[Junebug999]

I'm 11 days into this, and it can get better. You have to trust that you can breathe. I suggest you put the mask on and watch tv or read. I wear a FFM and watch tv or read some -- did that a LOT during the first few days, and did it last night. I was wired, not tired, so I sat up in a recliner and put the mask on. Also, I'd recommend some aromatherapy. It helped me in the early days. I like "spice" on pur-sleep.com It helped my brain think "oh citrus and a hint of spice...that's nice." instead of my brain thinking "alert alert there is something on my face." You have to be very determined though. I think of it like this: At first I wanted to say "can't fall asleep with CPAP" but I changed that thinking to "I can't fall asleep WITHOUT CPAP". Because I've known people who died from heart attack while gasping for breath, and my own dear grandparents who I am sure had sleep apnea had early dementia which I wonder now might have been due to oxygen deprivation all those years. I remember listening to them snore and when the snore would stop and then when they would gasp, and I remember always how exhausted they were in the day time.

Also, covering up the hose made the hose more comfortable...and also, I did get a prescription for Ambien inthe early days to help me sleep. I'm not having to use it now. I slept 9 hours with it on last night. One thing my sleep doc has me doing is cutting off food 3 hours before bedtime and drink 2 hours before bedtime. Another thing I do is I get all ready then put the mask on, then attach the hose. I've learned to WELCOME that breath that comes from the hose.

Be diligent and go through this -- think of it as CPAP boot camp. It is hard and not easy, but if we preservere we get better health and better quality of life.

Good luck to you, I'll say a prayer for you to have sweet sleep tonight WITH CPAP. While I'm a newbie and lack a lot of technical knowledge, I'll bet there will be some fine folks along here in a bit who will give you more info to help you.

[rehpotsirhc21]

Thank you! Ill try laying down to read with it on and see if that helps any. I was so disappointed to find out I wouldn't let myself fall asleep. I was ready to wake up my first day feeling wonderful... It is great to know that I am not alone in having issues getting used to it.

[OutaSync]

You shouldn't feel as though you are suffocating. What range is your Auto set on?

[Julie]

If you feel like you're suffocating, it could be because you are... were you told to use the ramp feature (slow adjustment to prescribed pressure over a period of time)? If so, I bet they have you set at such a low 'start' that neither you nor anyone else can actually breathe at that number (care to share what that is?). Most of us, unless our prescribed number is very high (e.g. over 12-15) turn off the ramp altogether very soon after starting Cpap and just let the machine go straight to whatever number we're supposed to be at - it's really not a big deal at all. If you could give more info. on your equipment, mask, script numbers, etc., we can try to help more.

[robysue]

rehpotsirhc21,

I bid you a sad welcome to the insomnia club. I'm another newbie---only been doing CPAP for about 2 1/2 weeks. But I've developed a really, really severe case of bedtime-insomnia. Once I get to sleep, everything is hunky-dory: Don't pull the mask off, very seldom wake up with a leak that's bothering me, etc.

I sincerely wish you better luck than I've been having. Mine has now deteriorated to the point where I've called the sleep doctor's office several times about both the insomnia and several other issues that are going on with me. They've set up an appointment for me tomorrow. So if the insomnia doesn't resolve itself reasonably soon, call your doctor's office and try to speak to at least a nurse.

The suffocating problem could indeed be a ramp feature if you've got that on. The RT who set up my machine enabled the ramp feature and initially had it turned on with patient control of the length of time and allowed the patient to completely turn the ramp off. Very shortly after starting my therapy, I had to turn the ramp off because I'd feel like I was suffocating waiting for the ramp to kick up to something closer to my prescribed pressure of 9cm. But now I've got the opposite problem: When I put my nasal pillows on at 9cm, I feel like I'm immediately getting chipmunk cheeks and a stomach full of air---this is when I'm awake and very, very consciously keeping my mouth tightly closed. (Although as near a I can tell, my leak data doesn't seem to indicate that I have a problem with mouth breathing.)

Things that I'd recommend as ways of at least keeping the insomnia from getting worse:

1) Try to get all the CPAP-stuff done well before bedtime. Get the machine, hose, mask assembled with water in the humidifier long before bedtime so that your brain doesn't have an excuse to "wake up" when you want to go to bed. Wash your face well before bedtime. Make it as easy as you can to just put the mask on and turn the machine on and go to bed at bedtime.

2) Try some quiet relaxation time just before bed. If reading doesn't help you sleep (it keeps me awake) then try something else. Go to bed when you feel sleepy not just tired.

3) If you feel like you've been lying in bed for more than 20--30 minutes or if you're getting more antsy and less sleepy, then it's time to get up out of the bed, leave the bedroom, and do something quiet in another room until you start to feel sleepy again.

4) DO NOT STARE AT THE CLOCK. That just makes the insomnia worse. If you find yourself staring at the clock, turn the clock around or move it across the room. And get up and leave the bedroom until you start to feel sleepy.

Best of luck in beating the insomnia.

[Astrophytum]

Maybee it's help a little bit:

When I go to bed, in most times I have watched TV or readed a book.

In fact, when you go to bed, your breathing is more intensive as you lay in bed. In bed and when you are sleeping, the breathing is flater.

I do it so:

I go to bed, lay down without my mask. In this time the S9 is preheat the H5i humidifier. When I laying in bed, my body and breath comes to rest. I breathe more shallow.

And then, after 10-15 Minutes I put the mask on. So the breathing is from the beginning to use the mask more gently.

I hope this will help you a little bit.

Regards,
Astrophytum

[Junebug999]

oh great idea about the letting the breathing calm down astrophytim.....thank you!

[CinnyAnn]

rehpotsirhc21,
I know not everyone will agree but ask your Dr. to give you something to relax you. With that also use the ramp. I started back in June and after fighting it for about 3 weeks weeks my Dr. perscribed Ativan. Really helped. Only took it about 2 weeks or so. Don't need it anymore. Good Luck!!!!

[rehpotsirhc21]

I have a REMstar Auto A-flex with a connected heated humidifier. My normal pressure is 6, the ramp starts at 4. I am fine when it is on the lower number, its when it goes up to the 6. With the machine I have you have to actually press a button to lower the pressure to the start of the ramp. So when I turn it on its at 6, if i hit the ramp it goes down to 4. My pressure range is 6-16. I am not sure how I will handle a pressure higher than 6. As far as medications go for relaxation- for me that is not an option. I was put on benzo's like Ativan, and Xanax years ago and became very dependent on them- so not going back down that road. I do take a Trazodone and sometimes I supplement with Benadryl for sleeping.

I am going to try laying down without it on to calm my breathing and see if that helps. If I am not able to sleep with it by Friday, I am going to call the home medical place and maybe try a different mask or if they can set the machine to take longer to get up to 6. I can breathe through my nose fine, but I feel like I have to focus so I do not breathe through my mouth.

[cobra4x4]

I have a REMstar Auto A-flex with a connected heated humidifier. My normal pressure is 6, the ramp starts at 4. I am fine when it is on the lower number, its when it goes up to the 6.

I would suggest setting it up as straight cpap @ 6cm (don't use the auto feature until your used to the cpap machine). Do NOT use the ramp feature. Your pressure is on the low end so you shouldn't need to ramp it and this comes from experience.

When you decide to use the auto feature, narrow the range from 4 to 16 to something more reasonable like 5 to 9. Its recommended that the minimum pressure be 1 or 2 below titrated pressure and maximum be no more than 3cm above your titrated pressure.

...if they can set the machine to take longer to get up to 6. I can breathe through my nose fine, but I feel like I have to focus so I do not breathe through my mouth.

This is exactly the opposite of what you should be doing, its a common way of thinking but actually makes things worse. Your better off starting at your set pressure and getting a good mask seal right from the get go rather than have a low pressure which increases as time passes. As pressure slowly increases it tends to cause the masks seal to break albeit slightly.

Which mask are you using? I can't tell by the small picture, but it looks like a swift fx possibly. If it is try starting the machine at 6cm then putting your mask on. Now pull the mask away from your nose and gently put it back down then wiggle your nose to get a good seal. Once you have a good seal just lie down,take a deep breath and fall asleep.

[robysue]

Once you have a good seal just lie down,take a deep breath and fall asleep.

Oh if only it were this easy for me. But whenever I take a deep breath ( through my nose) once I've got the Swift FX on and the machine is at pressure, all I get is a really big mouth-full and tummy-full of air and lots of ear pressure with the need to cough, cough, cough to get the extra air out.

I really miss being able to take deep cleansing breaths once I'm in bed and trying to get to sleep. For years, this has been my stock first line defense for any transient insomnia.

[LoQ]

But whenever I take a deep breath ( through my nose) once I've got the Swift FX on and the machine is at pressure, all I get is a really big mouth-full and tummy-full of air and lots of ear pressure with the need to cough, cough, cough to get the extra air out.

Hmm. Have you tried clenching your teeth to keep them together, pushing your tongue up against the roof of the mouth, making it as wide on the sides until it seals off against your teeth, and then taking a deep breath? It seems to work for me, but I use a FFM. If I were to relax my jaw and tongue and inhale deeply, I'd have the same problem you described.

[robysue]

Have you tried clenching your teeth to keep them together, pushing your tongue up against the roof of the mouth, making it as wide on the sides until it seals off against your teeth, and then taking a deep breath? It seems to work for me

I'm also a chronic teeth clencher/grinder to the point of having been diagnosed with TMJ about 25 years ago. Been wearing a splint every night for TMJ since then. So, yes the mouth and tummy fulls of air occur in spite of my clenching with my tongue up against the roof of my mouth.

Indeed, pre-CPAP part of my deep breathing was designed to unclench the teeth so the TMJ can more properly relax.

Talked at length at my appointment with the sleep doctor's PA about this and other issues. She thinks that they may have set my pressure to high. So we're starting a week's worth of AutoPAP to see what happens.