day 12 and struggling to get enough air

jimbo1957 · Post by **jimbo1957** » Wed Jan 11, 2006 11:27 am

Folks, your advice has really helped calm me down and to realize the wisdom of my brother-in-law's comment (he's used CPAP for 16 years): keep trying masks until you find the one that works for you...

I am sleeping about 2-3 hours a night with the CPAP on, sometimes less. The RT's initial settings were to ramp up from pressure 5 to 12 over a 45 minute period. I found that I could NOT get enough air at the low level to tolerate the mask. I stopped using the ramp function. But I still found that the C-FLEX function even at it's lowest setting (1) would back off the air too much, so that again, I felt I was really struggling to get some air. This whole process seems to work better when I have really shallow breathing and don't let it go too long, either inhaling or exhaling. I cut out the C-FLEX function so now I'm getting straight 12 cm pressure, and even so, I can start out okay with the mask (even using ramp up from 10 to 12 over 20 minutes-I conk off quickly), but later after waking, or trying again this morning, I just felt like I was unable to suck enough air through the nasal mask... Only once so far have I "found the sweet spot" where the air really seemed to make its way into my nose... my mask isn't leaking (and the RT is coming this week with the comfort curve--(boy do I wish I had found this web site and read the postings about cc before I called to TRY this mask-but I will be optimistic. I do understand that what works for some may or may not for me...)

Since the pressure setting was determined by the sleep lab, I am reticent to push it up a bit to see if it makes a difference in my feeling like I can breathe, but is there perhaps something else I need to be aware of? I am not particularly congested and am using HH at level 2 (up from 1) ...

Thanks for "being there" and I'd appreciate any advice on learning how to breathe with CPAP ? or anything else, too..!

NightHawkeye · Post by **NightHawkeye** » Wed Jan 11, 2006 12:52 pm

I just felt like I was unable to suck enough air through the nasal mask

jimbo, it may not be a nasal mask limitation so much as a nasal limitation. I don't know how folks can start CPAP at high pressures. I couldn't. I'm new at this too, and didn't think I was particularly congested either. I found out early on though that I can't exhale through my nose at high pressures, so I'm working to resolve that. Your problem sounds similar - only you can't breathe in. "Breathe Right" strips, by opening up the nasal passages, definitely help me although they don't entirely resolve my problem. Don't know if nasal/sinus congestion is related to your not being able to breathe with CPAP, but you might consider it if you haven't already.

"Breathe Right" strips are a quick, easy, simple and cheap thing you can try. There are several brands of the strips available. For a couple of bucks they may be about the cheapest relief for congestion available.

Regards,
Bill

leslie · Post by **leslie** » Wed Jan 11, 2006 3:19 pm

I just joined this group, so I hope I am not repeating anything someone else already said. I wanted to share info about the mask I have been using for the last few months though. It's the Mirage Swift Nasal Pillows System (https://www.cpap.com/productpage/1433). It took me awhile to get it just right, because the smaller pillow sections would make my nose sore, and the tightness or looseness of the straps makes a big difference, but once I figured out the right combo to use, I fell in love with the mask.

I used to go through the Breathe Right strips like crazy, but the nasal pillow mask actually "inflates" the nostrils. I have no mark in the middle of my forehead anymore like I did with my old mask, and it is possible to wear my glasses and read or watch TV until I am ready to fall asleep.

I also find that when I first get into bed, it is a little harder to get a good strong breath (with any mask) until I relax and get my breathing rhythm steady. Sometimes, if I feel like I can't get enough air, I go ahead and breathe through my mouth until I am more relaxed.

Hope this helps!

wading thru the muck! · Post by **wading thru the muck!** » Wed Jan 11, 2006 3:44 pm

leslie,

Great cpap story and great advice!

leslie · Post by **leslie** » Wed Jan 11, 2006 3:59 pm

wading thru the muck! wrote:leslie,

Great cpap story and great advice!

Thank you so much! I was afraid I was saying something someone else already said, since I just joined.

Your mask looks like it would solve the problem of rolling from one side to the other without knocking the mask out of place. That is my only drawback to my mask - the hose comes out of one side. I have gotten very good at turning and flipping the hose over my shoulder without waking up, though. lol

wading thru the muck! · Post by **wading thru the muck!** » Wed Jan 11, 2006 4:10 pm

leslie,

Don't be afraid to offer your advice. There can never be too many opinions offered.

I used the Swift when it first came out. It was the interface that convinced me that nasal pillows were the key to making the experience more normal.

The interface I use, is IMO the most comfortable that there is. When you are in the market for your next interface you might want to give the Aura a try.

Janelle · Post by **Janelle** » Tue Jan 17, 2006 1:24 am

When I first started using my APAP it was set to ramp at the lowest level of 4. I felt like I was suffocating and gradually raised the low level and settled at 6. So you can adjust the lowest level and that will probably help you when you first put the mask on.

Nothing is written in stone that you have to have the lowest level set at what they tell you. If you can't breathe, you can't breathe! Are you using a steroid nasal spray before bedtime. Everyone will have some nasal congestion once they lay down at night and a steroid (NOT over the counter) will really help do away with that congestion and is not habit forming. like the OTC

Snoredog · Post by **Snoredog** » Tue Jan 17, 2006 1:42 am

I would increase your Ramp starting pressure from 5cm to 6cm or even 7cm. The object is to use the lower pressure of ramp to allow you to fall deeper in sleep.

It is also up to you to determine the correct ramp timer, the time of the ramp should match how long it takes for you to fall asleep, if you fall asleep in 30-minutes or even 15-minutes then you need to shorten your Ramp timer. You don't want to spend too much time in sleep without the pressure being at the prescribed 12cm setting. Shortening the timer causes the machine to increase pressure faster from the starting pressure.

Again, the ramp is only there to help you fall asleep including any time you awaken during the night, if you can only sleep 2-3hrs then wake up and have difficulty falling back asleep you can use the ramp again. But it can also mean you need a higher pressure.

When your titrated in the lab at 12cm pressure they are most likely doing that with constant cpap pressure with no cflex. You can turn cflex completely off by going into setup and changing it from cfle to cpap.

Be careful turning your humidifier up too high as that can also cause you to feel stuffy or like your not getting enough air. It is your airway closing down because it is getting too much moisture from the humidifier. If your getting condensation droplets in the hose or mask you have it up too high.

As Janelle mentioned nasal congestion can also cause the problems you list.