do i need to increase cpap pressure

[corybodette]

i have been on cpap for almost two weeks now and the last couple nights have been interesting for me. right after i lay down and put my mask on i start to feel that i am not getting enough pressure. at first breathing on the machine was like sticking my head out a car window on the interstate very difficult for me to breath so i used the ramp feature so i was asleep by the time full pressure hit. Now i put on the mask and it feels like i am getting no pressure at all without the ramp feature turned on. i know that i am getting pressure though because when i take the mask off with the machine on i can hear it. I almost feel like i am suffocating with the mask on and the pressure at full but if i use the ramp feature like i tried last night i still feel the same way. I know that it is impossible to suffocate using the mask that i have and that all masks are like this but is feeling like i am not getting enough pressure normal or do i need to look into it.

BTW my overall ahi for the last 10 days has been 1.05 according to sleepyhead. only have ten days of data in sleepy head because i have not loaded the data from the last 3 nights into sleepyhead yet

[LSAT]

Sounds like you don't need the ramp. Turn it off. I think most people turn the ramp off after a few weeks. What is your pressure setting?

[Bons]

Does the ramp start at 4 cmH2O? That is about the equivalent of breathing room air, and many people feel that they are not getting enough air at that pressure through the mask. It is a psychological thing, and easy to deal with by either not using the ramp feature or changing the setting to begin ramp from a higher pressure.

Many new users end up asking if their machines are working properly because they get so used to the pressure that they no longer feel it. As one of my elderly church members says: 'You get used to hanging if you hang long enough". Feeling like you are not getting enough pressure is perfectly normal - some of us miss the sensation of the air in our airways once we get used to it, because after the fearful diagnosis of sleep apnea, feeling that air and knowing we are being treated is comforting.

When you get that suffocating feeling (and you will get over it with changing ramp or just getting used to it), try telling yourself that you are fortunate that the pressure is no longer bothering you (that head out the car window thing). Lots of people end up quitting cpap because they cannot get used to the pressure and it prevents them from sleeping. Your pendulum has swung to both extremes (annoyance with pressure and now missing pressure) and will soon end up in the middle - knowing it's there without feeling it.

[corybodette]

i have not been using the ramp feature for the past few nights and still feel like i am not getting enough pressure. i am glad to know that this is normal and just part of me getting use to the machine.
my pressure setting btw is 12 cmH2O. i know from the reading of the forum that this is relatively low setting and alot of people have a much higher setting.

[Todzo]

i have not been using the ramp feature for the past few nights and still feel like i am not getting enough pressure. i am glad to know that this is normal and just part of me getting use to the machine.
my pressure setting btw is 12 cmH2O. i know from the reading of the forum that this is relatively low setting and alot of people have a much higher setting.

Try this:

About five minutes before bed time find a dark quiet place and sit. Relax and start putting a pause in your breathing. Gentile breath out for a count of two, pause for a count of two, gentile breath in for a count of two. Slow counts, shallow easy breaths. Then keep the volume the same as you begin to slow the counts a bit.

When you go to bed and start with the machine try to imitate the volume and rhythm you ended the session with. Include the pauses. You may need to use the ramp to help keep the volumes similar.

PAPs are designed to put out many times the ammount of air we need and always throw away about twice or so what we need in the vent. But if we are excited or otherwise our breathing becomes great it will seem like not enough during the inhale. By quieting your breathing and keeping it quiet, as it should be for bed time, you avoid such unstable breathing and will very likely find yourself getting along much better with your PAP.

You are beginning to get used to the pressure. If you quiet your breathing and keep your life stress low you will likley do well. If your life stress goes up and/or if you loose weight in the next few months you may need to look at your pressure.

[jzap]

I agree with Todzo. It sounds like you are stressing yourself, and your stressed condition demands more air.

Before you go to bed, calm yourself and practice some slow, long breathing for a while (5-10 min). In through the nose, and out through the mouth. Just think, "slow, deep, calm"

The pressure that your machine is set for is the pressure that is necessary to keep your airway open as determined by your sleep study. It has only a minor bearing on the amount of air supplied. The amount of air, as was pointed out, is several times what you actually need, and the excess is vented. With an AHI in the 1 range, it appears that your pressure is correct. I would love to have numbers like that.

So, you are on the right track, turning off the ramp if you don't need it. What you need to work on is quieting your stress.

Good luck.

[rschneidvol]

FYI: Some nights, I have to lift the cushion from the skin to hear the "whoosh" of air because I can't feel the pressure anymore. It's a good thing...

[chunkyfrog]

It sounds like the pressure of or in your mask is causing you to feel "suffocated".
To ease your mind, look at the front of your mask, and observe how large your "anti-asphyxia valve" is.
Believe it or not, this valve means you can breathe safely through the mask with the power completely off.
If you try this, you will notice a little popping sound at the mask elbow.
This is the silicone flap shifting position as you switch from inhale to exhale.
Room air comes in through the valve, bypassing the machine;
exhaled air goes out through the fixed carbon dioxide vent holes in the mask,
There is a little resistance on exhale because these holes have a smaller area than the "inhale" opening.
Breathe a few breaths with the machine off {some of us have done this all night (no dain bramage) -- }
Now, when you turn the machine on, note how much more air is coming in.
If you do this a few times, you can help convince your body what the brain already knows.

[corybodette]

FYI: Some nights, I have to lift the cushion from the skin to hear the "whoosh" of air because I can't feel the pressure anymore. It's a good thing...

its good to know that i am not the only one. I do need to lose some weight currently i weight in at 400 lbs in 6 weeks i gained over 50 lbs because of a medication that i was put on. doctor has told me that i need to cut out all carbs and all sugars, the thing is that i have never been able to lose weight but usually i only gain 2 or 3 lbs in the same time span. being unable to lose weight runs in my family when my father died his weight was 600+ lbs. He died because of a complication to untreated sleep apnea. I have had every type of tests that the doctors can think of to try and figure out why i cant lose weight. I have tried every over the counter weight loss product and every prescription weight loss pill to no avail. i work out, cardio mainly, 4 times a week up to 2 hours a time. if anyone has any tips i will gladly accept them.

on another note to chunkyfrog i do know that the anti-asphyxia valve means that i will never actually suffocate but i do know that the thought comes in mind when i am having trouble.

[Mouth breather]

Is ramp time the same as pressure?

[Mouth breather]

Its 3am and I cant get to sleep because i cant get enough air to breathe. I dont know how to increase pressure . Mine never seems to change.
My Ramp "time" is 45 min. Is that the same as pressure?

[Julie]

Ramping is when you set your machine (in your case for 45 mins... quite a long time) to gradually increase pressure to your prescribed low, or minimum setting. But while that's going on (over 45 or whatever) minutes, you're not fully treated as you'd be if you skipped the ramp entirely and started out at your prescribed level. Try at least halving the 45 mins, if not just turning off the ramp entirely. What is your prescribed min. setting (and max)? If that's relatively low to begin with, and your ramp is 45 mins, you're depriving yourself of full therapy for all that time.

[palerider]

Is ramp time the same as pressure?

No, it's not.

[palerider]

Its 3am and I cant get to sleep because i cant get enough air to breathe. I dont know how to increase pressure . Mine never seems to change.
My Ramp "time" is 45 min. Is that the same as pressure?

Go to apneaboard.com, there's a link at the top of the page to request the clinical manual by email.

[D.H.]

Is ramp time the same as pressure?

No, it's not.

Specifically, ramp pressure means the starting pressure (when you turn on the machine) and ramp time means the amount of time that elapses between the time you power on the machine and the time that your full prescription pressure is reached.