Too Much Pressure

[Duncan117]

I can't breath out. I am just getting started with a Ramp pressure of 4. I have a nose mask, but have to open my mouth to exhale. My sinus is easily inflamed. Though I am thoroughly exhausted I cannot fall asleep. If I switch to a full face mask would I have a better chance of getting my breath out?

[LSAT]

I can't breath out. I am just getting started with a Ramp pressure of 4. I have a nose mask, but have to open my mouth to exhale. My sinus is easily inflamed. Though I am thoroughly exhausted I cannot fall asleep. If I switch to a full face mask would I have a better chance of getting my breath out?

How about some specifics...Fill in your equipment profile...we can't help if we don't know yoyr specific machine and mask. Your pressure setting would also be helpful.

[Julie]

There should be an exhale relief feature on your machine, but we need to know more before telling you about it.

[Pugsy]

Exhale relief (if available on your machine) won't even kick in at the starting pressure of 4.

Is it actually sinus issues or nasal mucosa issues? What "sinus" symptoms are you having exactly?
And are you using a humidifier and if you are at what setting?

Are you actually using the machine at night at all? If so, for how long?

To be able to offer more than general ideas we need to know exactly what machine you are using and exactly what the settings might be (besides the ramp) and what mask...along with humidifier setting information.

[Duncan117]

Not sure how to alter my profile to include the information but, I have an Air Sense 10 Autoset elite
The settings are 4-12 and I have the humidity level on 8 (the highest).

[Duncan117]

Rather "Air sense 10 auto set, NOT elite

[palerider]

Not sure how to alter my profile to include the information but, I have an Air Sense 10 Autoset elite
The settings are 4-12 and I have the humidity level on 8 (the highest).

I'd suggest you try clicking "user control panel" up there near the top, and then 'profile' and see if that doesn't get you somewhere.

[Pugsy]

Is it actually sinus issues or nasal mucosa issues? What "sinus" symptoms are you having exactly?

I will take a guess....runny nose? Congestion? Itchiness? Pressure?
All the "sinus" symptoms started with the beginning of therapy?

Here's the deal with the nasal mucosa and humidity. Some people need a lot of moisture and some people don't need so much and even some people do better with minimal to none added moisture.
It's just the way it is

When the nasal mucosa get unhappy...either too dry or too moist they react by producing histamines which we know about because that's what is also produce in the typical allergic reaction. So what we experience with the humidity not being what makes our nasal mucosa happy are the typical allergy like responses.

Since you are already using the highest humidity setting...try a lower setting and see the the symptoms reduce or go away. Maybe cut it in half and see if it helps. Please note that it can take a few days for the nasal mucosa to get back to normal after being unhappy with the humidity setting. So if immediate improvement isn't noticed it may take a few days. When I had it happen to me with the nasal mucosa getting too dry it took a miserable 3 days for things to return to normal. In the meantime treat the symptoms as you would with any allergy like symptom.
Decongestants, saline spray, etc.

Explain the difficulty exhaling...are you feeling like you are suffocating at the pressure of 4 and simply not getting enough air or is it that you just can't exhale at 4 cm? Many people describe the problem as a difficulty in exhaling when it is more of a suffocation feeling.
The fix is to start at a higher pressure and turn EPR on so that it drops during exhale. Believe it or not but it is much easier to breathe in and out when the starting pressure is 6 and EPR is set to 2 or 3. The machine can't ever go below 4 cm though.

Are you actually using the machine at night at all? If so, for how long?

This question needs to be answered.

[Duncan117]

Nose is rather dry. I had deviated septum "fixed" but still it is a bit tough to breath normally through my nose. At 4 cm It feels I only exhale about half of what I take in: Like someone is blocking the air from coming out. So, yes I guess suffocating or the reverse of suffocation. Is it easier to exhale at a greater pressure?

I have used the saline spray.

I have not been able to fall asleep with the mask on. I give up after an hour or so as I do not want to build up a negative association for too long.

[Pugsy]

Your nasal issues and sinus symptoms may not be all that related to the humidity setting since you really haven't actually used the machine for any duration and haven't actually slept with it.
So just file what I said about humidity and nasal issues on the back burner for now.

And yes...believe it or not if the pressure setting was 6 and EPR was set to 2 or 3 it is easier to exhale.
It's just easier to breathe period.
Give it a try while awake and not being under any pressure to get to sleep.

Here's the clinical manual that will explain how to get to the settings where you can change the starting pressure and turn EPR on and set it.
Also...turn off the ramp. It's starting at 4 cm which defeats the EPR purpose and is of no real benefit since you are using a low pressure to start with and have the machine able to go up to 12 if needed.
If your starting pressure was say 12...then ramp might be useful.

https://sleep.tnet.com/home/files/resme ... -guide.pdf

So turn ramp off.
Set the minimum starting pressure to 6
Turn EPR on if it isn't already turned on...and set it to 3.
Then see if you find it easier to inhale and exhale.

[Duncan117]

Thanks for your help. What is EPR?

[palerider]

Thanks for your help. What is EPR?

look in your manual.

[Pugsy]

EPR is Exhale Pressure Relief on the ResMed machines. Different brands call it by different names.

EPR is explained in that manual that I linked to above.
Get the manual..it explains a lot of what the machine offers.

[Duncan117]

I was able to do all those things in the settings. Thanks. I put the setting up to 8 to start, thinking that it would be easier to exhale than 6. The limit is 12. I have yet to fall asleep using it but am committed. Two things I notice. After a while the stream of air seems to slow down even though the meter goes up from 8 to 9. The second is that it seems like my body forgets to breath ( I am still awake just not fully alert) as if my body decided the machine could breath for me.

Is it uncommon to go several days/ week before actually falling asleep. Is adjusting a mental thing or is the body simply trying to figure this out on its own. Still wanting to stay positive.

[Julie]

I think what might help is to try and relax a bit however useless it sounds, because anxiety about what might happen is fairly useless except to make what does happen a bit harder.

Try not to mix up EPR with humidity, the latter only incidental to everything else and changes with seasons, local climate, etc... I almost never need any, others want it every night, but it's not a pressure relief feature of course. Too much can make you congested and feel like a cold is coming on though, if your local conditions don't warrant it - something to keep in mind.