At Wits' End

[TBonzie]

I've used CPAP now for 12 days. Day 1 was, of course, a disaster. But then the next 9 days were just fine and I was adapting well.

Then I had a bad night. Felt like I was suffocating. Tried and tried, but after 4 hours, gave up on using the machine.

Last night was just as bad. I had turned on ramp (it was off before) as it seemed that the big rush of air was bothering me. No luck.

I thought it was breathing IN that was the problem, but it was breathing OUT that I'm finding to be difficult.

I'm going to try auto ramp tonight.

Any thoughts on what to do? I'm fine with the mask and gear, but this suffocating feeling just sucks.

[RiverDave]

What are your settings (pressure, mode)?

[LSAT]

I've used CPAP now for 12 days. Day 1 was, of course, a disaster. But then the next 9 days were just fine and I was adapting well.

Then I had a bad night. Felt like I was suffocating. Tried and tried, but after 4 hours, gave up on using the machine.

Last night was just as bad. I had turned on ramp (it was off before) as it seemed that the big rush of air was bothering me. No luck.

I thought it was breathing IN that was the problem, but it was breathing OUT that I'm finding to be difficult.

I'm going to try auto ramp tonight.

Any thoughts on what to do? I'm fine with the mask and gear, but this suffocating feeling just sucks.

Most machines have an exhale relief setting...What machine are you using.

[DonO]

One of my issues was the lower end pressure was set too low. When I changed it from 5 to 6.5, it made a world of difference. That might not be your problem. But, adding a little more pressure made it easier to breathe both in and out for me. I’m sure if you put up some more data, folks here can help.

[bwexler]

If you are having trouble breathing, it is often too LOW a pressure setting. Any ramp makes it worse.
Try increasing your minimum to 6.5 and turn off ramp and see if that helps.

In the meantime it would help everyone if you posted more details about your equipment and settings.

[Julie]

Again - what machine do you have - most have a special exhalation pressure relief feature... but we can't help with it unless we know more.

[TBonzie]

OK, I have the AirSense 10 Autoset Machine and the AirFit P10 nasal pillows by ResMed.

What are your settings (pressure, mode)?

When I turn it on, it says between 5 and 20. There doesn't seem to be a way for me to change this figure, to those who mentioned that. When the machine first starts (I ran up to look at it just now), it starts at 4 and I assume climbs from there.

Most machines have an exhale relief setting.

Not seeing that on this machine. I've gone through everything in the last few days partly as a result of reading threads here.

Complicating matters is my fibromyalgia. If I wake up mid-sleep, I tend to go into a full on "aches and pains all over" and "needing to urinate every half hour" mode (even if I limit water at night). That's a known issue and happened both nights. There is nothing I can do about that so obviously not waking up unexpectedly mid-sleep is important if I want to get a restful sleep.

My perception is that I can't breathe out against the air. I don't know why. I did fine for 9 days then just went off the rails the last two. I really tried to stick it but by 6 AM the first night and 4 AM last night, I surrendered (temporarily).

Obviously I'll put a call into my primary, but you guys seem to know your stuff so I figured I'd ask here. I registered, but can't yet post under that name.

My support for this has honestly been nil. Got the machine from the place that distributes them (as per my insurance) and a kind lady gave me a quick usage/cleaning tutorial but I've been on my own.

I want this to work.

Thanks for all of the answers and of course, reading the thread. I am appreciative of those who take time to try to help the n00bs to this infernal contraption. *grin*

[rsvw]

I registered, but can't yet post under that name.

You are posting here right now and getting answers.

"needing to urinate every half hour" mode (even if I limit water at night).

That is a symptom of untreated sleep apnea.

My perception is that I can't breathe out against the air. I don't know why.

Prob the pressure is rising and you are not yet used to it. Keep wearing it as long as you can.

[RiverDave]

You have a good machine (wish I had it). It's definitely an adjustment, but you can adapt to it. Your minimum pressure is too low - I had the same problem when I started. In my opinion, you need to bump your minimum pressure to 6 or 7. I felt I couldn't get enough air and was rebreathing carbon dioxide with a setting less than that. Others here can get you access to the clinician's manual. The Expiration Relief is a setting that may help you in the beginning. After you feel like everything is working better, we can help narrow the range of your pressures to get you more optimal treatment.



Good luck,
RiverDave

[Goofproof]

Wear it during the day, to help in adaption. Your brain thinks it in a storm, it's not, only a breeze. Jim

[TBonzie]

You are posting here right now and getting answers.

That I am. It won't be my final name. Seems odd to be able to post *before* one gets permission.

That is a symptom of untreated sleep apnea.

I've heard that in the past few days (reading others' posts) but for me, it's a symptom of a middle-aged woman who has had 3 children bounce on her bladder for nine months. I don't know many older women who don't have to get up in the middle of the night for at least 1 trip to the bathroom.

Prob the pressure is rising and you are not yet used to it

But I WAS used to it for 9 nights. Suddenly, I couldn't hack it anymore. I can't figure out why.

Your brain thinks it in a storm, it's not, only a breeze.

True this. But my brain thinks it's in a HURRICANE, LOL.

We'll see what my doc says when I PM her. Perhaps the pressure needs to be adjusted. I'll see though, what happens tonight. It's the last thing that I can do without having things adjusted by the doc.

[Julie]

Don't confuse pressure settings (of between 4 and 20) with EPR (Exhalation Pressure Relief) settings... look for that feature on your machine and set it to 1 or 2 or 3 - see which one helps. The reg. pressure setting (if your min. is 5 it's very low... barely able to inhale at it for most... and raising that (min) setting may help inhaling, but won't affect exhaling (nor will changing the high pressure. One thing - EPR (or Flex if you have the 'other' machine) tends to let AHI go up by 1-2 cm or so depending on your settings, but it's not a big deal and you can find the right balance for you.

[TedVPAP]

OK, I have the AirSense 10 Autoset Machine and the AirFit P10 nasal pillows by ResMed.

What are your settings (pressure, mode)?

When I turn it on, it says between 5 and 20. There doesn't seem to be a way for me to change this figure, to those who mentioned that. When the machine first starts (I ran up to look at it just now), it starts at 4 and I assume climbs from there.

Most machines have an exhale relief setting.

Not seeing that on this machine. I've gone through everything in the last few days partly as a result of reading threads here.

Complicating matters is my fibromyalgia. If I wake up mid-sleep, I tend to go into a full on "aches and pains all over" and "needing to urinate every half hour" mode (even if I limit water at night). That's a known issue and happened both nights. There is nothing I can do about that so obviously not waking up unexpectedly mid-sleep is important if I want to get a restful sleep.

My perception is that I can't breathe out against the air. I don't know why. I did fine for 9 days then just went off the rails the last two. I really tried to stick it but by 6 AM the first night and 4 AM last night, I surrendered (temporarily).

Obviously I'll put a call into my primary, but you guys seem to know your stuff so I figured I'd ask here. I registered, but can't yet post under that name.

My support for this has honestly been nil. Got the machine from the place that distributes them (as per my insurance) and a kind lady gave me a quick usage/cleaning tutorial but I've been on my own.

I want this to work.

Thanks for all of the answers and of course, reading the thread. I am appreciative of those who take time to try to help the n00bs to this infernal contraption. *grin*

It is not clear to me that you understand that your machine is auto-pap. So the pressure will change automatically within the settings (5 to 20 in your case) as the machine does its best to prevent apnea. It is possible that your pressure needs have changed and that is why you are noticing higher pressure (e.g., sleeping on your back). You have exhalation relief turned on if the pressure decreases every time you exhale. You can hear the change as the machine noise will change.
Read your manual so you become more familiar with your machine. I don't have your machine but you should be able to check the settings.
At some point you may want to get the clinician manual (on line) so you can learn how to make changes to the settings. And then there is learning how to use the data to optimize your treatment. An educated patient has the best outcome.

[TBonzie]

Don't confuse pressure settings (of between 4 and 20) with EPR (Exhalation Pressure Relief) settings... look for that feature on your machine and set it to 1 or 2 or 3.

As far as I can tell, EPR is *not* on my machine. And yes, I have read both of my manuals cover-to-cover. What info they provide is minimal, at best. There are very few things that I can set other than ramp and humidity. I can't set my air pressure and to be honest, I don't know to what it should be set. That is something I would discuss with my doctor first. The machine is very basic when it comes to functions.

[TBonzie]

It is not clear to me that you understand that your machine is auto-pap. So the pressure will change automatically within the settings (5 to 20 in your case) as the machine does its best to prevent apnea. It is possible that your pressure needs have changed and that is why you are noticing higher pressure sleeping on your back). You have exhalation relief turned on if the pressure decreases every time you exhale. You can hear the change as the machine noise will change.

Read your manual so you become more familiar with your machine. I don't have your machine but you should be able to check the settings.
At some point you may want to get the clinician manual (on line) so you can learn how to make changes to the settings. And then there is learning how to use the data to optimize your treatment. An educated patient has the best outcome.

I am new to this. I am still learning which is why I found you guys. Obviously, I read the manual(s) cover-to-cover (more than once, in fact) before I ever came online in search of assistance. As I said above, the manual gives very little information. From a patient's point of view, it's very, very limited. I'm a very good researcher but at times there is too much information online and some of it has been contradictory.

When I open my mouth and exhale (as I did last night), there was no pressure drop. There was just a rush of air out of my mouth. I am a side-sleeper.

I prefer not to do the doctor's job (re the clinician manual), and if it comes to that, I would consult my doctor first. I come from the school of not messing with stuff if I don't understand it first. I'd have to be a lot more experienced to mess with stuff like that.

I figured you guys have been through some of this stuff and perhaps what was happening to me was common or at least easy to fix. At this point, I've done everything (or will with tonight's session) to fix the problem. If that fails, and hopefully it will not, I will be on the horn to my doctor and/or the people that gave me this contraption for advice. I'm a little irked that they gave me this with so little support other than how to do the basic stuff (turning it on, and cleaning it).