Pschological Issues from CPAP use

[bluesky129_2000]

Hi Board,

After attempting to use my CPAP machine, I began to experience a feeling that my nose was always congested and my breathing affected. It manifested itself into a psychological issue where even though I was breathing ok, I still felt congested and would pick at my nose and constantly blow it. It would than trigger a response in my body that generated adrenaline and cortisol and not allow me to sleep. Lack of sleep has significantly impacted my life.

I know its a psychological issue because my body gets an adrenaline rush now even when i am not stuffed up from my mind perceiving congestion. I have never had issues before and and am looking for a psych fix 1st before I retry the machine. Has anybody experienced anything like this and found a solution?

Helpful responses are greatly appreciated.

[Julie]

Are you using humidity with the machine? Depending on where you live and the season, it can certainly cause congestion, though your note is confusing because you say you are able to breathe regardless.

Also, you don't 'know' adrenaline and cortisol were generated - that's subjective, though possible of course.

And we have zero info otherwise to go on - which model of what machine you use, at what settings? What mask? take any meds? How many hrs you sleep (not just lie in bed) and this is not a psych forum. If you want help using Cpap then please provide pertinent info so we can try to help.

Also, you could download Oscar - terrific software (see top of pg) and follow instructions re setting up to post here (in this thread plse), so we can see what's what overnight and interpret, advising possible setting changes etc if necessary.

[Janknitz]

Especially in the beginning, it's easy to feel claustrophobic, especially when your nose is stuffy and you feel like you cannot breathe.

You can address the stuffy nose feelings by using a saline nasal spray or nasal irrigation before bed, and adjusting the humidifier up OR down to see if that alleviates the nasal congestion (make ONE change only every few nights to see if it helps). If it's still an issue, a full face mask permits you to open your mouth to breathe, and at least until you get used to CPAP, that might work best for you (but it will cause a wicked dry mouth if you mouth breathe no matter how much humidity).

If you have apnea, every time you stop breathing, your body excretes a lot of stress hormones to get you breathing again. So for however long you've had significant apnea, you have spent your nights essentially drowning in stress hormones. They may still be in your system, causing you the claustrophobic feeling. Once you get your settings dialed in and start getting some optimal treatment, you may find that this feeling fades away. I had some anxiety driving over bridges and in tunnels that surprisingly got much better when my apnea was adequately treated--stress hormones spill over into your day.

So my advice is give it time. When you feel like you cannot breathe, try to count to 10 slowly while you breathe without taking off your mask. If you make it through counting to 10, try to count to 10 again. Calm yourself as much as you can.

I had two goals when I first started CPAP:
1. to simply put my mask on just like my pj's and go to sleep.
2. To sleep through the night.

It took me about 2 months and many masks to meet the first goal. It's HARD to get used to sleeping with a chunk of plastic on your face! And the second goal took a good month more, but it was absolute bliss when I woke that first morning after 8 uninterrupted hours of sleep and waking very peacefully. It took a lot of work and tweaking things to get there, but very worth the effort.

Make sure you are not looking for an excuse to quit CPAP. If you have significant apnea, that's NOT an option.

[McSleepy]

It manifested itself into a psychological issue [...]
[...] a solution?

I have had something similar. I can't quite say it was "solved", but it's under control. Psychological issues never really get "solved" and the only way to manage them is by therapy. You're getting some "therapy" by posting here, but maybe you should try a professional. Here's what I have to say for me.

I don't think one can develop OSA suddenly; I suspect I've had it my whole life. That had made me hypersensitive to breathing issues. The CPAP machine is imperfect and it's hard to be able to "trust" it fully. Some trust will come with you making conscious efforts to get it to work. As a scientist and engineer, what helped me is to "geek it all out": I got the most-advanced CPAP machine and played with all the settings until I felt happy. It worked quite well, but nothing in our minds is 100% stable, forever. We can just hope to keep it going for as long as it would last. Now, for some specifics. For me, it took a bi-level CPAP, and one with an abrupt inspiratory pressure rise to make me comfortable and overcome the "congested" feeling, and, after many years - having a septoplasty to really free up my upper airways. I don't know what will work for you, but you may have to put some serious effort into it. Good luck!

McSleepy