Panic Attacks and claustraphobia

[Amy0916]

Hello, it's been 25 days I've been using a cpap. I'm up at 3am because I've just had another complete meltdown and panic attack over putting on my mask.
I'm not sure of my machine (I'm just too tired to look) I use
a full face mask (second one. The first one was an air pillow under nose thing that covered my mouth)
I have to have a mask that covers both nose and mouth. I'm severe mouth breather.
I've had some good nights where I can work though my anxiety and go to sleep with the mask on. But it's just been getting worse and worse. I take a trazadone to help me get to sleep, I've done tons of reading and research on the panic associated with a cpap. I use a 30 min ramp and most nights have to reset it once.
I'm at a loss and don't know what else to do. I have obstructive sleep apnea and also the other one where I forget to breathe. So I'm terrified of sleeping without the machine but I'm also terrified of the mask and air pushing at me.
Sorry if I'm confusing, I'm just extremely upset and don't know what to do.

[Conrad]

Try smoking a lil weed, or eating a gummy, an hour or so before bedtime. It can help reduce your anxiety and make you sleepy.

YMMV

[ozij]

I've had some good nights where I can work though my anxiety and go to sleep with the mask on. But it's just been getting worse and worse. I take a trazadone to help me get to sleep, I've done tons of reading and research on the panic associated with a cpap. I use a 30 min ramp and most nights have to reset it once.

Try to get used to the machine during the day. Not in bed, - e.g. - in the living room - while watching something pleasant on TV, listening to relaxing music, something like that.
Remind yourself that at least part of your panic response is a direct consequence of your sleep apnea: As long as you're not treated, you are being physically, literally, choked when you try to sleep and the very healthy, primitive, life-saving part or your brain, responds to that by flooding you with stress hormones to make you wake up and breathe.

Presently, the primitive part of your brain, that wakes you up (and keeps you from choking to death) doesn't realize the mask and machine are there to help. to take over.
It's your job to accept the panic as an indicator of something healthy in your system, but to gently convince the panic generating part that "it's OK, we now have a better way of keeping me breathing when I sleep". Slowly and gently.

When I started CPAP -- and at low pressure -- I was terrified of that feeling of having to breathe against resistance. We never do that naturally - normal breathing out is simply relaxing an letting the breath flow out. With CPAP, we have to make an effort - a small one, actually - but it's frightening because we're so unused to it. So it's a case of "come on brain, we can blow up balloons, so of course we can breathe out against this pressure." (Try blowing up a balloon with the pressure from your machine - it isn't even strong enough to do that).

I was so tense about "oh my when is the ramp going to stop, and what will happen then???" that I quickly realized thar for my peace of mind, and in order to be able to fall asleep with the CPAP running, I had to stop the ramp entirely.
If you're terrified of the pressure, and you don't experience your ability to breath out against the machine's pressure when you're awake, then of course you can't trust yourself to handle the pressure when you're asleep.

CPAP is such a strange way of sleeping - many of us have had to struggle to learn how to do that.
Many of us are here because we needed help, and many of us have stayed because we know how critical that help is.

Take it one step at a time, and we're here to help.

[Janknitz]

I had terrible panic attacks at first, too.

I agree with acclimating during the day.

I made some rules for myself:
1. I had to count to 10 slowly before removing the mask.
2. If I made it to 10, I had to try to to count to 10 again.
3. If I made it through the second set of 10, I would ask myself if I could just leave it on.
4. I never went to sleep without the mask. It had to go back on before I tried to sleep, or I had to get up out of bed. If I was too tired and wanted to sleep, the mask had to go back on.

Also, do you have a ramp setting? IMHO, that can make you feel more claustrophobic when you first put the mask on because you feel like you can't get enough air. Turn RAMP off. And if your settings are 4 to 20, ask for help to find a better starting number where you won't feel like you are suffocating.

The panic attacks are a product of your sleep apnea. For how many years have you been sleeping bathed in stress hormones because your body needed you to BREATHE. When you get this under control and get real treatment, the panic attacks will subside, and not just the ones caused by the mask. But you may have to do it in baby steps. Hang in there.

[jsavinmedicine]

When i started CPAP therapy i could only wear it like 2 minutes a night. I have severe claustrophobia. It was so bad the dr had to prescribe me Xanax to take at night, to be able to acclimate to it.

Usually, you want to avoid benzodiazepine based anxiety medicine, because it makes your throat muscles relax too much and makes your apnea worse. However, my dr said it was more important for me to get used to the mask. After about 6 months i was able to keep the mask on all night and the over the next 2 months i weaned off the Xanax and since then its been fine!

[jsavinmedicine]

Oh, I also forgot to post my other acclamation method which was the first night I wore it for like two minutes and then I couldn’t take it anymore so I took it off. And then whenever I would wake up in the middle of the night and put it back on again for as long as I could take and then take it off And slowly day by day each night I started to be able to wear it like a minute longer so from like 2 minutes to 3 minutes, to 4 mins, 4:56 minutes, etc. then I would just go to sleep without it and then when I woke back up in the middle of the night, which I usually do 3 to 4 times, I would just put it back on again for however long I could take it. I had worked this method out with the doctor, because I felt really guilty and was pushing myself to keep it on all night and I couldn’t do it and the anxiety was so bad that I started dreading bedtime and started feeling panicked all day. The doctor told me that I had survived in life up to this point without the CPAP machine so if it took me a few months to get used to wearing it, it was OK and that each night, just wear it as long as I could. And then some thing about knowing that I could take it off when I felt too panicky made it much easier and the Xanax helped a lot too I felt like a guilty failure a lot at first for not being able to wear it for more than a few minutes but actually the repetition and doing a bit by bit slowly got me there and once I got to about 347 night I started feeling so much better the next day that it became sort of a self reinforcing thing, because even though I would feel panicky, I would remember how good I felt the next day and that helped as well.