exhailing against the airflow

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
rmendez8

exhailing against the airflow

Post by rmendez8 » Fri Sep 19, 2008 2:56 pm

I tried sleeping with the cpap machine last night for the first time and I could not fall asleep because of the discomfort of exhailing against the airflow. I'm already discouraged but I know I need to use it. Any advise?

jnk
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Re: exhailing against the airflow

Post by jnk » Fri Sep 19, 2008 3:20 pm

Some machines have a timed "ramp" or "settle" feature that allows you to fall asleep to a lower pressure before the full pressure kicks in.

Some machines have comfort settings that lower the pressure on exhale.

But most can eventually get used to the pressure and fall asleep even without either of those features. It can take a few minutes or so for the lungs to adjust to the back pressure, but once they do it's just a matter of you getting used to the sensation. It can take a few nights for you to get over the thought that it is somehow unnatural to breathe out against pressure. But most quickly get to the point that when they wake up at night they think "hey, what happened to the pressure? did my machine go off?" They get THAT used to it.

If you have very high pressure and can't adjust to it for some reason, that may (depending on your doctor and insurance) qualify as "failing CPAP" so that you then get a machine that gives two pressures, one for inhale and one for exhale, a bilevel machine. But those are more expensive than CPAP machines.

The key is not to give up. You have to make this work. So you WILL! Discouragement is OK. Giving up isn't. Making this work may very well turn your whole life around. You may end up feeling so good that you scare yourself. So let's give this thing the full shot. OK?

jeff

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Babette
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Re: exhailing against the airflow

Post by Babette » Fri Sep 19, 2008 3:53 pm

My machine (Respironics M Series Auto w/Aflex) has two different settings for exhalation relief - Cflex and Aflex. If you tell us what machine you have, we can tell you whether that machine comes with exhalation relief, and if so, how to set yours for a more comfortable setting.

Cheers,
Babette

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Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap.
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula. :)

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SeaPappy
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Re: exhailing against the airflow

Post by SeaPappy » Fri Sep 19, 2008 6:56 pm

jnk wrote:The key is not to give up. You have to make this work. So you WILL! Discouragement is OK. Giving up isn't. Making this work may very well turn your whole life around. You may end up feeling so good that you scare yourself. So let's give this thing the full shot. OK?
Jeff, truer words were never spoken...Kudos to you!!

Mendez, talk to your RT about your problem with the knowledge you gain here. Bitch, moan, and do backflips if you have to, but make sure your therapy is what you NEED, not what he wants to give you. I approached my RT with enough knowledge and BS to get the machine I wanted and needed and you can, too. In the last three weeks, because of proper therapy, I have found the "Fountain of Youth" and feel years younger and full of energy.

Best of luck and remember not to forget the goal.

James
When I woke up this morning my girlfriend asked me, 'Did you sleep good?' I said 'No, I made a few mistakes.'
Steven Wright

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yorkiemum01
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Re: exhailing against the airflow

Post by yorkiemum01 » Fri Sep 19, 2008 7:00 pm

This...was my biggest obstacle in therapy, and found talking to my Dr and the RT
was the answer. My physician ordered an machine with EPR, expiratory pressure relief,
and the difference for me was day and night. Thats when my therapy began to 'click', so
keep communicating, and keep coming back to the forum. Best of luck to ya!

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Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Additional Comments: pressure is 11, began cpap tx 2/25/08. Also use Chiro-Flow Pillow.
Live simply. Love generously. Care deeply. Speak kindly. Leave the rest to God. And remember - the richest person is not the one who has the most, but the one who needs the least.

Cloud 9
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Re: exhailing against the airflow

Post by Cloud 9 » Fri Sep 19, 2008 8:02 pm

I am only on my 27'th day on CPAP. After the titration my pressure was set at 17. Higher than I anticipated. My first impression was that exhaling against the pressure felt a bit confining for lack of a better word. Sure didn't make me feel better about having to do this CPAP thing, but I knew how severe my apnea was.

It is natural to feel some anxiety especially when breathing is involved. You can try a technique that really helped me, and using the ramp in the beginning helps also. When you first put on the mask, it's difficult to ignore the contrast between inhales and exhales, but try to control your breathing by using slow controlled breaths as if you were taking in a big fresh breath of morning air and then slowly exhaling. Imagine your heartbeat slow with every exhale. Pretty soon I no longer notice the contrast in pressure and every breath feels natural and non labored.

Like others have suggested, a different machine or different features may be necessary, but don't give in too soon, it does get a lot easier. Once you feel the benefits of CPAP, if you are like me, you won't want to sleep a night without it.

Keep us up with how it goes with you.
"Good people sleep peaceably in their beds at night only because rough men stand ready to do violence on their behalf." George Orwell

cflame1
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Re: exhailing against the airflow

Post by cflame1 » Sat Sep 20, 2008 11:30 am

Cloud9... try and get a better machine... a compact will give you no data and it'll only go up as far as 20. You really should be on a bilevel at that pressure.

DSM (oseas)

Re: exhailing against the airflow

Post by DSM (oseas) » Sat Sep 20, 2008 2:00 pm

Cloud9

It is very normal for all of us to experience that difficulty when we 1st start the machine.
Ramp feature is the 1st thing to set up on the machine to help get past that short dropping off to sleep period.

Ramp will usually solve the problem. Most machines are adjustable up to 20 mins - many now offer longer ramp periods.

The next help you can get are the exhalation relief features that some machines have - c-flex and EPR for example.

The next step beyond that is to use a Bipap (bilevel) machine that has a lower pressure for breathing out against & normal pressure for the breathe in part of the cycle.

Good luck.

DSM