Feel like I'm suffocating

[flyingwithoutwings]

I started CPAP on October 1, 2013. Was given the PR REMstar SE with System One Heated Humidifier and Swift FX for Her. I started suffering sinus problems from day 1 (nasal congestion + runny nose, sneezing, watery eyes). Was told to use a Saline solution and antihistamine. I have HBP so my doctor prescribed Flonase which made me feel worse. I starting using the nettie pot twice a day and a saline solution but nothing seemed to work. I increased the humidification to 5 and the preheat and starting sleeping better but had 3 miserable weeks of sinus problems. Thursday DME swapped my Swift FX pillows for the PR Wisp nasal mask and issued the heated tubing. I was fine until I put on the Wisp nasal mask. Immediately I felt my nostrils get stuffed and I felt like I was going to suffocate. I took it off and I was fine. I tried again a little later and the same thing, my nose stuffed up and I felt like I was going to suffocate. Needless to say I did not use the CPAP that night and I dragged all day Friday. When I got home from work Friday, I tried putting on the nasal mask while watching TV to try to get used to it. As soon as I put on the mask my nose gets stuffy. I take the mask off and I'm fine. I preheated the humidifier and tried to go to sleep with the mask on but couldn't overcome the feeling of suffocation so I took it off. I awoke at 1:00 am and decided to try it. I eventually fell asleep with it on but woke up at 6:30 with a major league headache and extremely dry mouth, so I know I slept with my mouth open (am not a mouth breather). I was so tired I just laid in bed for 2 hours (that is not me). Please someone tell me how I can make this work. I am so tired of being tired. Did I mention I'm claustrophobic?

[Julie]

Try lowering the humidity - it congests many people and can aggravate sinusitis if you have that. If humidity in the room is low, try a standard room humidifier.

Once you're breathing better through your nose, you may not have the dry mouth problem, but if you do, may need to try e.g. a Hybrid mask that lets you not have your nose covered (though mouth will be), and still breathe through your mouth if you need to without losing therapy air out of it.

[Pugsy]

The pressure of the Wisp on my nose actually caused me to have nasal congestion so much that I couldn't sleep well with it.
Anything that touches the sides of my nose up by the nasal bridge simply closes off the nasal passages. Even the tiniest amount of pressure results in nasal congestion.
So that may be your problem with the Wisp...
or what is your starting pressure? Using the ramp starting out at 4 cm pressure? That will also make a person think they are suffocating. Simply not enough air movement is felt for comfort.

Humidity needs for the nasal passages are highly individualized. Some people do better with less added moisture and some people need all the machine will give. I pretty much need all the machine can give and have the symptoms you experienced initially with the nasal pillows when I don't get enough added moisture.
Just have to play with the settings to figure out what way your nose wants.

[flyingwithoutwings]

The pressure has been 4 but last night I raised it to 5. I don't know at what point I finally fell asleep.

I was sleeping better with the humidity at max with the nasal pillows but when DME swapped the pillows for the Wisp mask and the heated tubing she lowered it to 3. I can't tell right now which setting works best for me with the Wisp mask because I can't keep it on long enough. I've been putting the mask on every so often today to try to get used to it but within a few seconds my nose feels stuffy and I can't breathe but as soon as I take off the mask, I'm fine.

I am determined to make this work.

[Julie]

You can raise it to 6-7 without any consequences (except easier breathing). It would only be an issue at something above 10=15.

[Pugsy]

With the PR S1 heated hose there are 2 settings available.
Settings 1 through 3 are for humidity delivered...1 being 70%, being 80% and 3 being 90%.
There is also a setting for the air temperature...1 through 5 with 5 being the highest temp and starting point is base on the bedroom air temp.

Did you get to keep the nasal pillow mask when they gave you the Wisp to try?
If so, maybe go back to the nasal pillows and try the slightly higher starting pressure of 5 (or 6) and see if that helps and if the added humidity with the heated hose helps.
The first way of delivering humidity that you used initially actually uses much less water even at the highest setting.
The PR S1 without heated hose uses the default "new humidification system" and I have used it...much less water is used and even at the max setting it can sometimes leave a lot to be desired for people who need more moisture.
Investigate your settings to see what the actual humidity delivered is set at along with temperature...they are in the clinical setup menu where you change the pressure.

[flyingwithoutwings]

Thanks Julie - I'll try raising the pressure to 6 tonight.

Pugsy - DME didn't explain much to me except for the Ramp feature. I discovered the preheat and humidity setting by reading forums. I think my problem is more of air temp. When the air was coming thru warm (with nasal pillows) I was sleeping like a baby but the air would cool during the night and I would wake up with sinus problems. DME took back the nasal pillows. I wish I had still had them to see if the heated tubing helped with the sinus problem. Hopefully I get past this feeling of suffocation with the Wisp and get a good nights sleep.

[kteague]

I'm with Pugsy in that the nasal masks I tried seemed to cause the airways in my nose/sinuses to block as within minutes after putting it on I could feel things closing up.

[Pugsy]

If increasing the starting pressure for ramp doesn't help the congestion/suffocation feeling with the Wisp then maybe you are like me and that little pressure from the Wisp makes the total congestion issue worse because it physically compresses the nasal passages.
Too bad they took back the nasal pillows...they just tossed them in the trash can. It would be nice to see if they helped.

I know what you mean by the cold room air being a possible issue. I found it gave me what I called "ice cube nose" during the winter months when I use the PR S1 without the heated hose. Extremely uncomfortable and woke me often. The default humidification system for without the heated hose simply doesn't use as much heat and the air was uncomfortably cold going into my nose. There are ways to lessen the impact without using a heated hose but the heated hose is the easiest and best way IMHO.

There's nothing stopping you from going back to the nasal pillows though.

[flyingwithoutwings]

I started this morning by just putting the mask on (no tubes no headgear) and within seconds I would feel the stuffiness and the feeling of suffocation, but would clear up as soon as I took the mask off. I've continued to do it throughout the day while reading, watching TV, etc. and now it's not so bad. Now I'm putting it on with the small tube but no head gear. Hopefully this will desensitize and I'll have a good (or better) night's sleep tonight.

[avi123]

The pressure has been 4 but last night I raised it to 5. I don't know at what point I finally fell asleep.

I was sleeping better with the humidity at max with the nasal pillows but when DME swapped the pillows for the Wisp mask and the heated tubing she lowered it to 3. I can't tell right now which setting works best for me with the Wisp mask because I can't keep it on long enough. I've been putting the mask on every so often today to try to get used to it but within a few seconds my nose feels stuffy and I can't breathe but as soon as I take off the mask, I'm fine.

I am determined to make this work.

Comment,

I can tell you with 90% confidence level that you feel suffocated b/c the pressure is too low. I would raise it to 9 cm for a night and see how I felt.
Blow your nose before you get ready to fall asleep as many times as needed to get it clear. The warm air from the humidifier will take over and keep your nose clear. If blowing does not clear your nose then spray it with Saline.

From Dr Krakow (Kraiko):

[flyingwithoutwings]

Thanks for the info.
My maximum pressure is 7.
I did pick up some saline spray. My doctor prescribed Flonase but it made me feel worse. I'm not really allergic to anything and I don't use antihistamine because of HBP which (woohoo) was the lowest this week in a long time, thanks to CPAP.

[Julie]

Again, you can almost leave your high pressure setting open, or at least higher than 7, but it's the low pressure setting (4-5 or whatever) that determines how easily you breathe, and if yours is still at that bottom level, you're going to feel suffocated no matter how warm or cold the temp is, and no matter what mask you're using.

[flyingwithoutwings]

Woohoo I slept 6½ hours straight, woke up looked at the clock and slept another hour. First time since I've been on CPAP.

[SleepyToo2]

Wow! Congratulations! There will be times when you sleep less then that, but at least now you know that you can do this thing called CPAP.