Ist night problems - new CPAP user

Hi just got my new machine yesterday. It's a Fisher & Paykal CPAP set at 12. The titration night WAS the worst night of my life, so was looking forward to an easier 1st night.
I still feel a panic feeling with the smell of the nasal mask, the resistance to breathing out and the feeling that the air coming in is not 'fresh' and cool - Only lasted an hour and a half before I ripped it off. Felt terrible again this morning. Also felt a failure.
I KNOW I have to succeed in this. But does this feeling go away?- I just lie there and can't get to sleep with the alien feeling, noise, resistance to breathing out with my heart thumping. Any suggestions?

michaelho wrote:Hi just got my new machine yesterday. It's a Fisher & Paykal CPAP set at 12. The titration night WAS the worst night of my life, so was looking forward to an easier 1st night.
I still feel a panic feeling with the smell of the nasal mask, the resistance to breathing out and the feeling that the air coming in is not 'fresh' and cool - Only lasted an hour and a half before I ripped it off. Felt terrible again this morning. Also felt a failure.
I KNOW I have to succeed in this. But does this feeling go away?- I just lie there and can't get to sleep with the alien feeling, noise, resistance to breathing out with my heart thumping. Any suggestions?

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Welcome to the board. Click the yellow light bulb at the top of the screen and also click profile and fill in you equipment info so you won't have to keep entering it..

Well as much as you think it is an alien, it is now to become your friend and best buddy for life.

Honor it, cherish it, and accept it.

The attitude that YES I CAN DO THIS helps.

Try each night to get another half hour on the machine. If you need to wear the mask and use the machine while watching TV or listening to some music for a while to get used to the breathing against pressure go for it too.

Having a rough first night is disappointing. It will get better, and reading on here can help with that.

I'm not familiar with your machine, but you are very specific about difficulty exhaling against the pressure, so I suggest if your machine does not have exhalation relief, call your supplier and tell them you need it. If this will mean a machine exchange, please do read the site as suggested so you don't end up with another machine that's not what you want. There's all kinds with bells and whistles, but my bare minimum I would accept was a machine that captures therapy data (not just compliance data) and had exhalation relief.

You also mention the plastic smell, which will probably lessen in time, but some on here use essential oils or a product called Pur-Sleep behind the machine near the intake to avoid that mask smell and make the experience more pleasant.

It does get better. Really - it does.

Kathy

michaelho wrote:the resistance to breathing out

I'd go back to your doctor (any doctor...doesn't have to be a sleep doctor...can be a family doctor) and ask him/her to write you a prescription that reads this way:

Respironics REMstar Auto with A-Flex M series
6 - 14 cm H2O
A-flex setting 3
Ramp off
Show AHI/Leak feature On
Fisher & Paykel HC 150 heated humidifier
Nasal mask, Full Face mask, or nasal pillows mask of patient's choice.

Every word is important. That's a much more detailed Rx than doctors usually write, but that will be clear about what machine and what settings the DME (home health care supplies store) is to provide you.

If the DME tries to tell you, "Oh, your insurance won't pay for an autopap; they'll only pay for a cpap" tell them (nicely),

"The billing code and the reimbursement are exactly the same whether I get an autopap or a cpap, because an autopap IS a cpap machine. It has an autotitrating mode, but it is considered nothing more than a 'cpap' machine for billing purposes. The billing code for either one...cpap or autopap... is E0601."

If they still balk (after they've closed their dropped jaw) thank them for what they've done so far, tell them you'll be returning the cpap they gave you and will do business with another DME who will fill your doctor's prescription as written.

COMFORT is a huge issue in being able to do this kind of treatment. The mask is the #1 thing to get right. Being able to breathe out easily against pressure is a close second in my opinion. I'm not a doctor or anything in the health care field, but I really, really, REALLY think it's important to get as comfortable a delivery of the pressure as possible. That machine with A-flex can give you a much easier time getting adjusted than the machine you have.

A-Flex will provide nice relief from pressure when you breathe out, and will smooth out the feel of pressure coming back in when you inhale. It will feel much more like natural breathing than the machine you have which gives no relief from pressure whatsoever when you try to exhale.

The fact that the machine is an autopap and can be set for a range of pressures gives further relief. It may be that most of your night can be spent at considerably less pressure than the 12 you were prescribed. You may need the pressure of 12 only occasionally during the night. An autopap will vary the pressure as needed, when needed. It won't be blowing that straight 12 at you all the time.

Welcome to the board, Michael. It can all be a lot better than what you've experienced so far.

Is that you Dr. Ho Michael from Monash Medical Centre-Sleep Lab? How conicident it can be?

I am fairly new here and haven't posted yet. I just want to let you know it does get better, and you will feel better. I no longer have to use the ramp feature on my machine, I can adjust to the pressure in seconds instead of hours now. My insurance for lack of a better word, "sucks", for durable medical equipment. You will pick up info from others here that is worth it's weight in gold. When they fitted me for a mask to use, like so many others I had no idea what the heck a good mask for me would feel like.
I found I could pick up other masks at affordable prices (quite a bit less than my copay) on the cpapauction. My initial mask was ripped off both on purpose and in my sleeping stuper before half the night could pass. I am currently using a comfortlite I picked up for 20 bucks new in the package. Only one of the interfaces "did it" for me....but it stays on all night. I guess my point is you will have slow improvements you may not notice until you look back over time....but, sometimes a change in mask can make a world of difference. I will keep experimenting with new masks until I find the one but for now I'm sleeping 7-8 hours with mask in position. Don't always put stock in all reviews for masks because mask choice, fit, and comfort are such a personal thing. The a-flex machine wil definitely help you along. Keep your head up you are moving in the right direction wether you know it or not and there will always be someone here for support. Keep us posted.

Rich

ratkinson wrote:I am fairly new here and haven't posted yet. I just want to let you know it does get better, and you will feel better. I no longer have to use the ramp feature on my machine, I can adjust to the pressure in seconds instead of hours now. My insurance for lack of a better word, "sucks", for durable medical equipment. You will pick up info from others here that is worth it's weight in gold. When they fitted me for a mask to use, like so many others I had no idea what the heck a good mask for me would feel like.
I found I could pick up other masks at affordable prices (quite a bit less than my copay) on the cpapauction. My initial mask was ripped off both on purpose and in my sleeping stuper before half the night could pass. I am currently using a comfortlite I picked up for 20 bucks new in the package. Only one of the interfaces "did it" for me....but it stays on all night. I guess my point is you will have slow improvements you may not notice until you look back over time....but, sometimes a change in mask can make a world of difference. I will keep experimenting with new masks until I find the one but for now I'm sleeping 7-8 hours with mask in position. Don't always put stock in all reviews for masks because mask choice, fit, and comfort are such a personal thing. The a-flex machine wil definitely help you along. Keep your head up you are moving in the right direction wether you know it or not and there will always be someone here for support. Keep us posted.

Rich

Rich,

Welcome to the forum.

Best wishes for continued good therapy.

Den

ratkinson wrote:I guess my point is you will have slow improvements you may not notice until you look back over time....but, sometimes a change in mask can make a world of difference.

Well said, Rich..and so true!

Welcome to the board.

In addition to getting the best gear for you and making the proper adjustments, you can also ease into CPAP therapy. It might be helpful to become aquainted with the mask and air flow before trying to sleep. Perhaps wear just the mask without the hose while watching TV or reading. Say "Luke, I am your father" a few times . Then try the mask and pressure without trying to sleep for some time.

Keep in mind that for most of us, it's well worth the effort. For me, just feeling so much better was worth it, not counting the long term health improvements.

I have an FP CPAP, and it does not have exhalation relief.

As most others tell you, the mask is important. My first mask was a Flexifit 405. I used it for three weeks, and then switched to a Comfort Classic. Quite a difference. The Comfort Classic is easier to breathe in and out with, but at the cost that it spills a lot of air through the exhaust port.

I am thankful that I can breathe easily at night, and I am working to get my energy back. I can assure you, it is worth the effort to get used to this equipment.

Welcome to the forum!

From what I see it looks like you already have a Respironics APAP with C-Flex. So I think that means it could be set for a range of pressures if you can't adjust to the single pressure and it should have the "ramp" feature so the pressure will build up gradually. Since you also have the humidifer, you may want to use that depending on your circumstances.

It looks like you have a Swift II nasal pillows mask. In order to make that a bit more comfortable and seal better, it may help to use just a little bit of either Ayr gel or KY jelly or liquid on the outside and just inside your nares.

And try to remember that this is really important to your health and it will get better over time. If need be, your machine could be set to a range of pressures and various other adjustments can be made.

I've found that even though there are still some challenges, after 3 months I feel enough better that I'm more than willing to keep working on it.

Mindy

Oops! I see that the picture of your machine doesn't match what you said it is so I don't know if yours has APAP capability. Sorry!

Mindy

I struggled to get used to the whole thing too. Frustrating is a very mild description, and I know reading about others who couldn't live without it was unimaginable. Now I'm one of those people...
After a about 6 weeks I noticed a huge difference in the way I felt. I calleld the DME in tears a couple of times. It was well worth sticking it out in the beginning. Not easy, but well worth it!
Keep trying!
Annie