First night with a CPAP... please tell me it gets better!

Hi everyone!

Last year I had my two sleep studies but I held off getting a CPAP... partly because I really couldn't stand my sleep specialist, and the second because I was scared. Stupid, I know -- much more to be scared about WITHOUT the CPAP than with, but I also have a generalized anxiety disorder, so there's that for you.

Anyhow, over the past few months I met that special someone and they finally convinced me to get my CPAP. My general practitioner had all the notes and data from my studies and felt comfortable reaching out to DASCO and having them fill a script. I got setup with a 3B BMC RESmart CPAP and after today's machine turn over and fitting, ResMed N10 for Her XS pillows (because I'm a man with extremely small nostrils apparently... the medium and smalls were too big, and they don't make men's XS). I am very happy with both my general practitioner and DASCO but now I've tried to sleep with it... and well, my anxiety is making it hard. So I have a few additional questions or concerns now that I've tried really using it; I'm hoping I can ask here to avoid a copay

My machine seems really great -- heated humidifier, set to step from a 4 to a 9 over 20 minutes.

Here are the things bothering me:

-When I open my mouth I hear a lot of air leakage I don't hear otherwise. I'm assuming that's normal since I'm creating a leak in the circuit by doing that, right? Also, does it ever get easier to breathe through your mouth? I'm NOT a heavy mouth breather, but I do yawn and it feels SO strange.

-It seems difficult to breathe out sometimes. I've seen others say the same thing when searching google about the N10s. I was exhaling through my mouth some but that caused the air leakage noise so I'm assuming that's frowned upon...

-I hear extra noise from the machine when I'm breathing in (it doesn't sound like a bad noise, just kind of a quicker burst of air if that makes sense). Everything is properly sealed and I don't think I have a leak -- there's no gushing or whooshing noise except when I take the mask off. I just notice extra noise from the machine when I breathe in.

-About an hour ago I went to Walgreens and bought a Pulse Oximeter just to help calm myself down anxiety-wise. I see some of you use them. I just got a Walgreen's branded C20 by ChoiceMMed for now. (Funnily enough even though I got it from Walgreens and it had Walgreens packaging, they accidentally put in the CVS instructions. I just find that humorous.) Any tips or suggestions? I assume that it would help show if there was a problem (air leak, exhaled air, etc).

-My lungs feel fuller than normal when on the machine. Again, just a weird sensation to get used to for someone who has anxiety and asthma.

So I guess my bigger question is... does this all sound normal to all of you? What did all of you do to make it get better/easier? I want and I need for this to work and I am confident in both my doctor and DASCO. They were great answering questions and talking to me when I got my machine and I know they have a number I can call and if I feel I need to, I will. But I guess I'm just thinking I'm probably not alone in any of these feelings, and y'all may have some fantastic advice.

If you've made it this far, thank you so much for reading. If you answer any of my questions, thank you even more

-E

Ya it will get better. Alot of things honestly come from attitude if you ask me. You get it in your head...this sucks....won't work out...I can't handle this crazy thing doing this crazy way or that....then you likely won't get there. Its just different..... thats all....try to keep a good attitude about different. Smile about it instead of poking your lip out. Understand and know that very few people just throw on these masks and pure love it immediately. Hardly anyone anyone I don't think goes from sleeping without one all there life...to slipping on a pressurized mask attached to a hose before trying to fall asleep and thinking....wow this is better than sex. Try to relax and embrace the horror lmao...just kidding. After a week or two... you'll likey won't mind it at all....and in fact come to love it. Stick with it and after you start seeing positive changes in daytime energy...you'll know it was all worth the adjustment.... and then some. If your breathing out your mouth at all...I'd consider a new mask. Perhaps a full face mask.

Hi, a couple of things - the pulse ox is to check how often (if at all) your 02 goes below 88-90 overnight - nothing to do with air leaks (or only very indirectly as part of overall therapy). You need to find out if the one you bought is an overnight recording one rather than something you'd wear to check yourself if you were e.g. a jogger - big difference.

Your ramping 'up' to a modest 9 from 4 over 20 mins is keeping you from getting full therapy for that time and quite honestly you might find you don't need the feature at all as most of us turn it off within a short time of starting Cpap. Four is too low to get any reasonable air at and only if you were prescribed e.g. a pressure quite a bit higher than 9 would 20 mins be necessary for comfort. Try a much shorter time, and/or try going straight in without the ramp.

Next, if you mouth breathe when sleeping, you lose therapy air and aren't getting properly treated, and your choice of mask won't help. Have you tried any full face masks? They'll allow you to mouth breathe but still get therapy, and there's a good variety to choose from, plus nostril size won't matter except with the hybrid type such as Liberty. Do try them when lying down of course, because your face changes a lot then compared to sitting up.

And if you do all that and still find trouble exhaling, your machine has a feature that makes it easier - exhale relief pressure (EPR), so you can look into that as well.

Franky wrote:Ya it will get better. Alot of things honestly come from attitude if you ask me. You get it in your head...this sucks....won't work out...I can't handle this crazy thing doing this crazy way or that....then you likely won't get there. Its just different..... thats all....try to keep a good attitude about different. Smile about it instead of poking your lip out. Understand and know that very few people just throw on these masks and pure love it immediately. Hardly anyone anyone I don't think goes from sleeping without one all there life...to slipping on a pressurized mask attached to a hose before trying to fall asleep and thinking....wow this is better than sex. Try to relax and embrace the horror lmao...just kidding. After a week or two... you'll likey won't mind it at all....and in fact come to love it. Stick with it and after you start seeing positive changes in daytime energy...you'll know it was all worth the adjustment.... and then some. If your breathing out your mouth at all...I'd consider a new mask. Perhaps a full face mask.

To add to Franky's post, what I've experience as someone who has only been on bipap for 5 weeks, more energy, better memory, don't get as drowzy while sitting in church listening to monotone preacher, and fewer bathroom runs during the night (from 3 or 4 to 1 or 0)

If you do a bit of googling, you'll find that they don't exactly know whether sleep apnea causes alzheimer's or if alzheimer's causes sleep apnea. There are studies going on to figure this out but I'd rather error on the side of caution and be 100% compliant and possibly dodge the bullet.

What you'll probably find is that there are various mask.....some work better for some than others, and that the pressures that you start out with may not be all that accurate....so you'll learn how to monitor them and adjust according.

In any event, the longer you stick to it, the more likely you are to get the objections resolved.

It will get better, but sometimes it takes a while to find the mask that works best for you. I have tried nasal pillows and have not been successful. Other people really love them. I use a very old style gel mask, it has a real thick layer of gel and that works for me. sorry I don't know the type at the moment and don't want to slip down to my bedroom to get the info because I may wake my mom who has Alzheimer's ( meaning every moment we have with her sleeping is such a blessing). You can't open your mouth with cpap on, and yes that is a bit weird at first, but you absolutely do get used to it. If you want to have a sip of water or anything that involves opening your mouth just slip the mask off for a sec. There is no denying that sleeping with a mask of any type is a pain, but it's a matter of perspective. I look at my poor mom's life and can tell you that losing brain cells will cause much more anxiety than you can possibly have right now. If you have episodes where your brain is not getting enough oxygen then the chances are that you are losing brain cells. To me that's knowledge will keep me using my cpap. If you continue to feel like you can't breath out you may need pressures adjusted, use a bipap system where you have different pressures for breathing in and breathing out, or use an autoadjust feature which I have never had, but seems like a great idea. Since you just started it not time to look at any of those options yet. Start with thinking about what is happening to your brain without the cpap.

Yes, it does get better. I remember at first it did feel really strange to open my mouth for even a second and yawning or talking seemed out of the question. You do adjust to it and you will discover ways to open your mouth and it not feel strange. I can even give 2 or 3 word answers now if my husband asks me a question while I'm using the CPAP.

cmhflyguy wrote: My machine seems really great -- heated humidifier, set to step from a 4 to a 9 over 20 minutes.

I agree with the advice to decrease ramp period.

cmhflyguy wrote: -When I open my mouth I hear a lot of air leakage I don't hear otherwise. I'm assuming that's normal since I'm creating a leak in the circuit by doing that, right? Also, does it ever get easier to breathe through your mouth? I'm NOT a heavy mouth breather, but I do yawn and it feels SO strange.

It's normal and isn't a problem unless you sleep with your mouth open. Occasional yawns are fine - even if they feel strange.

cmhflyguy wrote: -It seems difficult to breathe out sometimes. I've seen others say the same thing when searching google about the N10s. I was exhaling through my mouth some but that caused the air leakage noise so I'm assuming that's frowned upon...

If it feels like you're having a hard time breathing out, check out the setting that lowers the pressure when you exhale. If you are having a hard time breathing in when the machine first starts, increase the minimum ramp pressure to about 6 or so. I don't know if anyone on the forum uses the Resmart, so don't know how much help we'll be at figuring out how to change he settings.

cmhflyguy wrote: -I hear extra noise from the machine when I'm breathing in (it doesn't sound like a bad noise, just kind of a quicker burst of air if that makes sense). Everything is properly sealed and I don't think I have a leak -- there's no gushing or whooshing noise except when I take the mask off. I just notice extra noise from the machine when I breathe in.

I remember one post where someone was indicating that the ResSmarts are a bit noisier than the RemStar and ResMed machines. Even with the Remstars and Resmeds there is a little bit of noise. I use a white noise generator - the machine noise isn't very loud and I find a very low volume on the white noise generator masks whatever is there.

cmhflyguy wrote: -About an hour ago I went to Walgreens and bought a Pulse Oximeter just to help calm myself down anxiety-wise. I see some of you use them. I just got a Walgreen's branded C20 by ChoiceMMed for now. (Funnily enough even though I got it from Walgreens and it had Walgreens packaging, they accidentally put in the CVS instructions. I just find that humorous.) Any tips or suggestions? I assume that it would help show if there was a problem (air leak, exhaled air, etc).

The oximeter will not provide information regarding cpap leaks - you need to get access to that info from the cpap machine. Each of the cpap brands has machines that provide full data and other machines that provide only information regarding time used. You want a machine that provides full data (and you may have to complain to get it). I don't know if the Sleepyhead software supports the ResSmart machines. Manufacturer's software for reading the detailed data is usually only provided to health care professionals - I don't know if anyone on the forum has access to the ResSmart software.

cmhflyguy wrote: -My lungs feel fuller than normal when on the machine. Again, just a weird sensation to get used to for someone who has anxiety and asthma.

This is probably more your imagination than anything - of course, hopefully your lungs really are more full of air!!!

cmhflyguy wrote: So I guess my bigger question is... does this all sound normal to all of you? What did all of you do to make it get better/easier?

This is all normal so far. It takes time to get used to anything new. When we're anxious we are hypersensitive to changes in our environment. Wear the mask before going to bed (while watching television, reading, or - possibly some alien fantasy play (just kidding) - to get used to it). Some people adapt to cpap almost immediately, while some of us take weeks or months to get comfortable.

To those who took the time to reply, thank you so much. I very sincerely appreciate the replies. My anxiety makes adjusting to something like this worse and it looks like I've got a long road ahead of me.

Frankie -- thank you for your sense of humor mixed with your straight talk It made me smile.

Julie -- lots of great knowledge and thoughts. I found my EPR setting and moved it to 3. It looks like they had it on 2. The manual says moving it up is the way to go. 3 is the highest setting. I am very much considering changing the ramp. I just haven't done it yet. In terms of a full face mask, claustrophobia mixed with my anxiety keeps me from going that route right now at least.

Jim -- just the stuff I needed to hear. I may PM you with extra insight since you're newer to this too

wherewillugo -- Also great stuff I needed to hear! Especially about taking time to find the right mask.

Sharry -- YES!!! Thank you!! I needed that specific encouragement!

Nick -- My main man! THANK YOU for your point by point. I feel so much better. You answered everything beautifully.

In closing -- thank you to the 5 of you. All of you rock and hopefully we can become friends over the years. In terms of the pulse oximeter I didn't word it well. I have an irrational fear of suffocation (in general) and the mask is bringing it out. So what I'm trying to say is that I purchased it so I can see my blood ox is actually okay and that I'm not suffocating but breathing just fine. Afterall, my blood ox wouldn't be 97-99% if I was having an actual problem. It's just. Weird. And I need more Xanax, lol

Oh and I should add -- I'm trying the small size instead of the extra small. It seems to feel slightly better.

It does get better. One of the things my DME encouraged me to do was to put on the mask and use the machine for short periods of time while I was awake to get used to the way it feels. So I masked up and read or watched tv in the living room a couple of times before I tried to use it at night. It really seemed to help.

Best of luck with getting adjusted to your therapy!

https://www.cpap.com/productpage/resmar ... ducts.html

Is this your machine? The equipment profile link is broken and you just need to add it to your profile comments section.
The humidifier you have chosen is incorrect. That one was discontinued back in 2007 and is for a different manufacturer anyway.

The link above mentions an iCode.
Looks like your machine offers very basic data...pressure and AHI. Doesn't offer leak data or anything else..
Doesn't offer AHI event category breakdown either.

I initially was diagnosed with sever sleep apnea in 2009. I tried to adjust to using CPAP. I couldnt. 4 years later, desperate I gave it another shot. Now I wont sleep with out it. I strap my full mask to my face and it signals my body to sleep. It gets better you adapt. No matter how hard you think it is you will adapt. Looking back Im so pissed at myself for not sticking it out initially. I love my CPAP now.

One thing that may help you get used to keeping your mouth closed while using the nasal pillows is to train yourself to keep the tip of your tongue right at the point where your teeth meet the gums at the roof of your mouth. Does that make sense to you? You can practice it a few times during the day and you will get used to it pretty quickly!!

cmhflyguy wrote: In terms of the pulse oximeter I didn't word it well. I have an irrational fear of suffocation (in general) and the mask is bringing it out. So what I'm trying to say is that I purchased it so I can see my blood ox is actually okay and that I'm not suffocating but breathing just fine. Afterall, my blood ox wouldn't be 97-99% if I was having an actual problem. It's just. Weird. And I need more Xanax, lol

Good luck - I am confident things will get better. Regarding the pulse oximeter - I'm glad that helps with the anxiety. This therapy is all about doing what works.

Yes it will get easier. I just started therapy recently, and I think the 16th night was the first night that I managed to get really good sleep. Before that I had better sleep since my apnea was being treated, but I had trouble sleeping through the night because I was still becoming accustomed to the machine and mask. I also switched from the F10 to the P10 with an added chin strap and that really worked well for me. So to answer your questions:

Yes, if you open your mouth with a nasal or nasal pillow type of mask then you are creating a leak. Oddly enough, that leak isn't severe enough to negate your treatment, but it can be uncomfortable, and it is definitely loud. It was loud enough that my wife complained about it forcing me to get a chin strap. You might want to look at chin straps as well.

I have not had difficulty breathing out, though I am using the large pillows. I also have a PR 60 Series machine and am using CFLEX+ so that might make it easier for me. I'm not familiar with your machine so I don't know if it has something that can provide equivalent relief when exhaling.

Extra noise while inhaling is normal. I can hear my machine's noise change depending on whether I'm inhaling or exhaling.

I don't use a pulse -ox device at night, though I am a big enough nerd that i may try it at some point. Sorry I can't offer any tips.

I think it is normal to feel a little bloated at first. You'll also feel your mouth fill with air. You'll get used to it. It isn't a problem. Eventually you'll barely notice it if at all.

Everything you've mentioned sounds pretty normal to me. If your machine has an attached humidifier, play around with the settings. Some people like more or less humidity, and that can make it much easier to breath through your nose. Beyond that, just give yourself some time to adjust. It is a big adjustment, but hopefully it won't be a difficult one.