Sudden intolerance to my cpap

Hi all,

I have been using my cpap for 4 months now. The first 3 months were fantastic, I had little to no problem getting used to the cpap. My sleep study AHI's were 17.
I immediately went down to around 1-2 per hour within 3 days of starting my therapy. I was able to sleep all night with no issue at all, 7-8 hours per night. Then the problems began. I picked up a new mask and tube right at the 3 month mark and it has been a disaster ever since. I now routinely can only get about 1 hour per night before I rip the mask off in my sleep. I tried going back to the original mask and tube but to no avail. The same thing happens. It feels like I can't exhale. I got my DME to replace my cpap ( I couldn't have them check it out in person as I'm out of town for an extended period of time) but it has made no difference at all. I'm getting pretty desperate here, my insurance will be taking the cpap back when I'm not compliant and that isn't an option... I'm using a Resmed Airsense 10 Elite, settings are 8.0 on the pressure, no ramp time and a 4 for the humidity. My mask is a large full face simplus. If anyone has any idea what in the world is going on here, I would LOVE to hear about it. Thanks!

Are you using the EPR? I would try setting the EPR as high as it will go. It may be that it was set at some point, and got changed by accident when changing some other setting, or some glitchy thing that happened. You didn't mention if you've looked at the parameters on your Airsense 10, but do that and look for your EPR setting. My S9 goes up to 3 for EPR, and it is very helpful for me. That would give you 3cm exhalation pressure relief. For a pressure of 8 on inhalation, that's quite a bit of relief, percentage wise.

Good luck, and don't give up! It's conceivable you might need a bi-level cpap, where you can set your exhalation pressure separately from your inhalation pressure, but in the mean time, I'd look for that EPR setting and increase it if you can.

Just a few things to check.

1.

ohsotired wrote:I picked up a new mask and tube right at the 3 month mark and it has been a disaster ever since.

Did you change hose size (diameter)? There is slimline and standard and the setting in the CPAP machine needs to match the hose or the machine will not provide proper therapy.


2.

ohsotired wrote: I'm out of town for an extended period of time

Are you under a type of stress you are not used to? Is your diet different? Your daily routine? Your exercise schedule?

3.

ohsotired wrote:It feels like I can't exhale.

If your pressure is 8 and this worked fine for 3 months, then I would not start fiddling with EPR. You have proof you can exhale against 8 cm pressure and 8 cm is already a low pressure. (I am a small, elderly woman and I can exhale easily against 16 cm pressure.)

Of course you do want to make sure the machine settings are correct. After that, I suspect this feeling that you can't exhale is a common experience that CPAPers have which is caused by stress from the mind concentrating on breathing. Try to distract your mind from breathing by thinking of being in a pleasant situation where you are very relaxed. For me, it helps to think about lazing on a warm, sunny beach in a pleasant breeze.

I do think you can get back to success with CPAP.

Good luck,

What was you old mask?

ohsotired wrote:Hi all,

I have been using my cpap for 4 months now. The first 3 months were fantastic, I had little to no problem getting used to the cpap. My sleep study AHI's were 17.
I immediately went down to around 1-2 per hour within 3 days of starting my therapy. I was able to sleep all night with no issue at all, 7-8 hours per night. Then the problems began. I picked up a new mask and tube right at the 3 month mark and it has been a disaster ever since. I now routinely can only get about 1 hour per night before I rip the mask off in my sleep. I tried going back to the original mask and tube but to no avail. The same thing happens. It feels like I can't exhale. I got my DME to replace my cpap ( I couldn't have them check it out in person as I'm out of town for an extended period of time) but it has made no difference at all. I'm getting pretty desperate here, my insurance will be taking the cpap back when I'm not compliant and that isn't an option... I'm using a Resmed Airsense 10 Elite, settings are 8.0 on the pressure, no ramp time and a 4 for the humidity. My mask is a large full face simplus. If anyone has any idea what in the world is going on here, I would LOVE to hear about it. Thanks!

Humidity? Maybe too high or too low. Maybe the relative humidity has changed in your area.
Nasal congestion? Are you doing nasal cleansing before bedtime?

You're probably going to need to do some self analysis with this one.


Den

.

Of course keep moving toward resolution. The timing of the mask and hose change sure does raise a red flag. I do want to mention that exhaustion from untreated sleep apnea can cause us to "crash" when treatment is initiated and the body/brain realizes it can safely relax and sleep. For me, once I passed a recovery period and was no longer so sleep deprived, my sleep became more fragile and I had to start working through other latent sleep issues. Maybe this plays a role with you. Good luck with sorting things out.

And, if you're not using software to see you nightly data, get "Sleepyhead" (or ResScan) to see what's happening.
There may very well be some clues in there as to why it's happening.


Den

.

Wow, Thanks so much for the many replies.

To answer the questions posed:
- I checked the EPR. It has 2 settings, on and off. It is on.
- When I picked up the new hose and mask, they are identical to the ones I was using during the first 3 months.
-My routine is completely different, I quit my job and am going back to school after being out of school for nearly 20 years. I moved 1500 miles away from my wife and home and will be gone for 1 year. I guess this could be part of the issue but my problem started before I even left town.
- I have checked all the settings and they are correct. I have even tried fiddling with the settings to see if any changes would help but to no avail.

I'm at a total loss here. I took to my cpap like a fish to water and to suddenly have major issues is very frustrating, especially since I'm in school and I really need to be able to concentrate. I can feel myself going downhill and I don't know what to do. I guess I'm going to have to find a sleep doctor where I'm currently living and see if they have any answers. Thanks all.

If you are just pulling off the mask in your sleep maybe you just need a little painters tape to tape it to your face.

ohsotired wrote:My routine is completely different, I quit my job and am going back to school after being out of school for nearly 20 years. I moved 1500 miles away from my wife and home and will be gone for 1 year. I guess this could be part of the issue but my problem started before I even left town.

This is a huge life change. Just thinking about it before leaving town could cause a lot of stress.

Since you checked everything out with the CPAP, my money goes on stress while you are lying there awake trying to fall asleep. The stress is causing you to think about breathing (manual breathing) and that is not good. Our body knows how to breathe without thinking (autonomous breathing). https://www.reddit.com/r/askscience/com ... we_switch/

Best of luck in your studies and using CPAP,

So, the tube and mask were exactly the same brand and size, before and after?

If that's the case, I'd agree with stress.

EPR does have an on and off but also settings 1,2, or3 which are the cm H2O decrease on exhale. Here is a link to the clinical manual and on page 10 it explains how to set the EPR. https://sleep.tnet.com/home/files/resme ... -guide.pdf

Also it would be a good idea to get Sleepyhead and see what changes if any show in your data. Here is a link to help you with that. https://sleep.tnet.com/resources/sleepyhead There are several other links on this site that you should check out. The site is provided by one of our members Krelvin. If you have any questions we will try to help.

In the meantime taping where it wakes you up is a good idea and you can put the mask back on.