Intro and question

Hello everyone! I've been reading posts for a few weeks trying to learn as much as possible. Now that I have my new Resmed Autosense 10 in hand and several nights to try it out I have a question. I have been acclimating to APAP during the day to get used to it but I find that after I start falling asleep I wake up in a panic because I'm gasping for air. This has kept me from falling asleep at all and feels a little discouraging. I really want to make this work and will continue trying but its been 4 nights and no luck at all falling completely asleep with it on. My question being is this normal?
What can I do to finally fall asleep with this thing.

copenhagen269 wrote:Hello everyone! I've been reading posts for a few weeks trying to learn as much as possible. Now that I have my new Resmed Autosense 10 in hand and several nights to try it out I have a question. I have been acclimating to APAP during the day to get used to it but I find that after I start falling asleep I wake up in a panic because I'm gasping for air. This has kept me from falling asleep at all and feels a little discouraging. I really want to make this work and will continue trying but its been 4 nights and no luck at all falling completely asleep with it on. My question being is this normal?
What can I do to finally fall asleep with this thing.

Sounds like your (minimum) pressure setting is too low and/or your Ramp settings are too low and too long.
Please post or add your settings to your profile so we'll be able to make suggestions.


Den

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copenhagen269 wrote:Hello everyone! I've been reading posts for a few weeks trying to learn as much as possible. Now that I have my new Resmed Autosense 10 in hand and several nights to try it out I have a question. I have been acclimating to APAP during the day to get used to it but I find that after I start falling asleep I wake up in a panic because I'm gasping for air. This has kept me from falling asleep at all and feels a little discouraging. I really want to make this work and will continue trying but its been 4 nights and no luck at all falling completely asleep with it on. My question being is this normal?
What can I do to finally fall asleep with this thing.

I'm assuming you mean the Airsense 10 Autoset.

if your doctor foolishly left the machine set at factory defaults, you may need higher pressure to feel you're getting enough air.

get yourself a clinical manual and check the settings.

The Dr. set it on 5-15 EPR is set at 2. I have ramp turned off.

copenhagen269 wrote:The Dr. set it on 5-15 EPR is set at 2. I have ramp turned off.

5 is way to low to start with NO wonder you are waking up in a panic. Bump the minimum pressure to 8.

Bill44133 wrote:

copenhagen269 wrote:The Dr. set it on 5-15 EPR is set at 2. I have ramp turned off.

5 is way to low to start with NO wonder you are waking up in a panic. Bump the minimum pressure to 8.

with an epr of 2, 8 might be worth a try. or it might be more than is necessary.

Thank you for the information on your settings and filling in your profile.

Next bit of advice........
Get Sleepyhead software and take control of your own therapy.
It will give you lots of information on your therapy.

Yes, I agree, your minimum pressure could be waaaay too low.


Den

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I will bump up the minimum pressure tonight a bit as well and take advantage of the sleepy head software once I get some sleep. Thank you everyone for the advice, it is greatly appreciated!
I will report back tomorrow with the results.

Update... I have tried bumping the pressure up from 5 to 7 and still cannot fall asleep. I start dosing off and wake up moments later gasping for air. I am not sure where to go from here but I am motivated to try and try again. I just visited my general practitioner who prescribed me a low does sleeping aid to help (my request). Am I on the wrong pressure? Wrong therapy? or is this common?

copenhagen269 wrote:Update... I have tried bumping the pressure up from 5 to 7 and still cannot fall asleep. I start dosing off and wake up moments later gasping for air. I am not sure where to go from here but I am motivated to try and try again. I just visited my general practitioner who prescribed me a low does sleeping aid to help (my request). Am I on the wrong pressure? Wrong therapy? or is this common?

Personally, I would feel starved for air at anything under 10 cm.
But, anytime I've bumped up my pressure (not that often), it took me a couple of nights to get used to it.

Are you using software to monitor your therapy? If not, get the Sleepyhead software.

Try using your machine while you're sitting in the living room watching TV or reading or something like that.


Den

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I feel choked in the opposite way. As soon as the pressure comes up it feels like it's shutting down my throat. I have to hit ramp over and over all night long to keep it at 4. Sometimes I can stand the 7, but, when it ramps to 10 I choke, badly. Once you look at sleepyhead you can see where it seems to be best. I know mine is going way too high, I just haven't seen how to fix it yet :/ hope you get it resolved!

What has your 95 percentile pressure been?

Sheriff

FairwayGirl wrote:I feel choked in the opposite way. As soon as the pressure comes up it feels like it's shutting down my throat. I have to hit ramp over and over all night long to keep it at 4. Sometimes I can stand the 7, but, when it ramps to 10 I choke, badly. Once you look at sleepyhead you can see where it seems to be best. I know mine is going way too high, I just haven't seen how to fix it yet :/ hope you get it resolved!

Well, lower your maximum or go to a fixed pressure till you get used to it.
Having to hit the Ramp over and over to drop the setting is no way to sleep.


Den

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FairwayGirl wrote:I feel choked in the opposite way. As soon as the pressure comes up it feels like it's shutting down my throat. I have to hit ramp over and over all night long to keep it at 4. Sometimes I can stand the 7, but, when it ramps to 10 I choke, badly. Once you look at sleepyhead you can see where it seems to be best. I know mine is going way too high, I just haven't seen how to fix it yet :/ hope you get it resolved!

FairwayGirl,

I too have serious problems with feeling like I'm being smothered when there's too much air coming through the mask. And too much air also triggers aerophagia (air in the stomach) in me, even after 5 years of PAPing.

Unfortunately your current "solution" of hitting the ramp all night long may be leaving you unprotected from the OSA: A certain amount of pressure is needed to splint your airway open and if the pressure is not high enough, you can still have a lot of apneas and hypopneas occurring.

You say that you "know" your machine is going way too high. Can you post some screen shots of your daily data? I'd like to see the following graphs:

• The event table
• The flow rate
• The pressure graph
• The leak graph.

Looking at the graphs will help us determine whether your machine really is ramping up the pressure farther than you strictly need it to ramp up. It will also help us help you determine why your machine is increasing the pressure to the point where you cannot tolerate it because the excessive amount of air triggers the choking.

Finally, if this has been going on for a very long time (as in several months), you really should report the problem to your sleep doctor: S/he may be willing to recommend a switch from APAP to a bi-level machine. In my case, I wound up being switched from APAP to BiPAP Auto because I just could not handle the pressure when it was above 8cm on APAP. Because of the subtle differences between BiPAP Auto and APAP with EPR, I am able to tolerate the my BiPAP when the BiPAP Auto algorithm increases the IPAP to the max IPAP setting.

I would like to post a screen shot I took in Sleepyhead, how do I do this?