First night was awful

so tonight I sit here getting less sleep than ever. I just picked up my CPAP today . I also recently stopped taking a very low dose of Cymbalta tat was really for my obsessing over issues in my marriage and subsequesn divorce.
Anyway I hate the pressure of the air blowing I to my face it set me into a panic attack. I have never had panic attacks even before I had gone on medication.
I also wear a mouth guard so I do not grind my veneers off. I took off the guard while wearing the mask because I ended up mostly mouth breathing and was afraid it would fall off and I would swallow or choke on it.

When the air flow ramped up from 4 to 5 it completely freaked me out and I had to tear the thing off my face. I then realized I had swallowed enough air to blech out the entire song all 7 minutes of Stairway to Heaven.

I am not happy with the swallowing air and the feeling I am getting . It’s not the mask it’s the airflow.

Now I am up writing for support and not sleeping at all!

Welcome to the forum.

I am sorry you had a bad first night.

First thing I would suggest is wear the mask and machine on while awake and under no pressure to fall asleep...like watching TV or reading a book.

Second thing...go here and request the provider manual for your machine...it has some useful information in it that isn't included in the user manual plus it tells you how to get to the clinical setup menu area to make any changes you want to make and you need to do that to implement one change I will recommend.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

Third thing...make use of the Flex exhale option and you can't right at the setting of 4 or 5 (the machine can't go lower than 4 and despite you feeling that air flow at 5 was excessive...babies get put on cpap with more pressure than that).
Flex doesn't engage until the pressure is at 6....so you never really got a chance to experience exhale relief.
Set the minimum pressure to 6 and don't use the ramp button.
Set Flex to 2 or 3 (try both to see what feels the best)

Fourth thing....quit worrying about the air flow until you actually get the mask sealed and things pressurized.
Yes, it feels like hurricane winds when we turn the machine on and don't have it sealed good against the face. That massive air flow will diminish if the mask is sealed against the face....until it gets a seal so that the pressure can actually be sustained it's going to blow like a hurricane. That's not what you get all night once the mask is sealed.

No worries! It can get better. I was probably lucky in that I dived right in and made it work without too much trouble.

One thing I am glad I done immediately was to try a couple different masks. I was told I needed a full face mask by the provider.

That simply was not so. I find the nasal pillows are so much less obtrusive feeling. You don't feel the air blowing on your face! There are things you can do to help the swallowing of air. I found no problem trying to breathe through my mouth or it coming open. You would just have to try the nasal versions to see how they work for YOU!

sorry to hear that your first night was terrible. I remember walking into the sleep clinic to pick up my equipment and the clinician had a pile of things on her desk ready to try them on me. I didn't know what to expect and why she had as much gear as she did. Definitely make sure that you have a good comfortable mask that fits your facial profile and breathing needs well. If your clinic allows it you should consider getting a full face has and a nasal one so you can try and see which one you prefer.

As Pugsy has suggested I would say that your minimum pressure really should be bumped up something where you won't be suffocating from lack of air flow. 5 was the absolutely minimum I could tolerate and just after a few weeks my start pressure is 11. The air blowing on your face is a result of the mask not sealing on your face. When your mask has a good seal on it that the blowing sensation is almost non existent b/c your airway is now pressurized.

Some tips that I found helped me tremendously in the first few days.

1. Wear the mask with being attached to the unit so you get used to it being strapped to your face. Wear it for a short period of time while you're watching TV or reading a book. I wore mine while I was working on my computer.
2. Ask your clinician (or download the clinician manual for your machine) to up the minimum pressure to level where you can make use of the EPR functionality (exhaust pressure relief). My machine for example has a EPR relief set to 3 which means if my inhale pressure is 11 then the exhaust pressure is 8. This seems to make things more comfortable but on most machines EPR doesn't even kick in unless the inhale pressure is set to at least 6 or greater.
3. Attitude, attitude, attitude! I admitted felt very self conscious around my spouse and kids wearing a full fledged face mask around the house and especially in bed. Reminded me of ER patients that were put on a ventilator and I didn't want to look like that but I had to constantly remind myself that it ain't no beauty content and that by wearing a CPAP machine will ensure that I have the energy to keep up with my family. It's been almost exactly a month since I started treatment and I LOOK FORWARD to masking up every night b/c I know my treatment is working and the CPAP mask is just part of the bedtime routine. I dreaded sleeping with a full face mask b/c I am a combination sleeper and the first few weeks I couldn't sleep on my side without air leaks but now I can sleep in nearly any position and my mask has a night snug leak free fit and I don't even notice it on me anymore. It just takes time and YOUR drive to improve your own health.
Look at my avatar... imagine that AND a bunch of mask strap cushions + an anti leak strap wrapped tightly around my head. I look like something out of a weird bondage scene but it doesn't bother me one bit and it is VERY comfortable.
4. When you do hook yourself up to your machine just lie back and relax. Breathe normally and just try to relax. When I am wide awake and masked up that I lie in bed and I take a bunch of deep breaths and imagine myself inhaling sleeping gas (yeah I'm weird that way) and as I slow my breathing down that I fall asleep and have the best sleeps of my life.
5. If you have to take a break in the middle of the night then do so and just aim the next day to try wear it a little longer. I admittedly was fortunate enough to be near 100% compliant since day 1 but there were some nights where I woke up and the mask was clearly removed and placed on my end table. No biggie - I didn't beat myself up over it and I certainly wasn't discouraged from it.
6. Mask liners helped IMMENSELY. Silicone while very soft and pliable left a layer of sweat and oil between the seal and my face which resulted in a somewhat gross feeling + it caused leaks. I bought some inexpensive liners that I wash and reuse and my face surface is always dry and comfortable.
7. Talk things through with your significant other or with other CPAP users or even your clinician on the challenges you have. My paranoia about my looks in bed were quickly quelled when my spouse says "glad you started CPAP treatment b/c you're not longer a moody beeyatch". CPAP is like wearing glasses... you wear it when you need it and it just part of life.

I really hope your 2nd day goes much better. I think I can speak for the majority of folks here that we're all here for a common reason and to provide guidance and support to each other. We've all been at your stage at one point or another and with enough perseverance you'll manage to pull through like most of here have.

Good luck,

Fellow newbie here. 3 months in, but I remember the first nights pretty well.

I'll reinforce a couple things others have said above. Getting the mask sealed is the foundation for everything working right. For me, this made ALL the difference in the world. If the mask leaks the machine increases the flow rate in response, trying to keep the pressure up. This creates the feeling of "all that air".

"Breathe normally" - this is what I kept thinking to myself. But it isn't something we keep track of - we don't even know what normal is. For me, I realized that when I breathe "normally" I use my diaphragm(<-- thank you spell check!), and I wasn't doing that when I was using the machine. This helped immensely.

Regarding the feeling that 4cm is too much, I was very lucky to see this post during the time I was feeling that way about my 5cm min pressure. Truth is, 5cm wasn't nearly enough as time went by.

palerider wrote: ↑

Tue Jun 19, 2018 4:11 pm

You've managed to psych yourself out. There's very little air blowing when the mask is on your face. Sure, when you take the mask off, the machine revs up to full speed trying to build pressure... but when you put the mask on, it slows WAY down, to a super gentle low pressure. 4cm is what you get by sticking a straw 4 centimeters (1.5 inches) into water. if you can do that, and blow bubbles, you can overcome 'all that blowing air'. Even at a pressure of 20, it's not enough to blow up a balloon.

My recommendation is to focus on the mask leaks first. I'm not familiar with your machine, but I'd bet that it has a "leak test" mode like mine does. If so, use it. And a tip: if your machine does have a mask leak test, run it for a minute or so right before you start your therapy for the night. After the pressure of the leak test, you won't even be able to tell the machine is running at 4cm.

Stick with it. And good luck!

djams wrote: ↑

Fri Aug 03, 2018 3:59 pm

My recommendation is to focus on the mask leaks first. I'm not familiar with your machine, but I'd bet that it has a "leak test" mode like mine does. If so, use it. And a tip: if your machine does have a mask leak test, run it for a minute or so right before you start your therapy for the night. After the pressure of the leak test, you won't even be able to tell the machine is running at 4cm.

Stick with it. And good luck!

Very good tip, whenever I had to make major adjustments to my strap (due to removal for cleaning) that I would put everything back on and run it on full power (mask leak test mode) and then seal everything up properly and then run the machine normally. Rarely get ANY leaks after leak testing it that way.

I sympathize! August 2007, first 4 nights were from hell. I only sleep during my 45 minute ramp. When my CPAP pressure was reached, bam wide awake. I would get up, reset machine, back to sleep for 45 mins. What a PITA! Night 5 wow, brain finally convinced I was not going to suffocate so it let me sleep...9 hours of restful sleep. Continued at 9 hrs for several weeks then settled at just over 8 which is still preferred amt of sleep. Just gotta figure out what the issue is and then a resolution, one thing at a time.

PS You might like my mask, pillows and covers mouth. Click on it in my signature to see it.