Using machine but still wake up gasping

Im a 34 year old male. I have a deviated septum and Im about 6'4 310lbs. I use to be 370lbs. I changed my diet and started losing weight before I even got tested. The weight is falling off and this has helped a bit but I was still waking up gasping and anxiety and irritability.
I got tested 3 times for sleep apnea. My AHI ratings were 52 and 57 with the first place I went to but they were hard to deal with so I switched to a more professional company and they had a 10 hour window where they said my rating was 62. Both were home tests.

I got a DreamStation Auto Cpap DSX500T11. I used a Philips Respironics Dreamwear Nasal Mask at first which was extremely comfortable but I kept waking up gasping for air with air coming out of my mouth as well. I figured out I was a mouth breather as well and the apnea place gave me a Resmed Airfit F20. Ive been using the full mask for about 5 days and total have used the machine about 3 weeks.

I use automatic mode with a pressure setting of 9 to 12, and will ramp down to 7. My AHI was recorded at 4.8 by the professionals over a few weeks and my Dreamapper app is saying last night I was at 4.1

I still wake up fully with panic and anxiety 3 times a night with heart racing. Sometimes Im gasping for breath and pawing at my mask. I always have to urinate, and sometimes a really jolting event will keep me up for an hour before going to sleep. I can feel myself coming out of dreams and then realize I need air and my heart is racing and there's strong anxiety.

Im not on any drugs or medication. I also have begun to drink more water as I wake up with dry mouth. Despite this the humidifier is never empty in the morning for some reason, even though I switched to a full face mask which I would assume would use more water. It feels like maybe its not working but I turned it on and felt heat coming off of it.

Im exhausted and irritable during the day. I have headaches and Anxiety and anger are always lurking just beneath surface. I have trouble thinking since I stopped napping. I don't nap since getting the machine and I go to bed at the same time everynight. Ive even started eating earlier so my body has time to relax before bed.

Just wondering if anybody had any experience with this. Should I try to be patient, as hard as it is, with this? Or is there something I can do NOW to help improve my situation?
Thanks for reading.

EDIT: AHI dropped the next night as the chart below shows.

An AHI of 4-5 is a lot better than 60 but it's still bad. Once you post some charts we can see where the bulk of your AHI is coming from and hopefully help you from there.

BCman wrote: ↑

Mon Nov 26, 2018 6:21 pm

Should I try to be patient

No. Use Sleepyhead software and post some charts in this thread. Instructions are in a thread near the top of the index page.

Hopefully I did this right.
AHI seems to have dropped once again. Still waking up fighting off the mask. Still exhausted. Still panic attacks.

BCman wrote: ↑

Tue Nov 27, 2018 5:30 pm

Hopefully I did this right.
AHI seems to have dropped once again. Still waking up fighting off the mask. Still exhausted. Still panic attacks.

You have an autoset machine, I would use it and set min pressure to 9 and max pressure at 15. If you insist on staying at fixed pressure raise it to 11

I was confused at first by your post because my specialist told me the machine was set to AUTO and that it had a ramp of 7 for 30 minutes then moved to 9 where auto could go as high as 12. But then I read the readings and it says Fixed 9.

That's not correct though. When I press Ramp it goes to 7 just like the specialist said.

Can they change the settings via BlueTooth somehow? Because no one else has touched my machine.

BCman wrote: ↑

Tue Nov 27, 2018 9:45 pm

I was confused at first by your post because my specialist told me the machine was set to AUTO and that it had a ramp of 7 for 30 minutes then moved to 9 where auto could go as high as 12. But then I read the readings and it says Fixed 9.

That's not correct though. When I press Ramp it goes to 7 just like the specialist said.

Can they change the settings via BlueTooth somehow? Because no one else has touched my machine.

Even if they could change the settings via Bluetooth, Bluetooth has a very limited range, measured in meters.

Cellular, on the other hand, not so limited. If you don't have it in airplane mode, yes, things can be changed in at least some machines (not sure about all) if they have cellular connectivity.

My guess is that they were trying to describe what they intended rather than what they did. They describe a 30 minute ramp starting at 7. Then an auto range of 9-12. Except yours is set to "cpap" of 9 rather than an "auto" of 9-12. Or perhaps they meant a setting of 12 with a flex of 3....

I personally find a 30 minute ramp way too long (for me)

For me. Dry Mouth can be leaks or GERD (stomach acid can make the mouth seem dry.)

Waking up gasping, when you take the mask off, sounds like Aerophagia. Air gets pumped into the stomach with the extra pressure of the machine. The air in the stomach presses on the lungs and heart. I would ask you if when you get up, and walk around, if you belch air, the the gasping, sense of feeling short on air goes away. So it is like the first thing to make one feel right in the morning is to walk around a bit, even before coffee. Although one might not have enough space in the bedroom.

This is where I say that it is a shame that xPAP manufacturers do not supply bi-level machines as minimal machines, rather than an extra dollar cost to buy a bi-level over a standard APAP. For the OP, one might get rid of Aerophagia with a properly set Bi-Level machine. But I do understand that not everyone has insurance to pay for overnite sleep lab studies, and not all Sleep labs/docs do a proper job of diagnosing patients.

Where are you Pale Rider to tell me how what I said is wrong, and/or how to say it better.


For the OP, trust Pugsy over anything I say.

Woke up around 1 badly and couldn't get back to sleep. I noticed my snore got pretty high(2nd chart) before waking so maybe thats what made me choke
Number is down again but extreme dry mouth still pervades. I wonder if thats affecting my snore. I don't even fill my humifidier the full tank and there's still a lot left over in the morning. Im wondering if its not heating properly.
Terrible headache, irritable, and exhausted today. I know this can take time, Im not complaining Im just describing symptoms.

purple22 wrote: ↑

Wed Nov 28, 2018 6:18 am

For me. Dry Mouth can be leaks or GERD (stomach acid can make the mouth seem dry.)

Waking up gasping, when you take the mask off, sounds like Aerophagia. Air gets pumped into the stomach with the extra pressure of the machine. The air in the stomach presses on the lungs and heart. I would ask you if when you get up, and walk around, if you belch air, the the gasping, sense of feeling short on air goes away. So it is like the first thing to make one feel right in the morning is to walk around a bit, even before coffee. Although one might not have enough space in the bedroom.

This is where I say that it is a shame that xPAP manufacturers do not supply bi-level machines as minimal machines, rather than an extra dollar cost to buy a bi-level over a standard APAP. For the OP, one might get rid of Aerophagia with a properly set Bi-Level machine. But I do understand that not everyone has insurance to pay for overnite sleep lab studies, and not all Sleep labs/docs do a proper job of diagnosing patients.

Where are you Pale Rider to tell me how what I said is wrong, and/or how to say it better.


For the OP, trust Pugsy over anything I say.

Well, what you said is a reasonable theory, it may not be right, but it's possible, and worth exploring.

Its from lack of oxygen from not breathing, not swallowing air or whatever. Great suggestion and I examined it like everything stated on this board but unfortunately incorrect. Thanks though!

I'd up the min pressure to 10.

Your humidifier was likely still fullish because the ambient humidity, room/local climate was humid = not hot or steamy, but defiitely less than 'dry' and the humidifier will not use water unless it needs to.

As my sleep doc said when I visited him. The higher pressure of a bi-level machine allows your lungs to inflate more fully.

This is an example when an overnight sleep study in a competent sleep lab might solve the problem more directly.