Gasping for air when starting to fall asleep with CPAP:

Hi, I have been trying to use a CPAP machine for about 2 months but every time I begin to fall asleep I begin gasping for air. After that happens a couple of times each night I panic and remove the device. So basically 2 months into this I have not met the compliance requirements and I only have one more month before the insurance stops paying for it. I do not believe it is a comfort issue. Wearing the mask doesn’t really bother me. I’m wearing a Philips dreamwear nasal pillow mask and I’m using a Resmed Airsense10 Autoset machine. My doctor recently increased my air pressure in hopes that this would help but it has not. The ramp is on for 45 minutes but I am considering turning that off because I think I need the air. I do suffer from anxiety and I do take Seroquel for sleep. My doctor does not believe the sleep medication is a problem, he told me to keep taking it. Does anyone know what could be causing this and how to prevent it? I’ve started wearing the mask sometimes during the day as the doctor suggested but as of now no luck. Any help is greatly appreciated! Thank You!

ag1996 wrote: ↑

Fri Feb 21, 2020 4:35 pm

he ramp is on for 45 minutes but I am considering turning that off because I think I need the air.

Turn it off and see what happens. Shouldn't be a problem.

ag1996 wrote: ↑

Fri Feb 21, 2020 4:35 pm

My doctor recently increased my air pressure in hopes that this would help but it has not.

What are your minimum and maximum pressure settings?

Use the machine while watching TV or reading. No one cares if you are really asleep or not when it comes to compliance usage requirements. This will at least satisfy those requirements while you are sorting out the other issues.
Has to be a minimum of 4 hours total within a 24 period. Doesn't have to be consecutive hours either. Just as long as they add up to over 4 hours...and make it at least 4 hrs and 15 minutes each 24 hour period.

Get OSCAR
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

I know it won't have much data to look at but I want to see what the machine is recording (if it is recording anything) when you first fall asleep.
Turn the ramp off...needs to be off because it won't record anything that does happen during the ramp time and we need to see if it records anything.
Plus you might like it going to full pressure anyway. A lot of people feel like they are suffocating using the low pressures of ramp.
Using it during the day while awake will help you get used to full pressure anyway.

Do you know how to turn ramp off? It has to be done in the clinical set up menu are.
Explained in the manual if you don't know how to get to the setup menu area.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

Read this for how to post images as I won't need or want all the graphs you will see
viewtopic/t158560/How-to-post-images-for-review.html

Definitely turn off the ramp. Most of us feel like we are suffocating at only 4 cm of pressure which is where the ramp is likely starting. We aren't, but it feels that way!

It would help if you would please fill in your equipment. For example, the hints for a full face (FF) mask are a little different than the hints for a nasal mask or nasal pillow mask. It would also help to know your pressure settings, and what kind of machine you have. It may be helpful to review your data, but we need to know what machine so we can tell you how to access that data.

There are two other possibilities to explore:
1) Anxiety/claustrophobia. This was a big issue for me at first. I had to use some techniques to relax and be able to keep the mask on. One trick is that when you feel like you are gasping for air, try to breathe slowly and count to 10 slowly before ripping the mask off. It's hard, but do your best. If you still feel like ripping it off after counting to 10, can you count to 10 again (maybe, maybe not). I found after a few days I didn't need to rip the mask off again but it still took me a week or so of consciously relaxing my breathing to be able to keep the mask on all night. You might practice wearing the mask while doing some quiet activity while you are wide awake (read, watch tv, listen to music) so you can learn to relax in the mask when you are awake and have full control.

2) Some people experience apnea right at the moment they fall asleep (me!). A higher starting pressure may be helpful, but you'd want to see your data to saw if that's the case.

ag1996 wrote: ↑

Fri Feb 21, 2020 4:35 pm

I do take Seroquel for sleep.

I need to read up on this medication...so remind me if I forget but I need to see what the machine is recording at the same time.
It's possible that you are experiencing what we call a sleep onset central apnea that is freaking your brain out causing the panic.
I need to read up to see if that med is known to maybe cause that sort of thing to happen.
It's not common but I can't possibly remember all the side effects and interactions with these meds.

Do you take any other meds? If so, what?

Thanks everyone! I will definitely turn the ramp off, sounds like my best option here. Someone asked what machine I have: It’s a Resmed Airsense 10 Autoset machine. I use a philips dreamwear nasal pillow mask(it’s clear with hollow tubing). Pugsy: I also take daily lithium 600mg X 3, risperdal 4mg X 2, gabapentin 600mg X 3, propranolol 20mg X 3, remeron 30mg X 1, pravastatin 20mg X 1 & amlodopine benzapril 5 - 10mg X. I also take vitamin D2(Ergo) 50,000 IU capsule 1 per week. Hope this helps! Thanks again.

When you have time you can edit your profile and show quick links to your equipment...see how I have mine right below this post.
The AirSense 10 Autoset...it's down in the R's...not in the A's with the rest of the AirSense machines. Somehow it got ResMed stuck in the first part of the name and it's down in the Rs.
Please use the text option. Icony make for small tiny images that are hard to make out what people are using.

I will check out the meds later. Short on time right now.

ag1996 wrote: ↑

Fri Feb 21, 2020 5:34 pm

It’s a Resmed Airsense 10 Autoset machine. I use a philips dreamwear nasal pillow mask(it’s clear with hollow tubing).

welcome to the zoo!

when you get a moment, will you fill in your equipment in your profile? that way it will show up at the bottom of each of your posts, as mine does below.

thanks!

I have added my equipment to my profile as suggested, thank you! Well here goes another shot at the title, it’s almost 10 pm here and it’s another try at the PAP! Wish me luck...

ag1996 wrote: ↑

Fri Feb 21, 2020 8:44 pm

I have added my equipment to my profile as suggested, thank you! Well here goes another shot at the title, it’s almost 10 pm here and it’s another try at the PAP! Wish me luck...

Luck wished.

JPB

ag1996 wrote: ↑

Fri Feb 21, 2020 5:34 pm

I also take daily lithium 600mg X 3, risperdal 4mg X 2, gabapentin 600mg X 3, propranolol 20mg X 3, remeron 30mg X 1, pravastatin 20mg X 1 & amlodopine benzapril 5 - 10mg X.

That's quite a cocktail of powerful drugs. Do you have one doctor who is coordinating the use and dosage of all those drugs? There are cases where multiple specialists prescribed drugs, and no one was paying attention to the total load and mix of what was being taken.

Sorry to be so frank, but it looks like doctors have just been "throwing drugs at the wall and hoping some of them stick".

Oh man....quite a combination of meds...the seroquel is under investigation for possibly making sleep apnea worse. In fact all the “atypical” antipsychotics are thought to maybe make sleep apnea worse...like the lithium and risperdal.
The combination of all those meds points to some sort of mental health issue that I am not going to touch. That's between you and your doctor.

What I want to see is the flow rate when you are in the process of falling asleep to look for evidence of some sort of apnea actually happening or not. I want to see if your gasping for air is a physical reaction or maybe anxiety reaction.

Thanks for all of the feedback! Another night, another failure I guess I must just keep trying plus wear it some during the day. Pugsy: if lithium can make sleep apnea worse than I am doomed. It is the only medicine that has ever done the trick since 1989 when I was first diagnosed with bipolar disorder with psychosis. I’ve tried Latuda & Lamictal and both put me into a state of mania and then of course the hospital. At this point there isn’t much I can do but to keep trying. However, I’m quickly running out of time. I’ve got a little less than 1 month before the insurance cuts me off for non compliance. I’m pretty tech savvy so with proper instructions I could probably get this machine data your talking about.

EVERYONE: thanks for your help!

ag1996 wrote: ↑

Fri Feb 21, 2020 8:44 pm

I have added my equipment to my profile as suggested, thank you! Well here goes another shot at the title, it’s almost 10 pm here and it’s another try at the PAP! Wish me luck...

i was playing the theme song from "Rockie" in my head when you said that!

sorry it didn't work as planned. keep at it and get those compliance hours in.

The jury is still out on those meds making apnea worse and even if they are guilty as charged there are ways to deal with the increased apneas. If it's plain ordinary OSA...just need optimal pressure tweaking. Not a big deal real...just something to be aware of.
We have people who have their OSA worsen when on their backs and they can't stay off their back so we deal with it with some pressure tweaking.
We have people whose OSA is much worse in REM stage sleep (I fall into that category myself) and we deal with it with some pressure tweaking because we have zero control over REM.

We can deal with potential complications...just as long as we know what we are fighting.