Newb needs help. Exhaling issues

Brad S wrote: ↑

Tue Aug 09, 2022 10:04 am

lynninnj wrote: ↑

Tue Aug 09, 2022 7:13 am

How’s it going Brad?

I hope you’re getting used to things.

Hello and thank you for asking.
I will get through this but I am having a difficult time adjusting.
I am averaging just over 2:30 per night. Last night I made it an hour and 20 before I sort of freaked out. For whatever reason, I wake up thinking I can't breathe. I was in a weird place last night I guess. On the verge of a panic attack, I have so many thoughts in my head and I just can't get them to stop some nights. I am usually able to wake up throughout the night and put my mask back on and sleep some more. I don't even realize I am taking it off while I am sleeping. This morning I woke at 5:00 and put my mask on and immediately felt overwhelmed and took it right back off. I think my brain is telling me to breathe and for whatever reason I feel like I am not getting enough air. I know that is not the case I am just having trouble adjusting. I have a oximeter and my levels are 94+ when I am using the machine. My oxygen levels were in the 70's and low 80's during my sleep study. My breathing is slightly labored breathing in and breathing out is even more noticeable. My wife loves her machine and can't understand why I am having trouble breathing.
I use the P10 mask and my doctor prescribed the N30 which is arriving today.
I am very hopeful and willing to keep on trying. I appreciate you checking on me.

How are you doing on your journey? Did you have trouble adjusting?

I LOVE LOVE my N30!

I feel very lucky that my journey is going so smoothly tho time will tell after I dive into my data after my 1m “compliance “ visit on Thursday.

That said, has someone looked at your OSCAR and settings to help you figure out if something needs tweaking? I only felt it difficult to breathe in when it was in the 15min ramp at 4cm. I turned that down to 5min so I could settle in and jump right in. I find the pressure once it goes to 8 after ramp period makes it much easier to breathe, not harder.

I hope you can find the answer.

I posted Stuart from Bleep video where he shows how he checks his mask. It’s worth looking at so you can feel sure the N30 is on. I do find subtle positioning differences can increase airflow but for the most part I find this mask dreamy.

Good luck!

Pugsy wrote: ↑

Tue Aug 09, 2022 10:10 am

[quote="
I think you are very likely in the throes of a full fledged panic attack and not necessarily on the verge.
What you are describing sure sounds like a panic attack to me.
Have you tried taping the mask to your face so that if/when you are asleep and the brain is directing mask removal that having the tape on the skin might cause you to wake up and not continued the unwanted behavior?
Have you talked to your doctor about this problem?

Hi again,
I agree about the verge of/ full fledged thing. I have struggled with it for years. It is always at night while I am sleeping and jolt awake and it's on. I usually walk up down the length of my house with my hands on my head trying to calm down, stretch and breathe.
That was one of the many reasons for the sleep study. I turned 60 last November and I am fat, about 50 pounds over weight and I am down 30 pounds since last February. I have been in construction since I was 17 and able to carry the weight without much problem. I am getting old and slowing down and everything is catching up to me. I am also type 2 diabetic. I am struggling with extreme brain fog and lack of focus. Went to the doctor 2 months ago and my cognitive abilities were horrible. At that time was also told I was severely anemic and that my red blood count was less than 2/3 of what it should be. They put me on iron and B12 and did the sleep study, prescribed me a machine and told me I would be as good as new in 6 months... And... here I am.

I don't have the full study from my doctor but I do have the email where he broke it down for me. I stopped breathing 63 times an hour and blood ox was in the high 70's low 80's. They want to do further testing but not until I can keep the mask on longer.

I have not tried taping my mask to my face yet. I have a full beard. I am more than willing to shave if necessary but I am trying not to if I don't have to. I can use my wifes F20 with no seal or leak problems. I think one of my problems is that when I wake up in that panicked state, whatever is on my face is coming off no matter how it is attached. So far though, last night was the first time since I started this on July 21st that it was full on panic. I have read others using the cervical collar and Scuncis to keep a mask on. I may have to try that, but I really think that would only make the panic worse being confined or not being able to get it off. With the exception of last night, I honestly don't remember taking the mask off. I wake up at some point and put it back on and try again. 2 and 3 times a night. It is not uncomfortable or unpleasant. I really do feel like while I am sleeping I am thinking I am not getting enough air and just unknowingly take it off and continue sleeping. I also think that last nights episode could be because I did not take it off soon enough to continue sleeping peacefully. I left it on too long and got past that point and when I did wake up, it was freak out mode.
One thing I have mentioned before, as I am lying there and feeling like I am not not getting enough air, if I just barely, and I mean just barely crack the seal on the P10 in one nostril the feeling goes away. I have done this and run the mask seal feature and the machine does not detect it and says my seal is great. I have no idea if this means anything but it works. I also very much realize this is not a solution, merely and observation. I have tried small, medium and large nasal pillows. I have tried adjusting the mask in every way possible. It works best when the head gear is as lose as possible to maintain a good seal. I have tried mashing it to my face and everything else I can think of. I can't get rid of that labored breathing feeling. I am anxious to try the N30 tonight. I can't imagine it will change that feeling but I really want to try anything to get this to work.

I have talked to my doctor about this and his response is to stick with it. It will only be 3 weeks on Thursday since I started CPAP, I am still brand new at this. To me, it seems like once I can get through this, the sleep and proper oxygen levels are going to do me a world of good. I have a follow up appointment with my doctor on the 29th.

I can't tell you how great it is that you and the others take the time to read this and maybe, just maybe one of your suggestions will be just what I need to get over this hump.
Thank you.

lynninnj wrote: ↑

Tue Aug 09, 2022 10:18 am

That said, has someone looked at your OSCAR and settings to help you figure out if something needs tweaking? I only felt it difficult to breathe in when it was in the 15min ramp at 4cm. I turned that down to 5min so I could settle in and jump right in. I find the pressure once it goes to 8 after ramp period makes it much easier to breathe, not harder.
I posted Stuart from Bleep video where he shows how he checks his mask. It’s worth looking at so you can feel sure the N30 is on. I do find subtle positioning differences can increase airflow but for the most part I find this mask dreamy.

Good luck!

Pugsy has been very patient and kind in reviewing my OSCAR info and relentless questions.
I have the ramp off and relief set to 3. Pressure is 7 to 15. The flow starts at 7 so I can get the full benefit of the pressure relief. It seems sometimes it is easier to breathe at 7 and other times at 11. I do look at my machine frequently to see where the flow is at in relation to what I am feeling. Higher is usually easier and I have noticed that it blows air through the exhaust vent of the P10 when it gets that high even though the seal is still great.
I believe my machine settings are dialed in for right now and the problem is me.
I did watch the video you shared. Lot's of good information, thanks for sharing.
Make sure to let us know your compliance appointment goes on Thursday.
I hope my N30 is dreamy too! I need some relief.

3 weeks huh? Some how I was under the impression it was a LOT longer than that. Maybe because it feels like that??

Full beard...if I knew that I have forgotten it which is easy...I am 70 now and I get to use that excuse when I want to.
It does present a challenge when the advice is "tape the straps to the skin"....not much skin available.
Shaving is always a possibility but I would hate for you to do all that and still have the same problem taking the mask off prematurely and not realizing it. People can sleep through a lot of things that are uncomfortable.

The problem is in your head....cold hard fact of life is that it is your mind screwing with you.
You are NOT suffocating...just not.
It's not caused by cpap though...you said you had that problem prior to starting cpap and it was part of the reason you had the sleep study.
Is it related to the apnea events you used to have and you were very likely gasping for air because you were indeed suffocating....it's very possible. Your brain/mind got in a habit of waking you up to save you from the apnea events and unfortunately the mind may have just developed a habit that is hard to break.

I wish you had a machine that would let you have a greater than 3 EPR or pressure support but you don't.
Since you say that when you wake up and the pressure is higher there is less chance of feeling that suffocation feeling if we had greater than 3 cm difference available you might feel more comfortable.
So lets try something that is available with your machine and that is increasing that minimum pressure just from a comfort aspect and not so much keeping the AHI low aspect.

Lets try minimum of 9 cm and max of whatever you are using. It's not coming near the max anyway so it's a moot point.
Keep EPR set to 3 full time.
See how you do with these settings for a week. The brain will perceive things as more air moving and maybe we can get the brain to settle down a bit as it learns to trust the machine better.
This is strictly a comfort experiment. You wouldn't be the first who needs a higher pressure from the comfort side and air movement side than you might need from a technical side.

Comfort is just as important or IMHO more important because if you can't sleep with the mask on or simply can't sleep then it doesn't matter what the AHI is does it? Gotta get the sleep first before any of the other stuff matters.

When/if you do wake up in a panic keep telling yourself "I am not suffocating" "I can breathe just fine"...over and over and over again until it stays sunk in the brain.

I have read others using the cervical collar and Scuncis to keep a mask on.

I don't have anything to add in the way of suggestions, but I'm pretty sure these techniques are to stop mouth opening/mouth breathing, not to keep the mask on.

lynninnj wrote: ↑

Tue Aug 09, 2022 10:18 am

I LOVE LOVE my N30!

UPS delivered mine and it is so soft and fluffy- Just finished washing it and I can't wait to try it. It feels like a little cloud of softness. Let's hope the old brain agrees tonight.

Pugsy wrote: ↑

Tue Aug 09, 2022 12:16 pm

The problem is in your head....cold hard fact of life is that it is your mind screwing with you.
You are NOT suffocating...just not.

I completely understand this and believe it 100%. Now tell my brain that at 2:30 AM when fight or flight is raging.

Pugsy wrote: ↑

Tue Aug 09, 2022 12:16 pm

Lets try minimum of 9 cm and max of whatever you are using.
Keep EPR set to 3 full time.

Done. Set to 9-15 EPR remains at 3

Pugsy wrote: ↑

Tue Aug 09, 2022 12:16 pm

See how you do with these settings for a week. The brain will perceive things as more air moving and maybe we can get the brain to settle down a bit as it learns to trust the machine better.
When/if you do wake up in a panic keep telling yourself "I am not suffocating" "I can breathe just fine"...over and over and over again until it stays sunk in the brain.

This is the hard part. Once I am aware and at that point, my brain is long gone down a dark, deserted road and won't come back.
I fully understand and I will tell myself that repeatedly to see if I can get it back. I know I am not suffocating, I can still breathe. That's the weird part for sure. I have woken up plenty gasping and at a total loss of air from the panic. It is the same mental feeling but physically, it is nothing like that.
I hope to report back in the morning after a great nights sleep.
Thanks for the suggestions.

Brad S wrote: ↑

Tue Aug 09, 2022 3:12 pm

Pugsy wrote: ↑

Tue Aug 09, 2022 12:16 pm

The problem is in your head....cold hard fact of life is that it is your mind screwing with you.
You are NOT suffocating...just not.

I completely understand this and believe it 100%. Now tell my brain that at 2:30 AM when fight or flight is raging.

Pugsy wrote: ↑

Tue Aug 09, 2022 12:16 pm

Lets try minimum of 9 cm and max of whatever you are using.
Keep EPR set to 3 full time.

Done. Set to 9-15 EPR remains at 3

Pugsy wrote: ↑

Tue Aug 09, 2022 12:16 pm

See how you do with these settings for a week. The brain will perceive things as more air moving and maybe we can get the brain to settle down a bit as it learns to trust the machine better.
When/if you do wake up in a panic keep telling yourself "I am not suffocating" "I can breathe just fine"...over and over and over again until it stays sunk in the brain.

This is the hard part. Once I am aware and at that point, my brain is long gone down a dark, deserted road and won't come back.
I fully understand and I will tell myself that repeatedly to see if I can get it back. I know I am not suffocating, I can still breathe. That's the weird part for sure. I have woken up plenty gasping and at a total loss of air from the panic. It is the same mental feeling but physically, it is nothing like that.
I hope to report back in the morning after a great nights sleep.
Thanks for the suggestions.

Oh I sooooo hope you and your puffy little cloud sleep well tonight!

I know it comes with adjustable strap but be aware that if strap is too tight it can feel a bit tight qnd uncomfy under the nose until the elastic stretches out a bit.

Good luck!

lynninnj wrote: ↑

Tue Aug 09, 2022 6:22 pm

Oh I sooooo hope you and your puffy little cloud sleep well tonight!

I slept so well, as a matter of fact I forgot to put it on!
I was so exhausted when I went to bed last night, I was asleep as soon as I laid down. I remember as I laid down to put my mask on. Next thing I know it is 5:30 in the morning.
I am bummed but I will make sure tonight.

Brad S wrote: ↑

Wed Aug 10, 2022 10:36 am

lynninnj wrote: ↑

Tue Aug 09, 2022 6:22 pm

Oh I sooooo hope you and your puffy little cloud sleep well tonight!

I slept so well, as a matter of fact I forgot to put it on!
I was so exhausted when I went to bed last night, I was asleep as soon as I laid down. I remember as I laid down to put my mask on. Next thing I know it is 5:30 in the morning.
I am bummed but I will make sure tonight.

LOL

Come on Brad!



I was so looking forward to hearing about a good nights sleep on your new mask.

Maybe tomorrow.

Brad S wrote: ↑

Wed Aug 10, 2022 10:36 am

I slept so well, as a matter of fact I forgot to put it on!
I was so exhausted when I went to bed last night, I was asleep as soon as I laid down. I remember as I laid down to put my mask on. Next thing I know it is 5:30 in the morning.

Even to this day after 13 years on cpap I ALWAYS put the mask on prior to laying down in bed.
Habit I got into many years ago.

Do NOT trust that little devil on your shoulder whispering "it's okay, you can put the mask on after you lay down".

He lies.

Pugsy wrote: ↑

Wed Aug 10, 2022 10:44 am

Brad S wrote: ↑

Wed Aug 10, 2022 10:36 am

I slept so well, as a matter of fact I forgot to put it on!
I was so exhausted when I went to bed last night, I was asleep as soon as I laid down. I remember as I laid down to put my mask on. Next thing I know it is 5:30 in the morning.

Even to this day after 13 years on cpap I ALWAYS put the mask on prior to laying down in bed.
Habit I got into many years ago.

Do NOT trust that little devil on your shoulder whispering "it's okay, you can put the mask on after you lay down".

He lies.

Sometimes I’m not sure I turned the machine on. So I open my mouth. If I get the slightly painful feeling of all the air gushing out, I know I have the CPAP turned on.

lynninnj wrote: ↑

Thu Aug 11, 2022 11:57 am

Sometimes I’m not sure I turned the machine on. So I open my mouth. If I get the slightly painful feeling of all the air gushing out, I know I have the CPAP turned on.

LOLOL!
Not being sure if the machine is on has not happened to me yet. I put the mask on and I KNOW for 100% certain that there is nothing coming out and watch the auto-start display for the numbers to start climbing.
I have played around with trying to talk to my wife while we are laying in bed. It doesn't work so well when your lips and head is vacuum sealed. I pull my bottom lip open and shut really fast and make weird noises.
I may be old, but I refuse to grow up!

Did you have your 1 month compliance visit today? How did it go?

Brad S wrote: ↑

Thu Aug 11, 2022 2:27 pm

lynninnj wrote: ↑

Thu Aug 11, 2022 11:57 am

Sometimes I’m not sure I turned the machine on. So I open my mouth. If I get the slightly painful feeling of all the air gushing out, I know I have the CPAP turned on.

LOLOL!
Not being sure if the machine is on has not happened to me yet. I put the mask on and I KNOW for 100% certain that there is nothing coming out and watch the auto-start display for the numbers to start climbing.
I have played around with trying to talk to my wife while we are laying in bed. It doesn't work so well when your lips and head is vacuum sealed. I pull my bottom lip open and shut really fast and make weird noises.
I may be old, but I refuse to grow up!

Did you have your 1 month compliance visit today? How did it go?

lol goofball thanks for asking

Was good visit. back in 2 months. I didn’t have an sd card in all this time. not sure why i thought there was. maybe because she said this is where the sd card goes in. what she clicked in was the placeholder apparently.

I don’t know why you wouldn’t know right away you had air coming through. Even at 4 cm it’s very obvious to me that the machine is on. And that’s during the ramping up period.

So how did you sleep last night with your new N30 cushion?

lynninnj wrote: ↑

Thu Aug 11, 2022 3:57 pm

So how did you sleep last night with your new N30 cushion?

More of the same last night. I love the feeling of it. It is similar to the feel of the P10 but way softer and fluffier
3 sleep sessions, approximately 1 hour each. The first two were actual sleep and woke up felling it difficult to breathe. The third was more of I'm awake and I am going to figure this out. Tried on my sides, on my back. Half on my back and half on my side. Dozed off and on and each time I woke up I felt the same. As I decided I had enough for the night in a state of frustration, I laid on my back and tilted my head farther back than normal and all of a sudden, I could breathe effortlessly. I was only partially awake and angry I was so tired, I took my pillow and went to the recliner in the living room and passed out for 45 minutes before my alarm went off.
I may have figured it out at least partially. I am anxious to try again tonight.
I will post more tomorrow. Thank you for asking.