Apparently hyperventilating in response to EPR

Well, technically it isn't EPR, if I've got the terminology correct: that's technically the name of a specific company's version, right? But I have the impression from my reading that at least a decent number of people use "EPR" for the feature in general. That makes sense to me, because "expiratory pressure relief" seems like a nice straightforward way of describing it. I have an ibreeze, so on my machine it's called "IPR", for "intelligent pressure relief".

I got diagnosed and was referred to a local medical-equipment vendor. But my insurance wasn't going to cover any of it, because the deductible lines up just wrong. I went into sticker shock, did a lot of reading, and finally decided to buy a more affordable machine and wing it. I wasn't in any hurry, because I feel as though I sleep just fine without it. The only sleepiness-scale question I gave a non-zero answer to was "if you take a nap, do you take a nap". Well, yes. Obviously. But I have diabetes (well controlled with Ozempic) and obesity (down 60lb since starting Ozempic). It was the weight-management doctor who referred me for the sleep study. I assume that my sleep apnea contributes to both the obesity and the diabetes, so I want to deal with it. But because treatment of the obesity and diabetes is working well without dealing with the sleep apnea, I figure I can afford (in terms of my health) to take the time to try the more affordable (in financial terms) route first.

The first night I used the machine, I had it on default settings across the board. I woke up after a couple hours feeling not really bad, just a little bit bleh. I figured that was enough time to get me a set of squiggles to look at in the morning, so I took off the mask and slept comfortably the rest of the night. When I looked at the data, I noticed that the my breaths were surprisingly fast. Second night, after some slight adjustment to the settings (I don't remember what -- the information is in the computer), basically the same sequence of events.

The next day, yesterday, I finally had time to do some real getting-acquainted with the machine and mask while awake.

With EPR turned on, it turns down the pressure when I start to exhale. Good. Then it starts turning the pressure back up, so my airway won't be collapsed when I start trying to inhale. Makes sense. Problem is, unless I consciously resist it, when I feel the air coming in, I inhale right away, even though it's not time to take the next breath. I got that characteristic feeling that comes from hyperventilating, so I stopped, because I have the impression that continuing to hyperventilate is considered kind of unhealthy. And it makes me feel kind of bleah.

I know the feeling of hyperventilation fairly well, because many years ago when I was a bored teenager, I practiced holding my breath just to see how long I could train myself to be able to, and I would take a few deep breaths beforehand. I've heard that people hyperventilate from anxiety, but in my case there was no anxiety involved. Not when I was seeing how long I could hold my breath back in the previous millennium, and not yesterday when I was getting acquainted with how the machine settings feel. Curiosity and a little impatience yesterday, curiosity and a little boredom way back when.

How common is this? Will I just get used to it, and not hyperventilate any more? Should I turn off EPR? Do I need to buy a different machine, with a different pattern of pressure variation over time in its EPR algorithm? Or is PAP treatment supposed to make apnea patients hyperventilate just a little, to cause some sort of physiological change in how we regulate our breathing, and restore the muscle tone that normally holds the airway open?

Is the norm around here to edit initial posts with updates, or to add them as separate posts? Anyway, it seems that either I found a setting that makes it not as bad, or I made some progress in training myself not to hyperventilate. I made it four hours before waking up.

Or maybe I'm still breathing faster than I've been accustomed to, but I'm adapting physiologically. I just saw a statement that it typically takes the kidneys three to five days to compensate for clinically significant respiratory alkalosis. Assuming I'm correct that I was hyperventilating (and I'm confident that I am -- as I said, I know the feeling), it's probably quite a bit less than what people deal with clinically, so a couple days could be enough.

dsws wrote: ↑

Fri Jun 27, 2025 5:14 am

Is the norm around here to edit initial posts with updates

With some exceptions (typos, for instance), don't edit a post or comment. Do as you did - make an update comment. DON'T start a new thread. It makes it difficult for members to see your history. Now, you should start a new thread if there is an entirely different subject.

dsws wrote: ↑

Fri Jun 27, 2025 5:14 am

Or maybe I'm still breathing faster than I've been accustomed to, but I'm adapting physiologically.

Before I read this, I was going to answer thusly:

dsws wrote: ↑

Thu Jun 26, 2025 10:33 am

Problem is, unless I consciously resist it, when I feel the air coming in, I inhale right away, even though it's not time to take the next breath.

What is happening, you are consciously focusing on the machine and your breathing. If you can distract your mind, you will fall asleep and breathe gently and rhythmically.

dsws wrote: ↑

Thu Jun 26, 2025 10:33 am

Problem is, unless I consciously resist it, when I feel the air coming in, I inhale right away, even though it's not time to take the next breath.

The machine is responding to your breathing. Your breathing does NOT have to be timed with the machine. There are much more advanced machines that FORCE breaths in users who have different issues from you.

dsws wrote: ↑

Thu Jun 26, 2025 10:33 am

Or is PAP treatment supposed to make apnea patients hyperventilate just a little

No. You, sensing a new experience, were causing yourself to breathe unnaturally. I doubt you hyperventilated during sleep.

Congratulations on the improvement. It can take a bit of time for many users to become comfortable with the CPAP process.

Thank you.

I kept the mask on all night last night, and my heart rate was mostly back down in the range that's normal for me when I sleep. SpO2 bounced around some of the time, though. This morning I didn't get a very good look at last night's flow-rate squiggles before the laptop battery ran low, and Windows decided it needed to update, and ... yeah, stuff happens. But in most of what I did look at, I was definitely breathing faster than would feel normal to me.

Specifically, I saw a bunch of four-second breaths. A web search says that up to 20 breaths per minute is considered to be within the normal range. For me it feels perfectly comfortable (I tried it with a stopwatch while I was on the bus the other day) to wait ten seconds after I finish exhaling, before starting to inhale the next breath. I also installed a time-your-breaths app and did some fourteen-second breaths with the mask and the pulse oximeter both on: it felt good, the SpO2 was good, and my heart rate was normal. So four seconds per breath seems as though it's faster than I ought to be breathing while I sleep.

The more you question and fuss about your breathing the more trouble you'll find... stop conciously doing it and you should have a better time.