New to CPAPand question about pressure

Hello everyone!

I was diagnosed with possible mind sleep apnea - index of 6.
I now have had my CPAP for a week and I am having a terrible time adjusting. I feel like I am just not getting enough air.

My minimum pressure started at 4 and max at 14. We have since bumped the min up to 8.5. With that setting, I finally slept well on 2 nights ago. However, last night with the same setting, I woke up and could not go back to sleep. I again felt like I was not getting air. I laid awake for quite a while before turning on the light to look at my pressure. It was at 14.

I think that is very high for being awake and still feeling like I am not getting air.

I called my resp therapist this morning (actually the on-call therapist, not mine), and she made me feel like I was crazy. She said she had never heard of being awake at 14. I told her I obviously was because I stared at the number for several minutes, fiddling with my mask for leaks, and checking hoses to make sure everything was set correctly. I finally turned the machine off and then back on. At 8.5 I still felt like I was having trouble breathing and so after an hour of trying to go back to sleep with the machine, I turned it off and went to sleep without it.

So, am I crazy? The therapist thinks I am thinking about this tool much, but when I feel like I am struggling for every breath, and it is waking me up at night, I just can stop thinking about it.

I think last night was the worst yet and I had expected things to get better not worse.

Any suggestions?

TIA,
Michelle

Michelle,

My pressure actually was at 14 when I woke up this morning and that is very high for me. The mask was probably leaking during the night. I do remember waking up once to re-adjust the mask.

Very occasionally I have a bit of that feeling when drifting off. What I try to do is to make my entire body relax, I can do this very successfully. As I calm down, I just start breathing long and slow and not worry about the feeling of the machine trying to make me breathe a certain way. I KNOW that I am getting air whether or not it feels that way. It is just a feeling and not a fact, so keep that in mind to.

It sounds like you are a bit anxious over this whole therepy. I don't think you are crazy as some people seem to have a harder time than others getting started. I would not try to analyze it too much as that can add to the anxiety. Just try and go at it with a relaxed mind set. For now try not to worry over numbers and such. After things settle down, then you can start to think about tweaks and things. Make sure your mask is a good as can
be kind, size and fit for you. The right mask is the key!

Good luck and relax!

With the machine you have running in the auto mode the ramp button will set it back to the lowest pressure in the range. I need to use this when I wake up during the night.

Looking at my stats, I can handle my max pressure without waking up. But when I do wake up setting it back to the lowest pressure makes it much easier to get back to sleep.

Do you have a smartcard/reader & software? If not it is a very worthwhile investment.

I have a different machine than you, but I discovered that I just couldn't tolerate APAP. My machine would perceive every little cough, sigh, movement, as apnea and go up on the pressure.
It makes me mad that your respiratory therapist said the things she did. She obviously doesn't know much.
If you continue to wake up alot, you might consider changing over to straight CPAP. That's what I did, and it made all the difference in the world. Good luck.

Michelle,

I agree with Brooke you may be suffering from some anxiety, this is a big change. Some of your waking up may be simply out of habit. When you wake up, try to identify what woke you (right away before you forget what it was) This may help you identify some of your problems.

My first couple weeks on CPAP, I could not get to sleep without the ramp. Once I adjusted to the machine, then I could go to straight pressure (but I'm not at 14)

I really find it hard to swallow from your RT that she never heard of anyone being awake at a pressure of 14. It's called Rainout, an apnea, a mouth leak or someother problem that has told your mind to wake up.

Brooke's right about the mask - it seems to be the biggest problem for most. If you're having problems with your mask, this will be extermly hard.
Most companies have a 30 day return policy so if the mask is a problem call your DME. They should be able to listen to your problems and make a suggestion for a change.

Michelle,

You're not crazy. And.....what some of the others had to say.
Is the machine you're using a loaner......or is it YOURS?

The problem with using a APAP machine (like "guest" said) is that too many things will cause your pressure to change.......and that's not necessarily a good thing with you're just starting out and trying to adjust to this new way of sleeping.
If you're going to continue to use that machine in a range of pressures, your bottom pressure needs to be higher......so you don't feel like you're starving for air.

I would also suggest trying straight CPAP. That way, if you're having leakage problems, your pressure won't be bouncing all over the place.

And, the therapist that said those things to you.....is "knowledge challenged".

Den