Question from New Member

Howdy Everyone:

I am embarking on my second night with the nasal pillows. My pressure is set at 13 and I am having trouble adjusting to it. can readjust the pressure to 4 and have it gradually build up. Still it kind of concerns me that when I start at 13 I find myself unable to breathe. I am a life-long asthmatic so this is not a pleasant sensation.

Does anyone have an suggestions for me? I have not been sleeping well for about a decade and I am very committed to making this work.

Welcome to the forum.

It would help if you could fill in your equipment profile. (Exact make and model, mask, etc.)
Is you machine data-capable or does it have exhale relief? (EPR or C-Flex)


Den

"Howdy Everyone:

I am embarking on my second night with the nasal pillows. My pressure is set at 13 and I am having trouble adjusting to it. can readjust the pressure to 4 and have it gradually build up. Still it kind of concerns me that when I start at 13 I find myself unable to breathe. I am a life-long asthmatic so this is not a pleasant sensation.

Does anyone have an suggestions for me? I have not been sleeping well for about a decade and I am very committed to making this work. "


Hello there, and welcome!

It is very difficult for a "beginner" to start at thirteen.. that is like putting a toddler on a high dive, and say... Okay, JUMP!

Yes, if you provide all your information everyone will be able to help give you some great advice..
Ive been at it three months , so still in the novice stage.. but past beginning level.

Im guessing you have a machine that allows you to ramp the pressure from four to thirteen and above?
If you are a shallow breather, you will find four much more comforting..... to start to practice exhaling against..
When the pressure gets higher, some machines have exhalation relief too.. so they need to know that..

Having asthma, it will be a struggle at first to work thru this, but you can do it.. Its going to take a little time..
When you get stronger and more used to breathing against the pressure, you might be able to raise your starting pressure a bit if you want to.
Its going to take some time, I guess you can tell it doesnt feel natural right now.. hang in there.. it will get better..

Thanks for responding. It is clear to me that I am a total ignoramous in the world of Apnea. I will try to gain some knowlege by reading the posts. At this point I do not even know what questions to ask except that I am finding it increasingly difficult to use the C-pap. It makes me feel as if I have to struggle to breathe. I will be back with more informed questions.

When i started out i used the ramping feature on the machine and it was set to 30 minutes or so. When you are new the pressure can be over whelming at first. So it would slowly ramp up over the time frame and often i was asleep b4 it got to full pressure. they had the low end set for 4. after a week or so i felt i was not getting enough air on the low end so i decreased the ramp time and that helped get me out of the low 4 range faster. Finally i learned how to change the low end ramp pressure and i moved it up to 6. I rarely use the ramp feature any way as you grow accustomed to the presure and wont need it. I would suggest if u dont feel like you have enough air to up the low end ramp if u can.

You will get used to the high end pressure.

I forgot to add that I am also at 13 for pressure

One other thing is that your lungs get a work out as they adjust to overcoming the pressure resistance to breathe.
That may take a few days until you feel comfortable. That sensation passes and you breathing will become less labored as you adjust.

I've been a hosehead for 4 years now and it may be a surprise to you that very soon you will be trying to figure out
how to determine whether your machine is still blowing in the middle of the night. Once you get "over the hump" the pressure
will seem to disappear. You'll have to put your hand in front of the vent port to feel to exhaust.
I tried ramp a while but found it uncomfortable, but there are lots who swear by it.
As mentioned above many find 4cm too low and suffocating.
I have an auto and exhalation relief capable machine,
but have determined that I am most comfortable (and get the best data ) with the full pressure working all the time.

Good luck with you efforts to get this therapy giving you what you need,
You have found an excellent source of good information.

Regards,
TerryB

perchance wrote:Thanks for responding. It is clear to me that I am a total ignoramous in the world of Apnea. I will try to gain some knowlege by reading the posts. At this point I do not even know what questions to ask except that I am finding it increasingly difficult to use the C-pap. It makes me feel as if I have to struggle to breathe. I will be back with more informed questions.

We all started out not knowing anything much about apnea, I suspect. It's a whole new thing! As you read the posts and go thru your own trials...you will gain the knowledge you need. Don't be afraid to ask questions.

Soon, Perchance, you will be the one doling out assistance!

With asthma you really need some sort of EPR (Expiratory pressure relief) or "flex" option that reduces the pressure during the exhalation phase of the breath. That way you are not having to breathe out against the full 13 cm of pressure.

I don't know anything about your machine to be able to tell you whether or not your machine has that--you should call your DME provider or sleep lab for help on this. Hopefully your machine has that option, but it was not set for you. If not, you will need a new machine that has exhalation relief.

It sounds like your machine is running in straight CPAP mode if it goes right up to 13 unless you turn on the ramp. Most of us use auto machines that start out at a lower pressure and, by sensing our breathing patterns, only increase pressure when we need it. Straight CPAP at 13 is hard for someone with asthma as well--it's uncomfortable when we are awake. So you should check to see if your machine is an "autoset".

While you are at it, make sure that you have a "data capable" machine. Most machines collect at least compliance data (how many hours you are using the machine every night), but you need something that actually collects data on many more things like how much pressure it is really taking to keep your airways clear, whether your mask is leaking, etc. You should insist on such a machine, and, assuming you have had your machine for only a short while, ask the DME to swap you out for a better machine with EPR and auto and data capability.