Really rough night. Keep waking over higher pressures

What a rough night. Went to bed at 10:00, woke at 11:30 with my pressure at 13.6. I believe I woke because I couldn't seem to exhale against it. Kinda wigged out over that. Turned off the machine to reboot it to 5, and tried to go back to sleep. It freaked me out that I ended up turning it off again and sitting at the edge of the bed fighting the, "I can't do this." thoughts.

Happened again at midnight, so I got up again. Took a half dose of Tylenol PM, seeing if that would help. Had such trouble with panicing, that I turned the machine on and read for 30 minutes. Then, nights out again. Happened then at 10.6. It sure seems that the pressure wakes me, or the reason for the high pressure is what wakes me.

Would I be better off trying the small nasal pillows (I currently use XS) so I have more room to exhale against the current? Any other suggestions? Help!

Your could sure try the next size up in nasal pillows. For some people it makes a world of difference.
You also may just be someone who those changing pressures bother and straight CPAP might be a good option to consider.
Are you using EPR? A change in it might also help.

I just checked and my EPR is on Fulltime with a 2. I'm afraid I don't know what that means at all.

I did figure out the clinical setup menu and changed my starting pressure to 5. Way less suffocating in feeling when I first went to bed, which was great. I think I might bump it up a little higher. I had my multiple mini-freakouts during the night and shut off the machine momentarily and when I turned it back on, I was still agitated, so 5 was a little suffocating as well.

I downloaded my data from the past several days. When I was getting up to use the restroom, I wasn't turning off the machine since it was in "Auto" mode. By doing this, it seems to show my absence as an event. Last night, I just turned it off. Is that the right thing to do?

Thanks so much for your help. It is invaluable.

Pugsy wrote:Your could sure try the next size up in nasal pillows. For some people it makes a world of difference.
You also may just be someone who those changing pressures bother and straight CPAP might be a good option to consider.
Are you using EPR? A change in it might also help.

EPR at Fulltime just means it is on all night.
EPR...each setting amounts to a per cm reduction in pressure during exhale...setting of 1 equals a 1 cm reduction..setting of 2 equals a 2 cm reduction..
While awake and that starting out minimum pressure of 4 cm...EPR doesn't even kick in because the machine won't go below 4 cm.
At a starting pressure of 5 cm...EPR drops exhale down to 4 cm...even if you had it set at 3..it can't go below 4 cm.
If you set the starting pressure at 6 minimum...then your EPR of 2 will kick in and drop the pressure on exhale down to 4 cm.

Some people find and with anything less than 6 cm..they just feel like they are trying to suck air through a straw.

Turning the machine off when you get up to go to the bathroom...not a critical issue but if it is still moving along at higher pressures when you get back to bed it might be a bit of a shock to the body because normally when you first start the night you are using the minimum pressure.
The difference in any "events" that might get flagged when you take the mask off isn't going to make any real difference in the overall numbers though. Might elevated the leak numbers a bit because it might be perceived as a large leak.
So from a numbers perspective...probably not going to really make a huge difference but from a comfort perspective.....you might like starting back at your lower pressure.

If I get up during the night I have always just turned the machine off prior to removing mask (do it in the AM also) just so any large leak or weird something doesn't mess with my numbers...just in case.

ughwhatname wrote:What a rough night. Went to bed at 10:00, woke at 11:30 with my pressure at 13.6. I believe I woke because I couldn't seem to exhale against it. Kinda wigged out over that. Turned off the machine to reboot it to 5, and tried to go back to sleep. It freaked me out that I ended up turning it off again and sitting at the edge of the bed fighting the, "I can't do this." thoughts.

Happened again at midnight, so I got up again. Took a half dose of Tylenol PM, seeing if that would help. Had such trouble with panicing, that I turned the machine on and read for 30 minutes. Then, nights out again. Happened then at 10.6. It sure seems that the pressure wakes me, or the reason for the high pressure is what wakes me.

Would I be better off trying the small nasal pillows (I currently use XS) so I have more room to exhale against the current? Any other suggestions? Help!

My titration had me starting at 4 and ramping to 9 over a 45 minute period. After Pugsy's advise to try upping the starting pressure and lower the ramp, I raised the starting pressure to 5.4 and decreased the ramp from 45 min. to 15 minutes. Also changed my EHR to 3. Increasing the starting pressure and decreasing the ramp kept me from feeling like I wasn't getting enough air.

Definitely try the small pillows and don't overtighten the pillows, I found that if I "smash" them against my nose, it actually obstructs the pillow airway. Size is tricky. I use small pillows. Although I like the larger opening in the medium, the diameter of the part that goes into the nose is just a touch too wide and tends to fold over on itself which constricts airflow. I also use a nasal strip nightly for chronic congestion. Try to relax your breathing. Don't try to take really deep inhalations. Not so shallow that you don't feel like your not getting enough air, just kind of chilled out breathing lol....

I'm another newb btw.

I am quite brand new to all this and I can only give you what has really helped me in terms of pressure. I've been on my machine about three weeks. I found the changing pressures difficult and would wake when it switched to higher pressures. I found that was has worked well for me is to wear my mask with machine turned on for at least 1.5 hours in the evening before I go to bed. I wear it at whatever pressure I am going to start at or if I am doing straight cpap then that pressure. I find for myself that it takes me a while before I really get used to the air coming in so that I don't notice it. Also I am finding that just because I have stopped pullling my mask off at night, it isn't a good idea to stop wearing it in the evening. Last night I didn't wear it before bed and it took me over an hour to get to sleep and that was after taking a bit of childrens benadryl. But the nights I was wearing before bed, I noticed that I fell asleep quite easily with mask and eventually have stopped taking mask off in sleep. (Course that doesn't mean I might not end up doing that in the future) One thing I have noticed is the longer you wait before you take the mask off when it feels intolerable, the longer you will be able to tolerate it next time. I truly believe that adjusting to the CPAP is a war of attrition and every small step you take forward helps tremendously.