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Here the data of the sleepyhead from last night.
The machine was limited to max 10.0.
I was always fully awake. The air was too much for me to fall asleep. I took off the mask at 1.20 after about one hour.

If you were "fully awake"...the report means nothing.

The report is not totally useless...it shows movement on the pressure line while awake and if totally awake the pressure line shouldn't have moved.

You need to get with your DME and your doctor if you are unable to get to sleep.
The machine shouldn't have increased the pressure if you never went to sleep unless it was responding to some sort of perceived flow limitation while breathing...nasal congestion maybe... In APAP mode the machine shouldn't increase the pressure while awake because there shouldn't be any reductions in airflow to cause the increase unless there is something going on either with your respiration or the machine's sensors.

Since you haven't had an official titration study and these settings are an attempt to dial in appropriate therapy pressures (btw this normally works fairly well) but you cannot sleep then you are going to need some help somewhere. Believe it or not but these pressures aren't all that high. I know that isn't much comfort for you but they really aren't considered all that high.

You have to get some sleep to have any idea what pressure you may need.
I know that my next idea is far from ideal but a person has to start somewhere and in your situation I would suggest starting at the low end and work up slowly....also get with your doctor about your difficulties.
In an effort to limit pressure changes (which shouldn't be happening while awake anyway) I would suggest back up and go with cpap mode....modest pressure at 6 cm...EPR at 2....see if you can at least get some sleep.
Can't use EPR at 3 with 6 cm cpap mode because the machine won't go below 4 cm.

Heck, you might get lucky and only need 6 cm pressure anyway. Gotta start somewhere and get some sleep to have any idea what is needed.
I would change to cpap mode...set the machine to 6 cm and use EPR at 2. Don't use the ramp.
Inhale at 6 and exhale at 4 is going to be more comfortable than ramp at 4 all the time. It is a more relaxed rhythm and there is air movement.

You do need to make your medical team aware of your difficulties though. My ideas are just meant to be a short term fix to maybe get you to at least get to sleep with the machine and mask on.

sarah, did you have trouble with insomnia prior to CPAP?
are you trying to breathe "with" the machine? in my experience, it is hard for newbies because you have this foreign thing on your face. after a week or so you likely will be able to "trust" the machine and "let go" and be able to sleep better.
do you have any other health issues that might affect your sleep? medications, etc?
can you get into your doctor soon since you are not able to sleep?


hang in there.

avi123 wrote:bluesky5, posters on this website are not physicians, but may imposter as they are, and render medical advice. Your best bet is to deal with your own Doctor especially since you're a beginner who knows very little about this medical field, and what is good for you at this stage.

If you need a doctor you should see a doctor by all means. There are times when you need the help you can only get from someone who has experience using cpap. Not all doctors have experience in using cpap. A doctor may be able to tell you that you need pressure set at 15 but not realize that it is nearly impossible to start out on that pressure. That causes a lot of machines to end up in closets and on Craigslist.

Thank you all so much for your advice and experiences.
Oak, I had no insomnia prior to CPAP.
Stormynights, sure I'll inform my doctor but I am also sure all posts are very informative and necessary for me.
Pugsy, I will follow your advice tonight and we see tomorrow what sleepyhead has to show.
I think we figure out the problem and it just takes time.

bluesky5 wrote:It was my first night and everything was ok till my resmed auto changed the airflow over 5.5.

The air pressure went up to 14.9 and my lungs are not strong enough to exhale, so I had to sleep without the mask. Can I lower the pressure ?

That''s because you haven't changed your reference pressure to 14.9. If your lungs were filled with 14.9 cm H2O air, your breathing out would be effortless against 14.9 cm H2O CPAP because the delta Pressure is zero. When you turn the machine on, do nothing -- let it fill your lungs until it cannot fill them anymore. It feels like taking the deepest breath you can. Let in inflate your lungs to the max. The pressures you're dealing with, if your otherwise healthy (my pulmonoligist tells me) won't hurt you. Once this occurs, the pressure inside your lungs is 14.9, and the pressure inside the mask cavity is 14.9. Your lungs will be unaware that you're not breathing normally without a mask or pressure because the difference between lung pressure and mask pressure is zero. So relax, let the machine fill your lungs, breath out effortlessly. Then let the machine refill your lungs. Done this way, you only breath out. Let the machine breath in.

If you have any C-flex or BiFlex, set it to 1 or 2, and the pressure on exhale will be reduced, and it will be even more effortless.

My exhale pressure is 21 to 25, my inhale is 5 lower (I have a BIPAP). It's the differential, not the absolute pressure that you have to work against. With the Bipap, that is minus 5. Exhaling, even at a pressure of over 20, is less than effortless.

I've only used a Bipap for a few months, but I discovered this a few yours into the first night after fighting with the machine for a few hours. The damn machine tortured me for the first few hours until I discovered this. When you do what I suggested, it feels real weird at first and is really counter intuitive.

You see, right now, with partially filled lungs, you're trying to breath out at 14.9 cm of water, while the pressure in your lungs is much less. That will feel like breathing against a wall of iron.

Sorry, I got the pressures reversed. My inhale is 21-25, my exhale is 5 lower. Sorry

My doctor said: if the machine goes to 15, I need 15. And no EPR on! I should use the machine at daytime for 15 min, 30 min to get used to it.

I used the machine this night on 6 max, everything was good but in the morning I felt week, kind of dizzy and had the feeling I got too much air.