bipap causing anxiety

Just another vote for patience, on top of all the other tweaks suggested here.

I paid out of pocket for a very pricey (to me) BiPap, after 8 years of straight CPAP, and panicked I made a mistake on and off for a month. My data shows I wasn't able to keep the mask on more than 2-4 hours at a time for a solid 3 weeks or so, and this from someone very used to primitive (the Lightweight S7, circa 2003!), high pressure CPAP. Can you pinpoint the cause of the anxiety?

For me:

1) I felt like I was suffocating. I threw the machine on auto to see what it wanted to do (like I said, this was a nice expensive one) and gradually figured out that I personally needed to be at 18/15, when I had been playing around with just 11/14 (and lower). Alternatively, some people feel like they are suffocating when the pressure is too high.

2) I felt the machine was breathing for me or trying to--the transitions between inhale and exhale seemed impossible to tune out of my consciousness. This took a combination of time (about 6 weeks) and finding the right exhalation setting, and, frankly, having an expensive nice late model machine (other Bipaps I tried were lines developed 10 or so years ago--perfectly fine, but not as sophisticated in transitioning pressures).

3) Auto. For me: vital for diagnostic, and something that keeps me distracted, at least subconsciously, if it's on. So I had to use auto only for diagnostic, and then keep it as straight BiPap after that, even though that meant I missed out on flow limitation data (I have UARS so it can be interesting). If this is medically possible, consider it.

4) Time and trust. Your brain has been suffocating for years now when you sleep, and now you're throwing on strange, obstructive-feeling hardware, and forced air. It just takes time for your brain to say, "Oh, OK, this is actually better. Less hypervigilance necessary."

5) Masks. I thought I would always have to be full face (I even have a total face mask!) but it turns out the little bit of mouth leakage I experience is worth having a more minimal, and flexible, nasal mask. I actually love the Nasal Aire II at this point (and boy does that take time to get used to)--because it feel like very direct pressure and I can barely tell I have it on when I shift around at night.

6) Adequate (heated) humidity (but not too much). Too little, and I feel agitated about it getting forced down the airway, too much and I feel like I'm suffocating on swamp air.

Went to the doc today, he said just stick with it, it might work it self out and it might not, only time will tell. Ok thanks! Prescribed me some anti anxiety medication, plus Valium. Honestly not so sure I should start taking these, I have never had a problem before, and no way in heck do I want to have to take these pills if I don't have to. Not sure what to do, geez, back at square one I guess.

Guest wrote:Went to the doc today, he said just stick with it, it might work it self out and it might not, only time will tell. Ok thanks! Prescribed me some anti anxiety medication, plus Valium. Honestly not so sure I should start taking these, I have never had a problem before, and no way in heck do I want to have to take these pills if I don't have to. Not sure what to do, geez, back at square one I guess.

In my opinion, until you make sure your treatment is optimized, taking meds would be way premature. Kind of like taking aspirin for a headache that may be due to a brain tumor

I would go back through the thread and follow the excellent advice you have been given regarding masks. Also, you still haven't verified through data that your treatment is optimal.

49er

I'd recommend trying some slow release 5-HTP. I use it and find it helps.

Little update, I have an apap machine not bipap. Dr's know nothing, just prescribed anti depressions meds not sure I should take them. Everything getting worse by the day, dont know why this is happening. Today is better, but didnt use my machine last night. The two nights I have not used it the next day has been great. So I know its the machine, just dont know what to do about it.

Hey I,m with you. I've had bad anxiety too since i started .i,m on no meds hoping it goes away soon . will be 2 weeks wed. I do feel more awake then I have been in years.

I also use an APAP. I've found that the more you change at a time, the harder it is to pinpoint the cause of problems. So, if I make a setting change (last night I went from humidity of 5.5 to 5.0), I write down what I was hoping to see from the change, and give it a couple of days.
My non-clinical 2 cents:
- I think sleep meds are harder to stop than start, so if you sleep enough to get through the day, I'd hold off there.
- Read up on good sleep hygiene, and try one thing at a time.
- Every night is different, even with no changes.
- If your sleep doc is not willing to do anything but prescribe meds, find a new one.
- If your APAP settings are 4-20, I'd slowly shrink those to be a few cms on either side of the 95% # in your sleep study. I started at 4-20, my 95% was 10, and I'm now (after 3 months) at 8-13. I could leave it at 8-20, but I hardly have ever gone up there (lucky me!).

Go slow, post often, and you will find support and help. I sure did. If I had to rely on my doc, I'd have tossed this thing out the window after 2 weeks! It takes time.