Sleep length

I have begun CPAP therapy this week, having used it all night for the first time last night. Couple of questions:
1. My pressure initially was at 6, but I found that really hard to inhale. My tech bumped me to 8, which solved the problem. It was on auto, the tech changed it a couple nights ago to 7 constant as he is doing a titration home study with me now. I still find 7 to be somewhat difficult to inhale. Is this normal? I am using swift fx nasal pillows, medium which I switched to large to help with inhalation at 7. That helped a bit, but I still found it laborious to inhale at 7 with the large pillows.
2. I went to sleep last night exhausted, slept about 3 hrs and then awoke wide awake. The rest of the night I drifted in and out of sleep. Any idea why I felt so awake after only 3 hrs using CPAP?
Thanks for the responses.

Low pressure can make it seem hard to breathe but I wouldn't expect that problem with pressure set to 7. You may just be suffering from over-thinking the whole thing because it's so new which can cause anxiety and perceived breathing difficulty. That may also be why you woke up and couldn't get back to sleep. In saying this I'm assuming you aren't congested. Nasal congestion makes it hard to breathe at any pressure.

I still find 7 to be somewhat difficult to inhale.

This is probably purely psychological. Years ago I did a dye technology course, we had to wear masks to work with the dyes. These masks cover your face from forehead to below the chin with litle canisters on the side through which you sucked the air. When you first put them on it was like "OMG I can't get enough air in to survive!" But after you started measuring millilitres and mixing colours with great concentrating because a slight miscalculation and you mess up your expensive chemicals and maybe wreck your art piece, you totally forgot the damned thing on your face and walked out of the dye room and forgot to remove it.

slept about 3 hrs and then awoke wide awake. The rest of the night I drifted in and out of sleep. Any idea why I felt so awake after only 3 hrs using CPAP?

It takes a while to adjust to sleeping deeply again. At 3 hours (2 sleep cycles) your body may think it has had enough sleep because that was all it was getting in the past. You need to learn new habits which is not always easy.

bavinck wrote:1. My pressure initially was at 6, but I found that really hard to inhale. My tech bumped me to 8, which solved the problem. It was on auto, the tech changed it a couple nights ago to 7 constant as he is doing a titration home study with me now. I still find 7 to be somewhat difficult to inhale. Is this normal?

I am relatively new to all this, and I still remember that sensation of suffocating. It took me a few nights before I realized I was inhaling easily, but it was the back-pressure during exhalation which was causing my "breathing difficulty". I guess it is similar to sticking your head out of the car window at 70 MPH. There is certainly plenty of air, but it still seems to take my breath away. This problem seems to be a very common complaint with CPAP users. In fact the machine manufacturers recognize this and have built in features like "Pressure Ramp" and "Exhalation Pressure Reduction".

You seem to be quite certain that your problem is with inhalation, and you would know better than anyone else. In fact you found it easier to breathe when the tech upped your pressure from 6 to 8 (auto). But just in the off chance that the exhalation pressure is causing your discomfort, let me offer these explanations.

I was wondering if perhaps in auto mode your upper limit was set to 8 and your lower limit was actually set below the 6 that you found uncomfortable. It is also possible that the tech had set up the ramp feature during the second visit which would also provide a lower pressure until you fell asleep. Another possibility is that the tech had turned on the automatic pressure reduction during exhalation.

I don't think that anyone would find a shortage of airflow at 7 cmH2O. You only have to remove the mask from your face and listen to that hurricane of wind to confirm that. So it could be that you are used to breathing via your mouth, and you are sensing an air reduction through your nose. It could also be that your nasal passages have become inflamed (like mine did) due to CPAP use. You might have to fine tune the humidity settings to reduce that inflammation, or use a nasal spray (like I do). You might want to also try a nasal mask which you might be more comfortable with.

I think it is probably fairly personal. When I was starting I found anything less than 6 had that suffocating feeling for me, put others seem to be quite comfortable at 4.

At first I used the swift fx too but I didn't find the pillow size made much difference to the suffocating feeling. After quite a bit of tweaking, I arrived at 8 as my starting pressure as this is where I felt most confortable and the most like normal breathing. So you are not alone.

So now I set the range at 8-20 and let the auto manage increases. It largely sits between 8.5-10 all night for the last 2 years. I figure a little less than the average is the right place to start. That way with monitoring I can notice if the average starts to move lower and adjust.

I know that during the first month sometimes I would wake up during the night thinking I couldn't breathe. I would lift the edge of the mask and feel the hurricane and say to myself "There is lots of air. There is nothing to worry about" and it would go away and I would fall asleep again, but I had to FEEL the breeze in order for it to work.

Thanks for all the responses. Yes, at 7 I can definitely feel the rush of air coming out, but when I put it on I just feel like I struggle for air a bit - not a lot. 6 was definitely a struggle for air. Maybe it is psychological. My tech upped me today to 8, as I assume his data suggested I was needing a higher constant pressure anyway. On auto (2 nights) I averaged about 8ish and had a 90% pressure of 8.4 and 8.9, so when he moved me to 7 I figured it wouldn't be enough anyway which might be why I was looking for the problem in the first place.

I know a few people who find 6 or 7 cm pressure a bit stifling...so while most people might feel okay at 6 or 7...you aren't the only person who feels better at 8 cm. Not a big deal...don't worry about it.

Regarding the waking up prematurely...it happens fairly frequently with newbies. Part of it is the brain getting adjusted to having the alien stuck on your face all night. Normally we can go right back to sleep...so if this waking up and being wide awake and you can't go back to sleep becomes a habit..then we worry about it.
Part of it we just don't know why we do it. If it persists and you can't get back to sleep in a timely manner then we worry about sleep maintenance insomnia.