Posted: 8/11/2011 8:26:31 PM EDT
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Here I am three nights in a row unable to go to sleep with this damn thing on. Did desensitization time for a week with a unit by using it in the day for 30 mins to an hour at a time to get used to a mask and have been thru 4 different masks and finally am using the nasal pillows. Pressure ramps up in 45 mins and the little EPR or whatever it is that lowers the pressure so I can exhale is supposedly set but I am waking up gasping because I feel like I am smothering.
Do I have to wait until utter exhaustion kicks in and go to sleep that way? I keep shutting the thing off, getting my wits about me and starting over. I try for about 2 to 2 1/2 hours to go to sleep with it on and so far just pull it off so I can sleep. My ass was so tired today at work it seems like its having a negative effect. What am I doing wrong? |
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Quoted: Here I am three nights in a row unable to go to sleep with this damn thing on. Did desensitization time for a week with a unit by using it in the day for 30 mins to an hour at a time to get used a mask and have been thru 4 different masks and finally am using the nasal pillows. Pressure ramps up in 45 mins and the little EPR or whatever it is that lowers the pressure so I can exhale is supposedly set but I am waking up gasping because I feel like I am smothering. Do I have to wait until utter exhaustion kicks in and go to sleep that way? I keep shutting the thing off, getting my wits about me and starting over. I try for about 2 to 2 1/2 hours to go to sleep with it on and so far just pull it off so I can sleep. My ass was so tired today at work it seems like its having a negative effect. What am I doing wrong? What is your pressure, EPR setting, and what type of mask are you using? Some people have a lot of trouble with the adjustment, you appear to be one of those people, hang in there, it gets better. Also, what is your AHI score from the sleep study? |
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Not sure what AHI is but I had a total respiratory disturbance index of 41.2 events per hour, if that is the same thing.
EPR setting is "3" I believe and max pressure is set at 11. It was set up to ramp up to 11 in 5 mins initially and after I complained of the smothering sensation, the therapist suggested extending it to the full 45 mins to give me time to fall asleep before it reached max setting. I started with a full face mask in desensitization, tried out the nasal mask in the titration, moved to a smaller full face because I had trouble with the smothering using the nasal only mask and am now trying it with the nasal pillows. That is the most comfortable mask. I just feel like I am artificially breathing instead of relaxing and breathing normally. Then right about the time I drift off to sleep, I wake up gasping like I can't breathe. I assume I can't exhale well because my nasal passages are so narrow that I just don't have the volume to push back against the airflow, even with the EPR set at 3. At first I got a headache pushing against the pressure for half an hour to an hour so I assume the EPR is working - I don't know because I have not tried another machine. I appreciate everyone's input. This has been a miserable few nights. |
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it may be that nasal pillows are not for you either, I went through them all before
finding the right over the nose mask When you find the right setup you'll know Turn off the ramp and use full pressure from beginning as has been suggested. Talk to your DR. possibly you need to up the pressure some I kept getting the suffocating feeling and my Doc had me set the pressure up a digit every night until it went away now since then I have lowered the pressure a few settings and all is well Honestly after having used mine for the last 5-6 yrs I put it on and I'm asleep within a min or two Good luck When it works for you you Will feel like a new person |
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Quoted: Not sure what AHI is but I had a total respiratory disturbance index of 41.2 events per hour, if that is the same thing. EPR setting is 3 I believe and max pressure is set at 11. It was set up to ramp up to 11 in 5 mins initially and after I complained of the smothering sensation, the therapist suggested extending it to the full 45 mins to give me time to fall asleep before it reached max setting. I started with a full face mask in desensitization, tried out the nasal mask in the titration, moved to a smaller full face because I had trouble with the smothering using the nasal only mask and am now trying it with the nasal pillows. That is the most comfortable mask. I just feel like I am artificially breathing instead of relaxing and breathing normally. Then right about the time I drift off to sleep, I wake up gasping like I can't breathe. I assume I can't exhale well because my nasal passages are so narrow that I just don't have the volume to push back against the airflow, even with the EPR set at 3. At first I got a headache pushing against the pressure for half an hour to an hour so I assume the EPR is working - I don't know because I have not tried another machine. I appreciate everyone's input. This has been a miserable few nights. Ok, first step is to calm down a bit. This is going to take time and patience to sort out. Take a night off. Sleep without your mask tonight, the extreme exhaustion does you no good. 11 is a fairly high pressure for a new CPAP user, that takes time to get used to. I sleep at 12. Your AHI means Apnea-Hypopnea Index, its the total number of average Apneas and Hypopneas per hour that you experience. An Apnea is a stoppage of breathing for 10 seconds or longer, Hypopnea is shallow breathing where you don't get enough oxygen into your system...both are dangerous because they drop your oxygen saturation. 41 is severe. 30 and above is severe...but you don't have it the worst I have seen. I run a 65, and I know people who run a 120. You never answered one question I asked: What kind of mask? Full face? Nasal pillows? Nasal mask? Describe it and I can determine the type. Next question: What is the maker of your machine? Resmed? Respironics? If its a Resmed S9, I can show you how to enter the Clinician mode and change your Ramp, EPR, and Pressure. This is something you should NOT do unless you get educated on what these settings do, and how they effect your health...but most CPAP users have taken full control of their machine and they ultimately end up knowing as much or more than their doctors about their disease and the treatment for it. EPR of 3 means that when the machine detects your exhalation, it drops your pressure by 3 to an 8 (Since your final pressure is an 11). EPR is helpful as a comfort setting, but personally I turned mine down to 1. I found that with an EPR of 3, I was still getting a bad AHI and some snoring logged in the data on the card (more on that later). Here is what I recommend: Talk to your Respiratory Tech, and tell them that you are having these problems. They can recommend some different mask options for you. Personally, I'm a mouth breather at night (I used to snore horribly, and no, I'm not fat), so I have to use a full face mask. What I love about the full face mask is that it equalizes the pressure between my nose and mouth, so if my nose gets a bit stuffed up, I can breathe through my mouth and still get the benefits of the CPAP treatment. If you are on a nasal mask, or on nasal pillows, I highly recommend that you purchase and try life with a full face mask. Also: What position do you sleep in? I assume that your apneas are obstructive (throat closing) and not central (where the brain forgets to tell the body to breathe)...if this is the case, I recommend that you sleep on your side, and NOT on your back, sleeping on your back makes OSA (obstructive sleep apnea) worse for most people. I'm going to keep in touch with you. You are NOT the first person I have helped adjust to life as a CPAP user. Its changed my life for the better in TREMENDOUS ways, and ultimately, its going to save your life. But you aren't going to sort this out in a week. It took me SIX MONTHS of learning, frustration, emotional turmoil, and bad sleep before I finally got this thing figured out, and now I sleep like a baby. Read my post twice, and remember to answer my questions above. Now, tonight, ditch your mask and get some sleep. It won't be good sleep due to your apnea, actually, you don't know what it feels like to get a night's sleep where you aren't suffocating for 8 minutes of every hour (score of 41 means you stop breathing about 8 minutes of every hour, or 8 seconds of every minute)...but when you finally get this figured out, you will wake up one morning literally feeling like superman. Once you experience what it feels like to wake up after 8 hours of sleep where you aren't suffocating and drowning in your sleep, you will know this was all worth it. Get some rest and post up here again tomorrow, you aren't alone, there are millions of us out there. Tomorrow I'll point you to some dedicated sleep apnea support forums where you will meet TONS of other people just like you and me. |
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how is your breathing without the mask on, are you congested at all? do you get congested when you lay down? maybe the problem isn't with the machine but with you instead. Is the machine drying out the mucus membranes in your sinus's which might plug up the airway a little? do you have a humidifier on the unit and is it turned up enough? I have to change that setting on mine occasionally due to changes in the ambient humidity in my room.
I hope you get it working better. mine has done wonders for my blood pressure and headaches in the mornings. not to mention I get some rest finally. good luck |
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I don't think I can adjust my pressure but I will see. I'll turn off the ramp-up feature and give it a try that way. I am off tomorrow and on vacation next week so I can panic all night and sleep all day if I need to!!!!!!
I hope this thing works out. Well, here goes another try........ ETA: Nasal pillows tonite. There is one strap over the top of the head and one adjustable band around the back. I used a full face for two nights and while it was good like you stated for equalizing pressure if I opened my mouth to yawn, it felt like it constricted my nose a little more. I may have to go back to a larger size and try it again. I went back yesterday and today to the therapist to get the adjustments so far. Machine is a Resmed Elite. I'm not stuffy or congested at all so that's a good thing. I appreciate the info and will try to get back to you on this as I go along. |
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Quoted: I don't think I can adjust my pressure but I will see. I'll turn off the ramp-up feature and give it a try that way. I am off tomorrow and on vacation next week so I can panic all night and sleep all day if I need to!!!!!! I hope this thing works out. Well, here goes another try........ You cannot, without putting the machine into a special mode that only your respiratory tech is supposed to activate. Read my post above, and give yourself a night off...you have been living with this disease for years probably, another night or two without your mask won't hurt a thing. |
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I've been struggling with mine for two months now. Tried the full face, nasal pillow and now have a nose only mask. These things suck ass so far. I was really hoping to improve my sleep after being diagnosed, so far no luck.
I did successfully oversleep after taking Ambien, woke up without the mask on....] Thing feels like this on me: 
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Quoted:
I've been struggling with mine for two months now. Tried the full face, nasal pillow and now have a nose only mask. These things suck ass so far. I was really hoping to improve my sleep after being diagnosed, so far no luck. I did successfully oversleep after taking Ambien, woke up without the mask on....] Thing feels like this on me: http://i1114.photobucket.com/albums/k537/JohnSmith6073/c534_alien_facehugger_plush_inuse.jpg LOL We need to keep up with Parabelum's and others info in this thread. That Alien humor is just what I needed - nothing like a good chuckle to keep it in perspective. |
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The resmed S9 elite can set the ramp up pressure without going into clinician mode.
At the home screen, turn the knob until the ramp screen (green triangle) turns blue. Press the button. The triangle background turns orange. Turn the knob up or down. Ramp time changes from 0 to 45. Press the knob to confirm your choice. Don't give up. As you learn about CPAP's some folks take to it like a "duck to water" and others struggle. My sister in law has a half dozen masks she tried, until she found the one that worked for her. Keep with it. You're making an investment in your health. |
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Be persistent OP. It's worth it. My BiPap pressures are now 14 / 10 or such. Don't remember exactly. My blood pressure is now much better. Heart rate slower...now within normal range, not taching anymore. Memory has improved, although still shitty. My apnea was severe, O2 sats dropped to 69% several times during the study. I will not sleep without mine. I did have difficulty at first, but was determined for the benefits. I would get to work at 645a, and would need to take naps at 8:30. Two hours later. I could fall asleep anywhere, anytime.
I do have some medications to help if I really need to sleep. I used a few at first to get used to it, but soon after quit. I wear a full mask and headgear. I've walked out of the bedroom after sleeping at the camp, out of town w/friends, etc with it on, and asking people if they've seen my jet. 
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Quoted:
it may be that nasal pillows are not for you either, I went through them all before finding the right over the nose mask When you find the right setup you'll know Turn off the ramp and use full pressure from beginning as has been suggested. Talk to your DR. possibly you need to up the pressure some I kept getting the suffocating feeling and my Doc had me set the pressure up a digit every night until it went away now since then I have lowered the pressure a few settings and all is well Honestly after having used mine for the last 5-6 yrs I put it on and I'm asleep within a min or two Good luck When it works for you you Will feel like a new person This |
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Quoted:
Quoted:
Not sure what AHI is but I had a total respiratory disturbance index of 41.2 events per hour, if that is the same thing. EPR setting is 3 I believe and max pressure is set at 11. It was set up to ramp up to 11 in 5 mins initially and after I complained of the smothering sensation, the therapist suggested extending it to the full 45 mins to give me time to fall asleep before it reached max setting. I started with a full face mask in desensitization, tried out the nasal mask in the titration, moved to a smaller full face because I had trouble with the smothering using the nasal only mask and am now trying it with the nasal pillows. That is the most comfortable mask. I just feel like I am artificially breathing instead of relaxing and breathing normally. Then right about the time I drift off to sleep, I wake up gasping like I can't breathe. I assume I can't exhale well because my nasal passages are so narrow that I just don't have the volume to push back against the airflow, even with the EPR set at 3. At first I got a headache pushing against the pressure for half an hour to an hour so I assume the EPR is working - I don't know because I have not tried another machine. I appreciate everyone's input. This has been a miserable few nights. Ok, first step is to calm down a bit. This is going to take time and patience to sort out. Take a night off. Sleep without your mask tonight, the extreme exhaustion does you no good. 11 is a fairly high pressure for a new CPAP user, that takes time to get used to. I sleep at 12. Your AHI means Apnea-Hypopnea Index, its the total number of average Apneas and Hypopneas per hour that you experience. An Apnea is a stoppage of breathing for 10 seconds or longer, Hypopnea is shallow breathing where you don't get enough oxygen into your system...both are dangerous because they drop your oxygen saturation. 41 is severe. 30 and above is severe...but you don't have it the worst I have seen. I run a 65, and I know people who run a 120. You never answered one question I asked: What kind of mask? Full face? Nasal pillows? Nasal mask? Describe it and I can determine the type. Next question: What is the maker of your machine? Resmed? Respironics? If its a Resmed S9, I can show you how to enter the Clinician mode and change your Ramp, EPR, and Pressure. This is something you should NOT do unless you get educated on what these settings do, and how they effect your health...but most CPAP users have taken full control of their machine and they ultimately end up knowing as much or more than their doctors about their disease and the treatment for it. *SNIP* Parabellum, unless you are a physician, I'd highly recommend removing this part of your post for patient safety and legal reasons; it could be construed as practicing medicine. You do not want to be held responsible for the results of someone altering their prescription. This is the type of thing that drives doctors, sleep technologists, and respiratory therapists up the wall when a patient starts having problems. Critical CPAP/BiPAP unit parameters are locked-out from user control for a reason; any settings outside of ramp-time, C-Flex/A-Flex, etc, and humidifier heat should only be adjusted by a physician's order. As a sleep technologist, it's very frustrating when I have to fix a person's issues in the sleep center because someone decided to alter their equipment. This is why most CPAP/BiPAP units have their settings hard-coded on proprietary data cards. OP, if you need a full-face mask design to allow for oral airflow, nasal pillows alone is not going to help. The nasal pillows can actually increase the smothering sensation, it can be difficult to exhale back out of the pillows for some patients. If you naturally breathe through your mouth while asleep, you need a mask that will accommodate that. A mask that will only allow for oral airflow will feel like it is smothering you if your body needs to breathe orally. Contact your home-care provider and ask them about the ResMed Mirage Liberty interface. It's a hybrid mask that combines nasal pillows with a oral airflow design, it works very well for those who can't tolerate a traditional full-face design. You need to be talking to your physician to get this problem sorted out. Mirage Liberty |
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Another sleep tech here.
A lot of times mouth breathing makes people feel like they're suffocating. It's a pretty common complaint. It could be part of the problem, but everyone's a little different. Sometimes having too much of the "comfort" pressure lowering and raising like EPR I found in some people makes them feel like they're smothering. Hopefully, you've got good support on this, though. Adjusting to CPAP can be pretty difficult. I'd say the vast majority of patients take weeks to get used to it. The first few nights can be really rough. Keep at it, and keep working on getting the mask and settings that are right for you. Getting the right mask can help a great deal- especially if you need a full face, finding the right one can make a vast difference. |
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Quoted:
Another sleep tech here. A lot of times mouth breathing makes people feel like they're suffocating. It's a pretty common complaint. It could be part of the problem, but everyone's a little different. Sometimes having too much of the "comfort" pressure lowering and raising like EPR I found in some people makes them feel like they're smothering. Hopefully, you've got good support on this, though. Adjusting to CPAP can be pretty difficult. I'd say the vast majority of patients take weeks to get used to it. The first few nights can be really rough. Keep at it, and keep working on getting the mask and settings that are right for you. Getting the right mask can help a great deal- especially if you need a full face, finding the right one can make a vast difference. I figured there had to be another sleep tech here somewhere...pleased to meet you. Oral-breathers and high pressure levels tend to go hand in hand from what I see, especially with the issue of lower-jaw retro-pulsing. I'm betting the combination of oral airflow/high setting/nasal pillows is what is causing the problem. Another thing for OP to consider is that some people just simply can't tolerate CPAP, and may need to switch to a BiPAP unit for improved respiration. All the more reason to work with the physician and home-care people on this. |
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Op, I have been on my bipap machine for 9 nights now, and fortunately, I took to mine right away.
My AHI in my first sleep study was 192, which explains how I could barely function during the day. I'm on a resmed bipap machine with a full facemak Quattro FX. I find it's very comfortable, and with my pressure set at 23, as a mouth breather, I struggled with the nasal pillows. I found them very awkward in my sleep study. I just want to encourage you to stick with it. I can't tell you how much this has changed my life. In a week and a half I'm back to feeling like myself again, im awake typing this right now b/c I woke up fully rested an hour and a half early today. Keep working with your Dr. - you'll be glad you stuck it out. Feel free to PM me if you want someone to talk to - I know how tough this is. Posted Via AR15.Com Mobile |
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Have you had a printout of your sleep history with the CPAP yet? I would think that the nasal pillows aren't working for you, they didn't work for me. Also, do you know if you're having Central Apnea events? Traditional CPAP will not treat Central Apnea. I was having issues with gasping for air at night with the CPAP. Come to find out that I have Complex Sleep Apnea, which is a combination of both Obstructive and Central Apneas. I had to go to a higher level machine. Go back and talk to your Pulmonologist see what your sleep study showed and then get a print out of your history with your CPAP. The CPAP's can tell the difference between Central and Obstructive apneas and you might need to get retested for a BiPAP or an ASV. |
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Awesome info folks.
My sleep study showed Obstructive Sleep Apnea predominately and did not mention any central apnea episodes specifically. I think part of my anxiety towards this started during my initial sleep study when the tech wanted to try a CPAP machine on me. They told me they might want to do that if the data indicated I would need it but, once awakened and groggy, I couldn't tolerate the mask or pressure with out panicking. I think being starved for O2 and then putting on a full face mask, etc., was more than I could do that night. I was unaware that it takes some people so long to get used to the CPAP machine usage. Maybe I missed that info thinking I would be good to go. Last night I turned the ramp-up to 0 and read a decent but intricate story-line book until I finally fell asleep. I actually made it thru until I got up at about 7:30 a.m. Seemed to do better without the ramp-up and having my mind off of breathing by reading helped me slip on to sleep. Half a nights success is positive advancement for me! I only remember waking up twice. Once real briefly because I had opened my mouth and the pressure was rushing out. Shut it and went right back to sleep. I don't think I sleep with my mouth open much at all though. One other time was about 4:00 a.m. because my nasal passages were dry. So I bumped the humidifier up to 6 and went on back to sleep. Are any of you using the climate line heated air tube? I am just using the basic tube now. If the humidifier level doesn't help I can pick up the heated one. Only negative I see on the nasal pillows right now is if I have to yawn when I am settling down to sleep. The full face mask let me yawn unimpeded but I have to pull the pillows out so I can get a good deep yawn. Other than that, no other problems and the nasal pillows are real comfortable. I may pick up the full face mask to try it again though. Thanks for the help. I will keep plugging along on this. |
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Quoted:
Awesome info folks. Last night I turned the ramp-up to 0 and read a decent but intricate story-line book until I finaly fell asleep. I actually made it thru until I got up at about 7:30 a.m. Seemed to do better without the ramp-up and having my mind off of breathing by reading helped me slip on to sleep. Half a nights success is positive advancement for me! I only remember waking up twice. Once real briefly because I had opened my mouth and the pressure was rushing out. Shut it and went right back to sleep. I don't think I sleep with my mouth open much at all though. One other time was about 4:00 because my nasal passages were dry. So I bumped the humidifier up to 6 and went on back to sleep. Are any of you using the climate line heated air tube? I am just using the basic tube now. If the humidifier level doesn't help I can pick up the heated one. Only negative I see on the nasal pillows right now is if I have to yawn when I am settling down to sleep. The full face mask let me yawn unimpeded but I have to pull the pillows out so I can get a good deep yawn. Other than that, no other problems and the nasal pillows are real comfortable. I may pick up the full face mask to try it again though. Thanks for the help. Use the nasal pillows myself. Eventually, you will be able to burp, yawn, and even talk while they are on and under pressure - at least I got to that point..... |
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Quoted:
Quoted:
Awesome info folks. Last night I turned the ramp-up to 0 and read a decent but intricate story-line book until I finaly fell asleep. I actually made it thru until I got up at about 7:30 a.m. Seemed to do better without the ramp-up and having my mind off of breathing by reading helped me slip on to sleep. Half a nights success is positive advancement for me! I only remember waking up twice. Once real briefly because I had opened my mouth and the pressure was rushing out. Shut it and went right back to sleep. I don't think I sleep with my mouth open much at all though. One other time was about 4:00 because my nasal passages were dry. So I bumped the humidifier up to 6 and went on back to sleep. Are any of you using the climate line heated air tube? I am just using the basic tube now. If the humidifier level doesn't help I can pick up the heated one. Only negative I see on the nasal pillows right now is if I have to yawn when I am settling down to sleep. The full face mask let me yawn unimpeded but I have to pull the pillows out so I can get a good deep yawn. Other than that, no other problems and the nasal pillows are real comfortable. I may pick up the full face mask to try it again though. Thanks for the help. Use the nasal pillows myself. Eventually, you will be able to burp, yawn, and even talk while they are on and under pressure - at least I got to that point..... this. your body will become accustomed to and work around the air pressure for such things. |
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good to hear you made some progress. I don't use a heated hose, as it's hot here already, in fact, with the humidifier warming the air, a few nights it's been warmer than I wanted it to be, but at least the sleep is good. Sounds like you're headed in the right direction. Keep it up! I do recall now that the first night I had the machine I had a moment of panic where I felt I couldn't breathe properly, but I just laid still for a few moments and concentrated on breathing deeply and the feeling passed. i haven't had that happen since. |
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Quoted:
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Another sleep tech here. A lot of times mouth breathing makes people feel like they're suffocating. It's a pretty common complaint. It could be part of the problem, but everyone's a little different. Sometimes having too much of the "comfort" pressure lowering and raising like EPR I found in some people makes them feel like they're smothering. Hopefully, you've got good support on this, though. Adjusting to CPAP can be pretty difficult. I'd say the vast majority of patients take weeks to get used to it. The first few nights can be really rough. Keep at it, and keep working on getting the mask and settings that are right for you. Getting the right mask can help a great deal- especially if you need a full face, finding the right one can make a vast difference. I figured there had to be another sleep tech here somewhere...pleased to meet you. Oral-breathers and high pressure levels tend to go hand in hand from what I see, especially with the issue of lower-jaw retro-pulsing. I'm betting the combination of oral airflow/high setting/nasal pillows is what is causing the problem. Another thing for OP to consider is that some people just simply can't tolerate CPAP, and may need to switch to a BiPAP unit for improved respiration. All the more reason to work with the physician and home-care people on this. This right here is your answer. I had the same issues, went through 3 different machines and all types of masks. Went BiPAP and full face mask and never looked back. I have been using the same machine for 7 years now and I sleep great. My BiPAP goes everywhere with me. If I lay down on Sunday afternoon for a nap I have it on. My doc gave me a mild sleeping pill perscription to help me get used to it when I first started. I think it took about 3-4 weeks and I tossed the pills. No issues now and would not think about sleeping with out it. Good Luck OP |
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I'm kinda new to the cpap lifestyle myself, I believe that a positive attitude toward using the device is one of the best things you can have. After reading several threads here where posters have used the term "changed my life for the better" I just decided I was going to force myself to use it and love it. Damn the awkwardness of sleeping with a gadget strapped to my face and a tube draped across the bed I'm just going to deal with it was my attitude. Obviously I can't say that I wasn't just lucky and took to it naturally, but I do believe that having a very positive attitude toward the treatment is more beneficial than anything else. My first night was a the best night of sleep I can remember in at least ten years and most nights have gone as well. I won't lie and say I haven't had a few nights where I fight the headgear but when I wake up with it on the floor I just put it back on and tell myself I'll sleep better with than without. On a resmed s9, nasal pillows, 10 pressure, and I did like others have mentioned and shut off the ramp up feature so I get full pressure as soon as the machine warms up. Don't know if you have a humidifier but I do not sleep as well if I don't have mine on at least 4.5-5 I wouldn't advise you to do anything without checking with you doctor but it might not hurt to ask if a benedryl or nyquil for a few nights would help you nod off and get used to the machine. |
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Maybe the pillows arent for you. Maybe BiPAP is the way to go.
I run a respironics comfort gel mask. I go full pressure right off the bat. I breathe BETTER with it on. My initial pressure was 12.5 but I bumped it up to 14 recently. Theres no point in suffering. Talk to the sleep therapist - I'm sure he can answer most questions as hes seen it all. ETA: theres a little trick that I used to get accostomed to the face mask. Put it on and try to talk. Once you are able to control your "palatte" and talk with the mask on (block out nasal pressure) you are home free. |
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Mine does the ramp up.
I'm in the 65 times per hour bracket with the OSA. I use the nasal ones, and I have to use a chin strap to keep my mouth shut. Though I still wake up with my mouth open and all of the air running out of it. I have taken a couple of nights off with out using it, the next day I have severe headaches and I crash on the couch. If I could get corrective surgery and not have to wear it, I would be happier. Posted Via AR15.Com Mobile |
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Quoted: Quoted: Quoted: Not sure what AHI is but I had a total respiratory disturbance index of 41.2 events per hour, if that is the same thing. EPR setting is 3 I believe and max pressure is set at 11. It was set up to ramp up to 11 in 5 mins initially and after I complained of the smothering sensation, the therapist suggested extending it to the full 45 mins to give me time to fall asleep before it reached max setting. I started with a full face mask in desensitization, tried out the nasal mask in the titration, moved to a smaller full face because I had trouble with the smothering using the nasal only mask and am now trying it with the nasal pillows. That is the most comfortable mask. I just feel like I am artificially breathing instead of relaxing and breathing normally. Then right about the time I drift off to sleep, I wake up gasping like I can't breathe. I assume I can't exhale well because my nasal passages are so narrow that I just don't have the volume to push back against the airflow, even with the EPR set at 3. At first I got a headache pushing against the pressure for half an hour to an hour so I assume the EPR is working - I don't know because I have not tried another machine. I appreciate everyone's input. This has been a miserable few nights. Ok, first step is to calm down a bit. This is going to take time and patience to sort out. Take a night off. Sleep without your mask tonight, the extreme exhaustion does you no good. 11 is a fairly high pressure for a new CPAP user, that takes time to get used to. I sleep at 12. Your AHI means Apnea-Hypopnea Index, its the total number of average Apneas and Hypopneas per hour that you experience. An Apnea is a stoppage of breathing for 10 seconds or longer, Hypopnea is shallow breathing where you don't get enough oxygen into your system...both are dangerous because they drop your oxygen saturation. 41 is severe. 30 and above is severe...but you don't have it the worst I have seen. I run a 65, and I know people who run a 120. You never answered one question I asked: What kind of mask? Full face? Nasal pillows? Nasal mask? Describe it and I can determine the type. Next question: What is the maker of your machine? Resmed? Respironics? If its a Resmed S9, I can show you how to enter the Clinician mode and change your Ramp, EPR, and Pressure. This is something you should NOT do unless you get educated on what these settings do, and how they effect your health...but most CPAP users have taken full control of their machine and they ultimately end up knowing as much or more than their doctors about their disease and the treatment for it. *SNIP* Parabellum, unless you are a physician, I'd highly recommend removing this part of your post for patient safety and legal reasons; it could be construed as practicing medicine. You do not want to be held responsible for the results of someone altering their prescription. This is the type of thing that drives doctors, sleep technologists, and respiratory therapists up the wall when a patient starts having problems. Critical CPAP/BiPAP unit parameters are locked-out from user control for a reason; any settings outside of ramp-time, C-Flex/A-Flex, etc, and humidifier heat should only be adjusted by a physician's order. As a sleep technologist, it's very frustrating when I have to fix a person's issues in the sleep center because someone decided to alter their equipment. This is why most CPAP/BiPAP units have their settings hard-coded on proprietary data cards. OP, if you need a full-face mask design to allow for oral airflow, nasal pillows alone is not going to help. The nasal pillows can actually increase the smothering sensation, it can be difficult to exhale back out of the pillows for some patients. If you naturally breathe through your mouth while asleep, you need a mask that will accommodate that. A mask that will only allow for oral airflow will feel like it is smothering you if your body needs to breathe orally. Contact your home-care provider and ask them about the ResMed Mirage Liberty interface. It's a hybrid mask that combines nasal pillows with a oral airflow design, it works very well for those who can't tolerate a traditional full-face design. You need to be talking to your physician to get this problem sorted out. Mirage Liberty I'm not worried at all. All of the info to unlock clinitian mode is available to the public on every sleep apnea forum on the planet. 10 seconds of google search and its there. P.S. - I set my own pressure under the specific recommendation of my ENT and my Resp Tech, they both encouraged me to learn as much as possible and drive my own changes in my own machine. The useless method of getting one sleep study per 1-3 months is a highly lucrative practice for you folks isn't it? How can you as someone in the medical field possibly suggest that a few sleep studies are enough data to make a scientifically valid choice for pressure? My THREE sleep study titrations produced a recommended pressure of 9. They never tweaked the EPR settings, or the humidity settings, or the ramp. It was a typical "plug and chug" assembly line sleep study where they did as little as possible to see my AHI drop below 5. Of course, then I got home and after downloading the software to analyze ALL of the data, I realized that I was having about one night a week at a score of 5, and the other nights I was spiking up into the 20s. If all I did was sit back and trust the "experts" I would never have seen (at least not for three months, which is the interval they told me to go get another $4000 sleep study at) that my TRUE AHI averaged over more than just a few nights was still in the 20s. I talked to my ENT about this, who totally agreed with me that the current way of asking for a $4000 sleep study, four times a year is a very inefficient way to solve this problem, and he suggested I take control of my own machine. After analyzing the data EVERY single night, and approaching the problem like a scientist (because that is what I am), I slowly changed my pressure by .2 units every week, lowered my EPR to 1, and removed the ramp feature, which was causing clusters of apneas early in the cycle before my pressure fully kicked in. Now that *I* have control of my machine, instead of averaging in the 20s and needing a $4000 sleep study to make a change in my machine, I'm averaging 0.5, never spiking above 3, and often running at a 0.2 for many nights. I appreciate that you are a sleep tech, but frankly, my experience with you folks was extremely disappointing. If I had relied on the members of your profession, I would have needed to throw another $12,000 at this problem and I still wouldn't be NEARLY as well educated about this disease. I stand by my statement: He should get educated, learn as much as he possibly can, and when he understands it, take control of his machine. CPAP treatment is no different than when a doctor prescribes a bottle of pills: The patient is ultimately handed the responsibility to take the medication as they see fit, with a strong recommendation from their doctor to follow the doctor's prescribed schedule. However, as most doctors will tell you, patients who need those medications for life (such as diabetics) ultimately end up becoming the people who monitor their condition and adjust their medications accordingly. If diabetics can monitor their condition and adjust their insulin regimen, when the consequences are possibly fatal, Sleep Apnea suffers can do the same, especially considering the risk is even less. OP: If you want help, or just to chat, send me a PM. |
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I am going on 3 weeks using a nasal mask. I still wake up several times during the night, usually because the mask starts leaking or I open my mouth. It does seem to be getting easier to leave it on all night.
I tried the nasal pillows in the sleep lab for an hour or so, but they seemed to dry out my nose more than the nasal mask. I found that I cannot take any sleep meds while using the mask. I seem to pull it off and I am not aware enough to put it back on. So far I have averaged 7.5 hours per night, and its made a noticeable difference in my daytime sleepiness. 
I have my ramp set to five minutes, and use the humidifier. The only downside so far, is that if I fall asleep on my right side, I swallow air and have to burp constantly. |
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Not sure what AHI is but I had a total respiratory disturbance index of 41.2 events per hour, if that is the same thing. EPR setting is 3 I believe and max pressure is set at 11. It was set up to ramp up to 11 in 5 mins initially and after I complained of the smothering sensation, the therapist suggested extending it to the full 45 mins to give me time to fall asleep before it reached max setting. I started with a full face mask in desensitization, tried out the nasal mask in the titration, moved to a smaller full face because I had trouble with the smothering using the nasal only mask and am now trying it with the nasal pillows. That is the most comfortable mask. I just feel like I am artificially breathing instead of relaxing and breathing normally. Then right about the time I drift off to sleep, I wake up gasping like I can't breathe. I assume I can't exhale well because my nasal passages are so narrow that I just don't have the volume to push back against the airflow, even with the EPR set at 3. At first I got a headache pushing against the pressure for half an hour to an hour so I assume the EPR is working - I don't know because I have not tried another machine. I appreciate everyone's input. This has been a miserable few nights. Ok, first step is to calm down a bit. This is going to take time and patience to sort out. Take a night off. Sleep without your mask tonight, the extreme exhaustion does you no good. 11 is a fairly high pressure for a new CPAP user, that takes time to get used to. I sleep at 12. Your AHI means Apnea-Hypopnea Index, its the total number of average Apneas and Hypopneas per hour that you experience. An Apnea is a stoppage of breathing for 10 seconds or longer, Hypopnea is shallow breathing where you don't get enough oxygen into your system...both are dangerous because they drop your oxygen saturation. 41 is severe. 30 and above is severe...but you don't have it the worst I have seen. I run a 65, and I know people who run a 120. You never answered one question I asked: What kind of mask? Full face? Nasal pillows? Nasal mask? Describe it and I can determine the type. Next question: What is the maker of your machine? Resmed? Respironics? If its a Resmed S9, I can show you how to enter the Clinician mode and change your Ramp, EPR, and Pressure. This is something you should NOT do unless you get educated on what these settings do, and how they effect your health...but most CPAP users have taken full control of their machine and they ultimately end up knowing as much or more than their doctors about their disease and the treatment for it. *SNIP* Parabellum, unless you are a physician, I'd highly recommend removing this part of your post for patient safety and legal reasons; it could be construed as practicing medicine. You do not want to be held responsible for the results of someone altering their prescription. This is the type of thing that drives doctors, sleep technologists, and respiratory therapists up the wall when a patient starts having problems. Critical CPAP/BiPAP unit parameters are locked-out from user control for a reason; any settings outside of ramp-time, C-Flex/A-Flex, etc, and humidifier heat should only be adjusted by a physician's order. As a sleep technologist, it's very frustrating when I have to fix a person's issues in the sleep center because someone decided to alter their equipment. This is why most CPAP/BiPAP units have their settings hard-coded on proprietary data cards. OP, if you need a full-face mask design to allow for oral airflow, nasal pillows alone is not going to help. The nasal pillows can actually increase the smothering sensation, it can be difficult to exhale back out of the pillows for some patients. If you naturally breathe through your mouth while asleep, you need a mask that will accommodate that. A mask that will only allow for oral airflow will feel like it is smothering you if your body needs to breathe orally. Contact your home-care provider and ask them about the ResMed Mirage Liberty interface. It's a hybrid mask that combines nasal pillows with a oral airflow design, it works very well for those who can't tolerate a traditional full-face design. You need to be talking to your physician to get this problem sorted out. Mirage Liberty I'm not worried at all. All of the info to unlock clinitian mode is available to the public on every sleep apnea forum on the planet. 10 seconds of google search and its there. P.S. - I set my own pressure under the specific recommendation of my ENT and my Resp Tech, they both encouraged me to learn as much as possible and drive my own changes in my own machine. The useless method of getting one sleep study per 1-3 months is a highly lucrative practice for you folks isn't it? How can you as someone in the medical field possibly suggest that a few sleep studies are enough data to make a scientifically valid choice for pressure? My THREE sleep study titrations produced a recommended pressure of 9. They never tweaked the EPR settings, or the humidity settings, or the ramp. It was a typical "plug and chug" assembly line sleep study where they did as little as possible to see my AHI drop below 5. Of course, then I got home and after downloading the software to analyze ALL of the data, I realized that I was having about one night a week at a score of 5, and the other nights I was spiking up into the 20s. If all I did was sit back and trust the "experts" I would never have seen (at least not for three months, which is the interval they told me to go get another $4000 sleep study at) that my TRUE AHI averaged over more than just a few nights was still in the 20s. I talked to my ENT about this, who totally agreed with me that the current way of asking for a $4000 sleep study, four times a year is a very inefficient way to solve this problem, and he suggested I take control of my own machine. After analyzing the data EVERY single night, and approaching the problem like a scientist (because that is what I am), I slowly changed my pressure by .2 units every week, lowered my EPR to 1, and removed the ramp feature, which was causing clusters of apneas early in the cycle before my pressure fully kicked in. Now that *I* have control of my machine, instead of averaging in the 20s and needing a $4000 sleep study to make a change in my machine, I'm averaging 0.5, never spiking above 3, and often running at a 0.2 for many nights. I appreciate that you are a sleep tech, but frankly, my experience with you folks was extremely disappointing. If I had relied on the members of your profession, I would have needed to throw another $12,000 at this problem and I still wouldn't be NEARLY as well educated about this disease. I stand by my statement: He should get educated, learn as much as he possibly can, and when he understands it, take control of his machine. CPAP treatment is no different than when a doctor prescribes a bottle of pills: The patient is ultimately handed the responsibility to take the medication as they see fit, with a strong recommendation from their doctor to follow the doctor's prescribed schedule. However, as most doctors will tell you, patients who need those medications for life (such as diabetics) ultimately end up becoming the people who monitor their condition and adjust their medications accordingly. If diabetics can monitor their condition and adjust their insulin regimen, when the consequences are possibly fatal, Sleep Apnea suffers can do the same, especially considering the risk is even less. OP: If you want help, or just to chat, send me a PM. Just because some facility did a poor job treating you doesn't mean you should encourage others to adjust their own settings. There are complications that can result. I can get files and trigger parts online, too, but I'm not dumb enough to try performing my own trigger jobs, or encourage others to do the same. No patient needs to be tested 4 times a year, and it takes a physician to order a sleep study in the first place. You got scammed by some inexperienced crooks, and your ENT should have caught it and sent you elsewhere to get retitrated. Don't blame the rest of our field for someone else's mistakes, trust and patient-confidence in what we do is what helps people accept and acclimate to CPAP. Do not take chances with someone else's health based off your own bad experiences. |