Choking Sensation

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Choking Sensation

Postby Jackie » Mon Nov 14, 2005 5:08 pm

I've been using a C-pap machine on and off for several months. I have not been able to sleep more than 2 hours at a time and wake up every night with a dry mouth and sore throat. I've had the pressure increased, changed from a full face to a nose mask and use a breath right nasal strip at night without any success. Lately I've been waking up with a sensation of choking - like something is stuck in the back of my throat. I have not had heartburn or any taste in the back of my throat so I'm pretty sure its not GERD. Any suggestions on how to eliminate the sore throat and dry mouth as well as the choking sensation. Thanks for your input!

Jackie
Jackie
 

Re: Choking Sensation

Postby Daniel » Mon Nov 14, 2005 7:39 pm

Jackie wrote:I've been using a C-pap machine on and off for several months. I have not been able to sleep more than 2 hours at a time and wake up every night with a dry mouth and sore throat. I've had the pressure increased, changed from a full face to a nose mask and use a breath right nasal strip at night without any success. Lately I've been waking up with a sensation of choking - like something is stuck in the back of my throat. I have not had heartburn or any taste in the back of my throat so I'm pretty sure its not GERD. Any suggestions on how to eliminate the sore throat and dry mouth as well as the choking sensation. Thanks for your input!

Jackie


Hi Jackie,

Using cpap 'on and off' is really the equivalent of not using it.

What type of apnoea do you have ? (mild, moderate or severe), the more info the better.

Are you using the nasal strip instead of cpap, or with cpap ? What type of machine are you using, type of mask and pressure setting ?

A dry mouth and sore throat usually point towards mouth breathing with a nasal mask, or leaving your mouth open. With a nasal mask you must breath in and out through your nose, and keep your mouth closed.

The more info you post, the more likely you are to get some good responses, otherwise the content of the responses tends to wander from the main topic.

Post back,

Daniel.


If you are not using cpap all the time, I suspect that the choking sensation is in fact a severe apnoea event.
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

Re: Choking Sensation

Postby Jackie » Tue Nov 15, 2005 11:09 am

Daniel,

At the time of the sleep study the doctor told me I stopped breathing an average of 20 times per hour. I believe that is considered to be moderate apnoea.

Basically I'm using a nasal strip every night whether or not I use the cpap. The machine I use has heated humidity (sorry I don't know the brand or model). Originally I used a full face mask (I believe it is a mirage brand mask) and was set at a pressure setting of 6. I had a lot of problems at that setting and woke up every night with a dry mouth, sore throat and feeling like I was suffocating.

My doctor increased the pressure to 9. Although I stopped waking up feeling like I was suffocating, I continued to wake up in the middle of the night with a sore throat and dry mouth. I went back to the doctor again who instructed me to start using a breath rite nasal strip with the mask. This did not alleviate my symptoms.

I also had some trouble with the full face mask. In order to prevent the mask from leaking, I had to tighten it so much I had indentations on my face to the point that even though I would remove the mask between 2 and 3 AM, I would still have marks on my face at 11 AM. In addition, I started breaking out around the mask line. I tried using lotion on my face to alleviate the break out but it didn't help and it actually prevented me from getting a good seal and I was having a lot of leakage.

I tried adjusting the moisture setting on the machine and went from zero to six. Unfortunately this did not help my symptoms so I switched to a nasal mask. My thinking was that if I didn't have to take the mask off in the middle of the night to get a sip of water then I would keep the mask on and eventually get used to sleeping through the night with it. I used the nasal mask for several weeks and then stopped using it for a while. Okay, I know I should have continued to use it but I was moving and since I could not sleep more than an hour or two with the mask on I decided to stop using the cpap for a while. Now that I'm settled I am using the cpap again. I continue to have the dry mouth, sore throat and the past couple of nights I've awoken with a choking sensation.

Although it is possible I am breathing through my mouth, it should not have mattered when I had the full face mask particularly since I do have a unit with heated humidity. I might add that I do use distilled water and clean the unit either daily or at minimum every other day. I clean the mask two or three times a month and disconnect the tubing and hang it every day to avoid moisture build up.

As a side note, I continue to have problems maintaining a tight seal with the mask. Even though I remove the mask by 2 AM, when I wake up several hours later I still have indentations on my face from the mask. I know its too tight but I can't maintain a good seal on the mask without keeping it that tight.

Jackie
Jackie
 

Re: Choking Sensation

Postby Daniel » Tue Nov 15, 2005 12:28 pm

Jackie wrote:Daniel,

At the time of the sleep study the doctor told me I stopped breathing an average of 20 times per hour. I believe that is considered to be moderate apnoea.

Basically I'm using a nasal strip every night whether or not I use the cpap. The machine I use has heated humidity (sorry I don't know the brand or model). Originally I used a full face mask (I believe it is a mirage brand mask) and was set at a pressure setting of 6. I had a lot of problems at that setting and woke up every night with a dry mouth, sore throat and feeling like I was suffocating.

My doctor increased the pressure to 9. Although I stopped waking up feeling like I was suffocating, I continued to wake up in the middle of the night with a sore throat and dry mouth. I went back to the doctor again who instructed me to start using a breath rite nasal strip with the mask. This did not alleviate my symptoms.

I also had some trouble with the full face mask. In order to prevent the mask from leaking, I had to tighten it so much I had indentations on my face to the point that even though I would remove the mask between 2 and 3 AM, I would still have marks on my face at 11 AM. In addition, I started breaking out around the mask line. I tried using lotion on my face to alleviate the break out but it didn't help and it actually prevented me from getting a good seal and I was having a lot of leakage.

I tried adjusting the moisture setting on the machine and went from zero to six. Unfortunately this did not help my symptoms so I switched to a nasal mask. My thinking was that if I didn't have to take the mask off in the middle of the night to get a sip of water then I would keep the mask on and eventually get used to sleeping through the night with it. I used the nasal mask for several weeks and then stopped using it for a while. Okay, I know I should have continued to use it but I was moving and since I could not sleep more than an hour or two with the mask on I decided to stop using the cpap for a while. Now that I'm settled I am using the cpap again. I continue to have the dry mouth, sore throat and the past couple of nights I've awoken with a choking sensation.

Although it is possible I am breathing through my mouth, it should not have mattered when I had the full face mask particularly since I do have a unit with heated humidity. I might add that I do use distilled water and clean the unit either daily or at minimum every other day. I clean the mask two or three times a month and disconnect the tubing and hang it every day to avoid moisture build up.

As a side note, I continue to have problems maintaining a tight seal with the mask. Even though I remove the mask by 2 AM, when I wake up several hours later I still have indentations on my face from the mask. I know its too tight but I can't maintain a good seal on the mask without keeping it that tight.

Jackie


Hi Jackie,

Thanks for the info, but to progress please post the detailed name of the mask. I think it might be an ultra mirage, but can't be certain.

Without changing you mask I think you should look at the straps. I think you have them too tight, which will actually cause leaks...........Yes.

IF it is an ultra mirage mask, you will find two pads for your forehead, with a ratchet type device between them and the mask. Firstly, strap tension should be close to loose, rather than tight, maybe even snug and should be fairly even. If the top strap is too tight, leaks at the bottom and if bottom strap too tight then leaks into the eyes. The ratchet device clicks forward and backwards and should be set to suit your facial structure........far back if your forehead recedes behind the level of your lower face and forward otherwise...........trial and error. Take your time setting it up, even disconnect the hose and do it in the living room.

After turning on your machine, allow the air to fill the 'bubble' between silicone 'skins' on the mask. This is what will create the seal. If you become aware of a leak, don't tighten the straps, but lift the mask off your face and lower it again. Straps MAY need a little tightening but not TOO TIGHT. Tight straps force the silicone 'bubble' to collapse and creates leaks not to mention sores on your nose and marks on your face.

I think if you become less tense and more amenable to the mask the soreness etc will disipate. The dryness and sore throat are often associated with an open mouth during sleep. The dryness might also exacerbate the choking sensation.

If you are still having problems, post back, but in the meantime I suggest you try this.

If its any help, in my more lucid moments :lol: I will admit that it took me many months to come to terms with this therapy but you have to persevere. I know its not easy (its certainly not natural), but there is plenty of help available here.

Kind regards,

Daniel.
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

Postby shreck » Wed Nov 16, 2005 2:54 am

I get dry mouth when my heater is off, to low or when it's to high and I run out of water around 5 am. It seems to be a tricky balance to keep the heater where it works best.

For me, when I feel like I'm choking it's just stress or I'm using purified water instead of distilled. (It's amazing how much better distilled is) Unfortunately for the "stress" if I take a xanax, I'll get past the choking, but I always wake with a headache.
Everything, but green
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Postby Guest » Wed Nov 16, 2005 3:04 pm

Shreck: Thanks for your input. I've never used anything except distilled water and I'm pretty anal about keeping it full so I've never run out. I did try the machine once without water in the very beginning and have used water ever since. I'm still playing with the settings but haven't found the right balance yet.

I moved a few weeks ago so I guess the choking sensation could be stress...the jury's still out on that one :)


Daniel: I checked my masks and the one I am currently using is a Profile Lite Nasal Gel Mask. My full face mask is a ResMed Ultra Mirage. I stopped using the full face mask several months ago.

I did try adjusting the straps last night but didn't have much success. I had a lot of leakage but discovered if I tilted my head back as far as I could comfortably go the position eliminated most of the leakage. I was pretty good about keeping my head still for a while but eventually shifted positions and the leaking started again.

I also tried removing and reseating the mask. I guess this method only alleviates leakage with the the Mirage mask since the leakage was worse after I removed and reseated the Profile mask.

I eventually ended up over tightening the mask. I've taken to covering the clock at night and don't know how long I slept but I didn't make it through the night with the cpap and still have an indentation on my forehead from the mask.


I guess I'll just have to keep playing with the straps and the settings and hope for the best. Thanks for the support!

Jackie
Guest
 

Postby Daniel » Wed Nov 16, 2005 5:45 pm

Anonymous wrote:Shreck: Thanks for your input. I've never used anything except distilled water and I'm pretty anal about keeping it full so I've never run out. I did try the machine once without water in the very beginning and have used water ever since. I'm still playing with the settings but haven't found the right balance yet.

I moved a few weeks ago so I guess the choking sensation could be stress...the jury's still out on that one :)


Daniel: I checked my masks and the one I am currently using is a Profile Lite Nasal Gel Mask. My full face mask is a ResMed Ultra Mirage. I stopped using the full face mask several months ago.

I did try adjusting the straps last night but didn't have much success. I had a lot of leakage but discovered if I tilted my head back as far as I could comfortably go the position eliminated most of the leakage. I was pretty good about keeping my head still for a while but eventually shifted positions and the leaking started again.

I also tried removing and reseating the mask. I guess this method only alleviates leakage with the the Mirage mask since the leakage was worse after I removed and reseated the Profile mask.

I eventually ended up over tightening the mask. I've taken to covering the clock at night and don't know how long I slept but I didn't make it through the night with the cpap and still have an indentation on my forehead from the mask.


I guess I'll just have to keep playing with the straps and the settings and hope for the best. Thanks for the support!

Jackie


Jackie,

Get on to whoever sold you the mask. I'm not familiar with the profile lite.............it doesn't have a great name on this side of the pond. Don't ask me why. Funny enough nasal pillows are not very popular either, however they are starting to become a little more popular since ResMed started producing them.

You should have been properly fitted for the mask and someone should have spent a little time with you, or given you some time at their premises if you call. I sometimes rant a little on this, but THE MASK is everything.

You will have to make a little noise here and demand your rights as a consumer. DME suppliers are the same the world over.....you have to push.

Best of luck,

Daniel
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

Update

Postby Jackie » Tue Dec 13, 2005 5:14 pm

I went back to the original supplier of the mask for another fitting. Basically they suggested instead of taking off the mask by un-doing the velcro each night they recommended I slip the mask on and off over my head (the mask does not have clips so I was 'starting from scratch' each evening with the adjustment). That worked for a little while but it didn't last long.

I continued to have problems with the mask leaking and contacted the sleep center for an appointment. While I was waiting to be seen at the sleep center, I discovered that I had an Upper Respiratory Infection. I started taking medication and once the URI cleared up, the choking sensations stopped; however, I continued to have problems with the dry mouth, sore throat and leaking. In addition, I started having problems breathing with the mask and after a couple of evenings realized it wasn't related to my URI...there was a crack in the tube and I wasn't getting the pressure I needed.

I got a new hose and a chin strap. This helped but did not elminate the leaking or sore throat/dry mouth. I spoke to the doctor at the sleep center who informed me that a dry mouth/sore throat is an indication that the cpap pressure is too low. We discussed the mask problem and he suggested I speak to the respiratory specialist at the sleep center. Since I was having so many problems with leakage we decided not to increase the pressure until I could get the leaking under control.

I made an appointment with the respiratory specialist who took one look at my mask and immediately informed me that it was too big for my face which was why I was having so much trouble with it leaking.

We spent a long time going over the other mask options available and after much deliberation I decided to go with the Resmed Mirage Swift Nasal Pillow System. Of course, they did not have any in stock so an order was placed. The nasal pillows FINALLY came in yesterday. Last night was my first night with them. Its an adjustment for sure but I can honestly say I did not wake up with a sore throat or dry mouth this morning. I'm not sure if the new mask is the reason or not but I'll take what I can get!!

Hopefully the new mask will do the trick.
Jackie
 

Re: Update

Postby Daniel » Tue Dec 13, 2005 6:09 pm

Jackie wrote:I went back to the original supplier of the mask for another fitting. Basically they suggested instead of taking off the mask by un-doing the velcro each night they recommended I slip the mask on and off over my head (the mask does not have clips so I was 'starting from scratch' each evening with the adjustment). That worked for a little while but it didn't last long.

I continued to have problems with the mask leaking and contacted the sleep center for an appointment. While I was waiting to be seen at the sleep center, I discovered that I had an Upper Respiratory Infection. I started taking medication and once the URI cleared up, the choking sensations stopped; however, I continued to have problems with the dry mouth, sore throat and leaking. In addition, I started having problems breathing with the mask and after a couple of evenings realized it wasn't related to my URI...there was a crack in the tube and I wasn't getting the pressure I needed.

I got a new hose and a chin strap. This helped but did not elminate the leaking or sore throat/dry mouth. I spoke to the doctor at the sleep center who informed me that a dry mouth/sore throat is an indication that the cpap pressure is too low. We discussed the mask problem and he suggested I speak to the respiratory specialist at the sleep center. Since I was having so many problems with leakage we decided not to increase the pressure until I could get the leaking under control.

I made an appointment with the respiratory specialist who took one look at my mask and immediately informed me that it was too big for my face which was why I was having so much trouble with it leaking.

We spent a long time going over the other mask options available and after much deliberation I decided to go with the Resmed Mirage Swift Nasal Pillow System. Of course, they did not have any in stock so an order was placed. The nasal pillows FINALLY came in yesterday. Last night was my first night with them. Its an adjustment for sure but I can honestly say I did not wake up with a sore throat or dry mouth this morning. I'm not sure if the new mask is the reason or not but I'll take what I can get!!

Hopefully the new mask will do the trick.


Great stuff Jackie.

Keep up the good work. As I said, DME suppliers are just interested in sales. If you are feeling up to it, you should go back and demand a full refund for the ill fitting mask...........they have a nerve (as do they all, the world over).

Keep us up to date.

Kind regards,

Daniel
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

Postby Linda » Tue Dec 13, 2005 6:24 pm

Jackie,

I'm glad to see that maybe the nasal pillows will work for you. Keep us posted.
I have a nose mask, never used the nasal pillows, but many people really like them. And they just might do he trick for you.
Good luck!


Linda
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