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New To CPAP...Hard to Breathe

This area is for CPAP Mask and CPAP Machine Related Questions used in the treatment of Sleep Apnea.


New To CPAP...Hard to Breathe

Postby jr991 » Mon Jun 06, 2011 12:00 pm

I have been on a CPAP machine for 2 weeks and I have only been able to keep it on for 2 nights and they weren't full nights. I find my breathing feels very restricted like I'm not getting enough air and it's even worse when trying to exhale. I've read about getting a machine that has exhalation relief and I am awaiting that. I;m just wondering is this something that is quite common for people that are new to CPAP or is it just me? Any other suggesstions for me?

Thanks!
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Postby cowlypso » Mon Jun 06, 2011 12:41 pm

CPAP can take some time to get used to. However, it sounds like you might need to make some adjustments. You don't say anything about what kind of mask, pressure, or machine you are using, so that makes it hard.

Is your mask comfortable? One thing that can help is to put on your mask with your machine running while you are awake in the evening. Watch tv, read a book, etc. It can take some time to get used to how everything feels and be comfortable with it. If you try this for an hour or so and really feel like you can't breathe, then there is probably a problem somewhere.

Does your current machine not have any exhalation relief available? As far as I know, all of the new machines come with this feature. This feature drops the pressure when you exhale and can help a lot.

What is your pressure setting? If it is too low (like if it's set at 4 or 5), then you are likely to feel like you can't get enough air through the mask. Is the machine set to your prescribed pressure?
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Postby SleepyToo » Mon Jun 06, 2011 9:52 pm

jr, in adddition to the excellent advice that cowlypso has given you, many of the new machines have a ramp feature that the providers (DMEs) LOVE to set at 4 cm pressure. However, to most "normal" (with apologies to those who do only require that pressure!) 4 cm is too low - you feel like you are suffocating. You are trying so hard to get extra air in with each breath that you actually feel like you are struggling to breathe out. So, the first thing to do is check whether you have the ramp feature turned on. If it is on, what pressure is it set at? If it is lower than your prescribed pressure, you should be able to increase the starting pressure by 1 or 2 cm (until you get to your prescribed pressure). If you can't figure out how to do that, you need to demand that your DME shows you. The ramp pressure is a COMFORT setting that makes no difference to your treatment except to make you more comfortable at the start. If you are not comfortable with it, something is wrong!

If that doesn't work, maybe your pressure is too low. If so, you need to talk with your DME again, because they can help ease the path to the sleep doc.

Please be proactive about your treatment - you don't have to suffer in silence! Your DME and doc will let you if you want, but that is not the way to get the best treatment for YOU!
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Diagnosed September 2009, Respironics System One w/ C-flex and humidifier
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Not a medical professional, just a patient with severe OSA (31) who has done a lot of reading.
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Postby cowlypso » Tue Jun 07, 2011 9:21 am

About the ramp: It is not automatically turned on with your machine. To turn it on, you have to push the ramp button on the machine. Once you push the button, if the starting pressure is too low, you can turn the dial on the machine to increase it.
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Postby wd4ity » Thu Jun 09, 2011 6:55 pm

I am new to CPAP as well having only used the machine for about two months. At first I had the same problem. When I would put the mask on and lay down, I felt like I couldn't get my breath. Claustrophobic. My machine was set to start at 4.0 and ramp up to 11.0 over a 20 minute time span. It was horrible. I changed the ramp time to 5 minutes and finally turned it off so it started at full maximum pressure. This was better but had it's own problems. I learned how to make the settings on my machine and I changed the setting to what I feel most comfortable with. I set the start up pressure to 8.0 but left the maximum to the prescribed 11.0. I now set the ramp up time to 10 minutes. Much better. Now, if I could only get the "plastic" smell out of my machine. I've cleaned it with mild soapy water and diluted vinegar. Still stinks when I put it on.
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new to cpap

Postby drowsie1 » Sat Jun 11, 2011 2:04 pm

I'm having same problems been on cpap 5 days now feel like I'm suffocating and having exhale problems. I'm taking it completely off in middle of night duroing my sleep I don't like this at all. always tired and seems to be worse on cpap than off. what am I doing wrong? my dr says wait a month. I also have depression and anxiety problems. mask makes feel like I'm hyperventilating and panic attack.
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Postby energy » Mon Jun 13, 2011 1:17 pm

I understand your breathing issues using your CPAP.
I was diagnosed with severe OSA a bit over 2 months ago, and even with a machine with C-FLEX (a slightly lower exhalation capability) and ramping (starting at a pressure of 6 to my level of 10), I have had great difficulty fully exhaling. I have a slow resperation rate, and didn't have time to fully empty my lungs before a "rush" of air pushed at me to take a breath. I believe I have had some complications, including daily headaches, because of this issue.

The other day I was given a BiPAP--VPAP (ResMed) S9 to try. It is great, and allows me to fully exhale. No headaches the past 2 days of use.

Perhaps a BiPAP could be a solution for you, as it allows for much greater variation in programing.

All the best to you.
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Postby CrohnieToo » Mon Jun 13, 2011 2:51 pm

There are several possible causes of your problems w/PAP therapy as mentioned by other members above. The remedy for each of which is to contact your local DME provider's RRT for help and if it isn't forthcoming then contacting your sleep doctor for help.

1] Verifying your set pressure is the titrated pressure as scripted
2] Ramp starting pressure
3] Ramp length of time
4] Ramp not needed
5] EPR or Flex setting too low, too high or not needed
6] Mask not comfortable, leaking too much
7] PAP not calibrated to produce the set pressure
8] Pressure need not adequately titrated during titration PSG
9] Defective PAP device

This is YOUR health, YOUR sleep, YOUR therapy, YOU are the one paying for it whether thru insurance or out of pocket is immaterial, YOU are still the one paying for it; YOU are the one who endures the benefits - or consequences - of this therapy - or any other test, procedure or therapy you AND your doctors agree to try; NO ONE has a more vested interest in YOUR health and welfare than YOU. YOU and your health care TEAM need to work TOGETHER to get optimum care for YOU and your health care TEAM can't help you IF they don't know you are having problems! Don't be bashful, speak up, seek help, that is what your health professionals are there for - and if they aren't there for you its time to dump them and find those who will work w/you to get the best care possoible. But YOU have to do YOUR part. Let them know you are having problems, ask for help.
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Postby drowsie1 » Mon Jun 13, 2011 3:22 pm

all my dr says is wait a month I tryed. I also ask for a refferal to a sleep dr and neurologist he laughed and said not necessary.
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Postby Janknitz » Mon Jun 13, 2011 3:44 pm

all my dr says is wait a month I tryed. I also ask for a refferal to a sleep dr and neurologist he laughed and said not necessary.



This is rotten treatment by your doctor. Is he your PCP? If you cannot use the machine successfully enough to log in sufficient "compliance hours" on your machine, the insurance won't pay for it. Waiting a month for help when you are having issues is setting you up for failure.

Does your insurance require you to get a referral from a primary care physician in order to see a sleep specialist or neurologist? Some insurance companies require the PCP to make the referral and penalize the doctor for making such refferals because specialists cost the insurance company more. But PCP's are NOT trained in sleep medicine and your PCP may have no idea what to do to make the settings more comfortable so that you can successfully use the machine.

Do you really want to stick with this doctor who may be putting his own concerns above yours? Maybe it's time to find a better doctor who will make appropriate referrals and take your concerns seriously instead of laughing at you.
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Postby drowsie1 » Mon Jun 13, 2011 5:19 pm

yes he is pcp and my insurance requires him to write a refferal. its been a week now I feel no different. than before. I feel I'm getting even less sleep and sometimes when I nap I leave it off to sleep. however between all my naps and night I'm sure I am wearing it well above the 4 hours. tired of being tired already.
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Postby CrohnieToo » Mon Jun 13, 2011 5:45 pm

Have you talked to your DME provider's RRT and asked him/her for help??

While 5 days can seem like an eternity when you haven't been sleeping for beans "forever" before even starting CPAP therapy, for most it is not an overnight miracle cure. You do need to give CPAP more time -BUT - you should be getting some help w/your problems from your DME provider's RRT. By all means contact him/her and ask for help!!!

It sounds like this jerk PCP isn't wise enough to realize what chronic lack of adequate sleep can do to our psyche as well as our physical health and has written you off as a depressed anxiotic. I'd start looking for another PCP.

Sometimes younger doctors recently starting out in practice and needing to build up their patient base have more time to spend getting to know their patients and more sympathy to their patients' needs than those who have been in practice awhile and are getting or are just plain jaded.

Either way you need to get out from underneath this PCP's heavy hand and get a decent doctor who recognizes his/her limitations!!! Contrary to what many of them would have you believe, doctors do NOT walk on water!!! They slip on the ice and fall flat on their face just like the rest of us.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
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Postby drowsie1 » Mon Jun 13, 2011 6:31 pm

just went to the place that's providing my cpap they gave me a new mask and looked at the memory card while I am taking it off sometimes there is no certain time. I am still well into my compliance hours and since my sleep study where I had apnea 11 times its now down to a 2.9 so how long till I feel better and will I have to do this forever? what are chances of being cured or success with dental guards I asked about having tonsils and adnoids but my pcp said my tonsils aren't large enough to worry with it. I really want a sleep specialist. thanks for all your advice.
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Postby Janknitz » Mon Jun 13, 2011 7:15 pm

If your AHI was 11 on the sleep study you have mild apnea so you might benefit from some alternatives like an oral device or weight loss. It would be good to talk to a qualified sleep doctor about options, but meanwhile it's important to get used to the CPAP as other methods are not always successful and they don't always work in the long term. CPAP, when used properly (all night, every night, at the correct pressure and with a well-fitting mask) is 100% effective.

2.9 is very good (anything under 5 is considered good) but most of us feel best when our AHI's are below 2. So there's still some tweaking that may be done. Perhaps the new mask will help, especially if you were having leaks or discomfort that kept you from being able to use the CPAP all night.

It takes time to get used to this. Right now your goal should be to gradually increase the time you use your CPAP each night. If you have somethng that's really making it tough (i.e. mask discomfort or leaking, pressure changes waking you, rainout, etc.) be sure to post and someone here will be able to help. The more you use your machine, the better you will feel, but it won't work if it's not on your face.
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Postby drowsie1 » Mon Jun 13, 2011 7:58 pm

that's the thing its mild so I wish I could see a specialist and I don't need to lose weight I'm 5'7. and weigh 125. so I am wanting all my options known. I am trying to get used it all.
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