I've been using the CPAP for about 5 weeks now. I am still having trouble exhaling. I start off with the ramp speed, and that helps. In fact I am starting to fall asleep with it on. But when I wake up, I am having trouble breathing out. My setting is at 18. Also, I have to sleep on my back. If I roll onto my side, I find it even harder to breath out.

I guess my 2 questions are, will I ever get used to the pressure and have less problems breathing out, and is this normal?

And 2, is this normal to have a harder time breathing laying on my side?

I am committed to this, I am not going to give up. Since i've been using the cpap, I can tell I have more energy and my mind is clicking better. I had a tough week, and am tired, mostly because I've been taking the mask off after a hour or so, and using it less. It is just this pressure thing i am having trouble with. I amgoing to talk to my doctor this week about reducing the pressure to 16 to see if this helps. I never did get a difinitive number for a setting because i never did fall asleap at the sleep study. So i guess i need to ask my doctor how they came up wth 18.

Any way, am i going to get used to the pressure and breathing out. I feel like i am sufficating some times.

Hi, dagowisler,

You might want to ask your sleep doc about trying bipap. It works with 2 different pressure settings; one for inhalation and a lower pressure setting during exhalation. For example, mine is set at 17 when I inhale, and 12 when I exhale. I'm not sure how it is determined for each person whether he needs cpap or bipap. I was told after my first titration that I didn't respond to cpap but did to bipap and I have been on it ever since.

I don't know what normal is regarding positional breathing. I find it much harder to breathe on my side than on my back, and my apneas occur when I sleep on my side. But I've noticed in this forum that most people are just the opposite--apneas when on their backs.

Just from looking at my own sleep study results, it's clear that the pressure settings matter. The object is to find the lowest pressure that gets rid of the apnea/hypopnea. You might be able to breathe out easier by lowering your pressure, but if it increases the number of events it would seem sort of pointless to do that. On the other hand, if the pressure is so difficult that you can't use the machine or don't get any sleep, it's not doing you any good anyway.

I think you'll get used to the pressure if you stick with it, but it would be a good idea to ask your doctor if that's truly the pressure you need and how it was determined.

Hi dagowisler

       My machine is set at 16, and at times it feel like a hurricane. I just make sure my mask is tight eniugh so the exhaled breaths don't escape thru the sides of the mask. I thought I was going to be put on the bipap machine but I wasn't. I guess I responded well enough with CPAP.

        I have a thought for you, one that has worked for me for years. I am generally a side sleeper myself. I start out on my back, and always end up on my side, with no problems. I've found over the years  that if your arm that you are not sleeping on is elevated, it's easier to breathe. I sleep with two pillows, one for the head, the other folded in half, and under supporting the other arm. Now your arm is elevated away from the side of your body. I can't sleep without two pillows now. Hey, what the heck, nothing ventured, nothing gained. Give it a try, maybe it will help your situatuion. If it makes a difference, it was an easy fix.

         If not, maybe SnoozeHunter has the answer with the bipap. Definately check with your doctor.

dagowisler wrote:

I never did get a difinitive number for a setting because i never did fall asleap at the sleep study. So i guess i need to ask my doctor how they came up wth 18.

You might want to ask the doctor to let you have a trial with an autopap (auto-titrating cpap) machine at home for a week or two.  That might give additional information about what pressure you actually need most of the time while you're in your normal sleeping environment...at home.

Ideally, an autopap will sense from subtle changes in breathing when the throat is beginning to close slightly and will adjust the pressure to keep it open.  It could very well be that moderate pressures would keep your throat open most of the night.  You might not need "18" except for brief times (or at all!) during any given night.

If the trial at home on autopap confirms that you do really need a high pressure most of the night, then a bi-level machine as described by SnoozeHunter would be more comfortable for you.

I'm not a doctor, but here's how I'd ask for the trial on autopap to be done:

Machine:  Respironics REMstar Auto with C-Flex
Pressure set at 8 - 20, C-flex set at "3"

Don't wait two weeks.  After 5 days, download the data.  Look at the DETAILED report for those days, not just the "Summary" report.  Look at the Daily detailed graphs/charts to get an idea how the individual nights went.  Instead of glancing only at the Summary's overall average (the quick, easy way out) take a look at those individual nights to see if there was a crazy leak that drove pressure up unnecessarily, skewing the "average"... or a lot of zig-zagging pressure up and down that could indicate a need to raise the lower pressure from 8 to, say 10 or 12 to give smoother treatment during the auto-titrating trial.

Yeah, I know...that kind of individual attention and continued data gathering after the study is not going to happen with most doctors or DMEs.   But ask the doctor, anyway.  You've got nothing to lose by asking.  Except possibly a pressure that you might not really have to be putting up with.  

dagowisler wrote:

I've been using the CPAP for about 5 weeks now. I am still having trouble exhaling. I start off with the ramp speed, and that helps. In fact I am starting to fall asleep with it on. But when I wake up, I am having trouble breathing out. My setting is at 18. Also, I have to sleep on my back. If I roll onto my side, I find it even harder to breath out.

I guess my 2 questions are, will I ever get used to the pressure and have less problems breathing out, and is this normal?

And 2, is this normal to have a harder time breathing laying on my side?

I am committed to this, I am not going to give up. Since i've been using the cpap, I can tell I have more energy and my mind is clicking better. I had a tough week, and am tired, mostly because I've been taking the mask off after a hour or so, and using it less. It is just this pressure thing i am having trouble with. I amgoing to talk to my doctor this week about reducing the pressure to 16 to see if this helps. I never did get a difinitive number for a setting because i never did fall asleap at the sleep study. So i guess i need to ask my doctor how they came up wth 18.

Any way, am i going to get used to the pressure and breathing out. I feel like i am sufficating some times.

Hi Dagowisler,

18 is a pretty high pressure, particularly for a basic machine, whose top pressure is 20. It must be hard just keeping the mask on your face  

With such a high pressure I am surprised that Bi Level (BiPAP) wasn't mentioned to you. I think it would be more appropriate as it allows for a lower pressure to exhale.

Another option might be auto adjusting PAP (APAP) which will only deliver sufficient pressure to clear a specific apnoea event. This means that you might not require the full 18 setting all night.

If a proper titration study was not completed, it would be beneficial to have an APAP machine (rental) for a week or so to determine the correct pressure (by way of data card).

You certainly need to discuss the 'whole' thing with your doctor.

Post back with any more queries.

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Hi Snooze hunter, pauly, Rested Gal, and Daniel,

WOW, thanks for the replys. I work nights and get to be at 5 or 6am, so I don't get on the internet until late afternoon. I am going to talk to my doctor next week. I really do like the machine I have now, RESTAR, and the nose mask works GREAT. With the high pressure, it does not leek at all, and stays on my face with no effort.  I talked to my respetroy guy about a C-FLEX machine and he told me that they did not make that much of a difference, and that it would not benefit me any more. Last night, fell into a DEEP sleep with it on, for maybe the second time, and I felt pretty good about that. I just need to get used to sleeping on my side with it on. I am going to give PAULYs suggestion a try, because I really want to get used sleeping on my side.

My problem with changing machines now is, my deductable on my insurance. My deductable is met for 2005. If I buy the machine now, I need to pay 20% of the cost. If I buy one in 2006, my deductable starts all over and it has to be met before they cover any of it, so I will be responsible for $1,000. So I am thinking since I do like the  REMSTAR, I am just going to go with it. I just think it will just be a matter of time getting used to it. But I am going to talk to my doctor about the situation and a machine, the setting and how they came up with it.

MAN . . . .thank guys for the reply, this web site is a god send. I spent an hour after work last night going through the old subjects. Since I am new to this, there is a lot of good advice and just knowing I am not alone in this thing is help.