[CPAP] Anxiety, Panic, Depression worse on CPAP

[Brendon]

Hello, 

I'm totally new to this CPAP stuff. 

I recently got diagnosed with moderate/severe sleep apnea and I also suffer from horrendous anxiety and depression. 

My anxiety and depression was "managed" sorta but the mornings and most of the day leave me with headaches, disorientation, fatigue, nausea, spaced out to the point I can't even realise what is what. I thought it was due to side effects of the anti depressants I am on, then I was diagnosed with he sleep condition where I stop breathing at alarming rates in sleep. I wake up basically paralyzed and crippled with terrible anxiety, panic and depression every morning. 

I got a CPAP machine from the Therapist last Tuesday and tried it Tuesday night. Here are the issues and the problems I am facing with it..i feel worse! 

- I am struggling to sleep with the mask really being intrusive and the air seems to be making me panic and anxious and for some reason. It is the mask that has the nostril things and a band that goes over the head. I am suffering from even more crippling depression since using it. 

- when i do sleep, I wake up in the middle of the night with panic and anxiety and struggle to go back to sleep. 

- I am also struggling to eat during the day, I can hardly move and i feel more bloated.. which is a huge reason that I needed addressed in the first place. I also feel super sick, headachy, sore arms, legs as well. 

- The following day, I'm an even more mess than I was and it feels like the one thing that all the Doctors, therapists said would help is making me an even more mess and it is intolerable. 

I have adjusted settings for pressure etc and notified the Therapist last Wednesday but I got no reply. I'm also worried that although my insurance covers it, I have to pay basically 2.500 up front first and I don't have that money, let alone it not working. 

I know there is a period where it takes a bit to get used to but I an unsure if I'm even using it right or how long these side effects will last. My Therapist will have ideas but I can't see it being anything other than " seeing it out" if anyone knew what I go through on a daily basis for the last 30 years would know that this is basically my last hope in terms of feeling somewhat ok physically and mentally. 

Sorry for the rant, I'm just super annoyed, sick and feel so trapped.

[SarcasticDave94]

Hi Brenden, and welcome to Apnea Board.

Some of the issues you struggle with right now can diminish with usage of the CPAP machine. It can be very disrupting to body reactions to endure apnea events. I would suggest you try to get OSCAR installed on your PC so that you can view the data from the CPAP. You would need an SD card inserted in the DreamStation overnight to store the data, and then use it as well to transfer data onto the PC and OSCAR.

It would be a great benefit to us here on AB to see this data so we can help you with the therapy. It would also be helpful if you requested your CPAP Setup Manual from the top banner for your exact device. This helps to understand the machine settings. It's very likely that the doctor set up your CPAP with less than ideal pressure settings. Unfortunately, it happens to most apnea patients.

Post the OSCAR data here in a response post and we can see how to help. Best to you on this.

[Brendon]

Thanks so much for your reply,

Tonight will be the 5th night on it, I am very hesitant to continue as I am unsure if it is doing more harm than good.

I have had a look over the settings, and I didn't find one that made me feel comfortable. Maybe the therapist has the ability to add at her end i am not sure. I just can't continue in this way for much longer, it is affecting my work...well the sleep apnea does but since Tues, it is a new level of nausea, headaches, depression, anxiety etc etc.

I will see if I can get the data and the setup manual.

Thanks!

[SarcasticDave94]

You're quite welcome. In the meantime, it's your call to use or not. You have to decide that for yourself and it's not up to us to make you do what you'd rather not. I've been there before as well. Try to find what your settings are currently, and then at least we have some info. I seriously suspect the pressure setting is too low, causing air starvation. It would feel a bit like one nostril is plugged and you cannot breathe in enough without a big struggle. If so, it is fixable rather quickly.

If you are interested in getting into the Clinical Menu, holding the Ramp button and the dial for about 5 seconds gets you into it.

[Gideon]

Welcome to the forum.
The best thing you can do is to install OSCAR and make sure you have an SD card in your machine overnight.
The post the nightly charts after one night.

This will provide data and honestly we are pretty good at getting things straightened out quickly.

Very few get optimized therapy with their initial settings, it happens, but it is rare.

Everything you say is bad is most likely caused by non-optimized settings. Think about it. They were determined while you were in a strange room, on a strange bed, with a strange pillow, and you were put on this machine, wearing a mask all night, and just to add I sult to injury, you were ffully wired up like never before with strange people watching you sleep while recording everything.
That was completely normal for you right? Didn't think so.

Then your settings were determined by a 10 to 20 minute segment of that normal night looking good.

Setting pressure of 4 to 20 is done because doctors know the machines will adjust pressure and assume this will provide optimal treatment, it won't.

Once we see and have you adjust your settings I would like you to do an enjoyable activity with your mask on and under pressure. This includes reading, watching TV, playing games on the phone. This is to help you get used to your machine. Let your body learn that this is now normal

Ok?

[Brendon]

Hey, 

I tried to add some photos and the link for setup guide and model but it would not let me attach them as I had to have 4 posts or something. 

It is the Philips-Respironics Dreamstation series Machines (Dreamstation Auto BiPap, Dreamstation Bipap pro, Dreamstation Auto CPAP, Dreamstation CPAP Pro & Dreamstation CPAP link. I have no idea which one I have as the manual I got covers all of those models. 

Therapist said to start out on 4cmH2O then move up to the 6cmH2O. That us as high as it goes and the only 2 options..unless that get can be altered by the Therapist I dunno. I overheat a lot so anything warm makes me worse..I have always been overheated though. I see there are settings for the tube and I think it is the heat? On the main display screen too..anything other than cold air would make me overheat even more.

I'm not sure what the ramp feature really does and since I don't have a setting that works, I'm afraid to use it. There is ramp, ramp time, tube type as well. 

I see a lot of ppl seem to have similar issues but not sure why it would make my depression, anxiety, nausea and not being able to eat worse though. 

Using Resmed mask, the sort that has nothing over over the mouth but 2 rubber nasal buds - always feels super congested too. The mask is on right..I think..it's not too tight or too loose. There sometimes is air coming out of the bud due to it sometimes coming out from my nose too and gets quite loud. 

Thanks

[Sleepster]

Brendon, I have gone through what you're going through now, with many of the same symptoms.

You have to realize that of course, at first, things can very easily get worse before they get better. It's a lot harder to sleep when you've got the mask attached and that air blowing in your face. So all of the problems you have that are caused by poor sleep are going to get worse at first because you're getting even less sleep than before.

The good news is that you will start to adapt, and there will be times when you'll wake up and feel like you've actually gotten some real sleep for the first time in years. It wan't be a full night's sleep at first, but you will notice the improvement.

The worst thing you can do now is to give up. You must keep going, using the machine every time you sleep, all the time you are sleeping. That's the fastest way to adapt.

If the bloating persists tell your care providers, they may need to switch you to a BiPAP to relieve the bloating. Lowering the pressure can also help. In my case I had to do both, and then I slowly raised the pressure back up where it needed to be.

You can do this!

[SarcasticDave94]

A pressure of 4 is not helpful for an adult. 6 would be an improvement, but is it the best setting for you? We don't know that yet. And like I said earlier, if you hold Ramp and the Dial in for about 5 seconds, you're in the clinical setup menu. I'm not certain what Canada allows, but machine adjustment is easy.

Stick with us, I'm not trying to put you down. It's difficult for most, especially with little doctor support. But that's how they typically treat those with apnea. And that's also why Apnea Board exists.

As for machine, remove the water tub. Look for an ID sticker on the back or bottom of the main unit. Find a series of numbers and letters starting with DSX then numbers, letters again. That's the ID.

[SuperSleeper]

I tried to add some photos and the link for setup guide and model but it would not let me attach them as I had to have 4 posts or something.

Hi Brendon, welcome to Apnea Board! 

There is no post-count required for new members-- you can attach a file or image immediately in your very first post.

The 4-post requirement is for linking to files that are off-site (on another website).

But you can attach any file you wish now.

How to attach a file:
http://www.apneaboard.com/forums/Thread-...ttachments

[Dormeo]

Brendon, there are lots of subtle connections between sleep apnea and anxiety or depression.  If you feel like reading about this, there's a study you might want to look at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548844/

It may help you with your reactions to using the PAP machine at night if you give yourself a break on that, maybe for 3 days.  Instead, set the machine up outside your bedroom during the day or evening, and use it for at least 4 hours, watching TV, using your devices, or reading -- whatever is pleasant and diverting for you.  This helps you get used to the new sensations and may help to reassure your brain that it's all OK, no reason to worry.

This also gives you a chance to play around a little with the mask to get it the way you want it.  Sounds like you have what is called pillow mask, with the two little units that sit there on the end of your nose.  Usually there's a little play that allows you to bend them a bit before you seat them.  You might be able to find a more comfortable position for the pillows, and maybe one that is less likely to leak air (which really is noisy!).  Best of all would be if you can do that lying down on a sofa or reclining chair; mask fit can be a little different sitting up and lying down.

After this period of adjustment, you can go back to night-time use.  Your goal, of course, is to use the machine all night, but you don't have to reach it in a single bound.  Maybe the first night your goal is 2 hours.  If you wake up having trouble after 2 hours, don't fret; just stop, knowing you met your goal.  In another night or two, set a new goal -- and so on.

That bloated feeling is not unusual.  Sometimes we hoseheads get some "aerophagia," meaning we swallow some air at night.  Usually this subsides on its own over time.

Is your minimum pressure currently at 4 or is it higher?  If it is at 4, you can change it to 6, and should.  Here is how to get to the "secret" menu of settings and make the change:

Press and hold both the control dial and the Ramp button on the device for at least 5 seconds. You are now in Provider Mode. To adjust a setting, rotate the control dial to your desired menu option, then press the control dial to select that setting. Rotate the control dial to change the setting. Press the control dial again to save the change. Select the "Home" icon to exit Provider Mode and return to Patient Mode.

While you are in the Provider Mode settings, could you take a look to see what your maximum pressure is?  It might be 20, or it might be something lower than that.

Finally, do you have a laptop or desktop computer?  How do you feel about using the Oscar software?

There are a lot of people here who can help you. Your moderate to severe apnea poses long-term health risks in addition to keeping you from feeling your best day to day. It is hard to stick with CPAP when you're off to a rocky start, as the majority of us were, but really worth doing.