[CPAP] Difficulty breathing, panic attack, suffocating sensation

[Amandine]

I signed up today for this forum. I obtained my RemStar Auto A-Flex on Sept 29. I have been diagnosed with mild sleep apnea but my last sleep doctor said the second sleep study was really inconclusive (??).

I am struggling with the machine. I started with the nasal pillows then switch this past friday to the full face mask Quattro Air. It is better for me (according to the respiratory therapist) since I have on an off nasal congestion all day long (seeing ENT doctor Thursday since previous medications not working).

I have only been able to tolerate the mask for less than 5 minutes at a time during the day while awake. I have not been able to sleep with it. Both the nasal pillows and full face mask have given the same results. I feel that I am suffocating; I need to take big gulp of air in; my chest gets tight and I can't therapy. I cannot fathom going on even though I have tried and ended up with (I think) a panic attack. I spend the rest of my awaken hours gulping for air. I stopped using it all together for a week until I got the full face mask then the same thing happened with it. However, the first day with the full face mask I was able to stay longer with the mask and repeated 2-5 minute sessions probably 6 times with pause in between. I stopped because of the same symptoms described earlier. That was Friday night while awake (Oct 10). I barely slept that night when it was time to go to bed. I was afraid of sleeping because I had a panic attack after my 6 sessions of 2-5 minutes. I suddenly felt that I could not breath at all and will suffocate in my sleep. I did finally fall asleep for 4 hours (no APAP while sleeping). I tried again during the day today Sunday but seriously, I only kept it on for 10 seconds twice and my chest tighten again. I cannot fathom going back to have the mask on face again today just to try to get used to it. I have spoken to the respiratory therapist on call this weekend and he told me to try breathing slowly and to psychologically rationalized the process. I have tried but the sensation of suffocating takes over so I have to stop the machine.

I was thinking of seeing the respiratory therapist to see if maybe I need a higher air pressure. What do you think?

What do you suggest I do about this psychological blockage and possibly physical (higher pressure level?) need?

Are the sleep specialist and respiratory therapist suppose to educate and provide support through this transition/trial period of 3 months. I am just upset that they seem to be of no help.

I have started reading threads on the forum and saw the video for newbies about sleep disorders. I am pretty scared that the machine won't work for me, so what do I do? Maybe weight lost will cure me of it. I am 5'2" and 163 pounds. According to BMI I am overweight and need to loose at least 16 pounds. But this is not a quick process. I am working on it.

Thank you for reading!

[Ghost1958]

I have the same machine. Your posted min pressure is 4. You are going to feel suffocated at 4, the minimum pressure I can tolerate and im used to masks etc is 6. Get your doc to bump the bottom pressure up to six, turn off the heated hose also until you get used to the mask.

That little pressure and it being warmed as well is about a guarantee your going to feel like your being suffocated.

There is another little trick you can use I learned when training with masks for work that helps to start with. Let the mask leak a bit during your day time getting used to it sessions. That will give you a feeling of air flowing over your face and greatly does away with the OH MY GOD I CANT BREATHE feeling.

[Amandine]

I have the same machine. Your posted min pressure is 4. You are going to feel suffocated at 4, the minimum pressure I can tolerate and im used to masks etc is 6. Get your doc to bump the bottom pressure up to six, turn off the heated hose also until you get used to the mask.

That little pressure and it being warmed as well is about a guarantee your going to feel like your being suffocated.

Thanks for your response. I will follow up with the respiratory therapist on Tuesday.

[retired_guy]

Ghost nailed this for you Amandine. We could encourage you to download the software, get the clinician guide for your machine and make the changes yourself. But you're off on a very bad footing, so going back to your DME is the best thing for you right now.

Your minimum pressure should be at least 6, and probably 8. Your maximum should be a little higher, say 10 or 12. Be sure your therapist alters the starting ramp pressure while they're at it. It's probably programmed to 4 as well.

So have a quality conversation with your docs. That should turn this around for you.

As to the mask, you can work with the ffm, but I wouldn't count the pillows mask out just yet. Just about everyone is told or feels they can't breath through their nose with the pillows mask until they actually do. In my case that was certainly true but what I discovered is that the pillows mask keep my sinuses perking along very nicely. But, at a pressure of 4? Nope, that would not make me happy.

[trish6hundred]

Hi Amandine,
WELCOME! to the forum.!
It would be a good idea to talk to your respiratory therapist and your docabout raising your bottom pressure up a bit so you don't feel like you are suffocating.
Hang in there for more suggestions and best of luck to you with your CPAP therapy.

[zonk]

Welcome to the forum, Amandine
To tell you the truth, if my APAP pressure start at 4 especially if Ramp also set for a period time, would feel like suffocating to me but my pressure needs is higher than yours

I don't know about you but I need some moisture otherwise my nose stuff-up (for others, the opposite is true), I don't like the air feel too warm or too cold. Experiment with humidity level to figure your sweet spot, everyone is different

With full face mask, you can breathe through your mouth as well as your nose, you won't suffocate. Rest assured, full face mask have a valve open-up to allow fresh air inside the mask in case of power failure

As for congestion, I use saline sinus rinse, works better any medication

[PhyllisBalboa]

I wouldn't be able to breathe at all if my inhalation pressure was 4. As it is, my exhalation pressure is at 4.2 and that feels somewhat bad. I can only stand that because I know some stronger air (inhalations at about 7-10) will come in a few seconds.

I use the Swift FX nasal pillows and other than the venting system, love it. It's easy on my nose, the straps are nice, and I get plenty of air. I use the extra small pillows although I'm average size. Also, I bump up my humidity level so that the air coming through feels like a cool breeze. I would get panicky otherwise.

When using the nasal and full face masks during my sleep study, I had terrible nightmares throughout the night. Don't go that route if you find the same thing happening to you. The nasal pillows work great. People here love the P10s.

Get the clinical manual so you can make adjustments on your own if needed, and tell your doctor what's happening. They should easily agree to bump up your air.

And don't give up!

[Amandine]

It is making me feel good that this is not just in my head and that there is a problem with the initial prescription and that I need higher pressure. I can't wait tomorrow to call to someone at the sleep clinic.

Thanks All!

[Amandine]

As for congestion, I use saline sinus rinse, works better any medication

I do the sinus irrigation on a regular basis but sometime it works against me. My nostril get completely blocked. Have you experienced that Zonk? I will mention this experience to my ENT on Thursday.

[Whitewabit]

I would try wearing the mask with out the hose hooked up to your machine. this will tell you if your having a panic attack because of the mask or because of the pressure or lack of it. you will be able to draw more then enough air that you won't have any trouble breathing through the open hose.

I found using pillows and not a mask my nose remained clear but the humidity set to 80% helps also!!