[CPAP] breathing problems

[lakegirl12]

I'm only on my first week with my ResMed machine. The first night I had a panic attack when I put the mask on. Now when I first put the mask on I have trouble breathing out and start to panic so start taking more deeper breaths in. What am I'm doing wrong.

[retired_guy]

1st, don't panic. Everything will be fine. We're glad you came by so we can help you with this.

You mention your pressure is set to 3.5. I don't think that's right. Can you verify this please?

The "panic" is probably because of a low initial pressure during which you don't think you'll be able to get enough air. You will, but the machine probably needs to "ramp up" to a more comfortable pressure.

It may be too late today, but tomorrow bright and early can you call your sleep doc or whoever set up your machine and tell them what you are experiencing. There are a couple of ways that this will be resolved. One, the beginning pressure may need adjusting so you are feeling more assured about it. Another option that may be of help is for you to trade your nasal mask in on a pillows mask. These little guys are much less intimidating to use and might be just the thing for you. I suggest the Resmed P10 mask, but there are others.

For tonight, just sit for awhile in your chair and practice with the mask on and the machine running. Just watch a little tv for awhile, and let your body experience the mask and the machine. Know that if you really can't get enough air from the mask, your mouth still works fine. It's just that it doesn't really work all that well at the same time. But it'll be fine.

Report back on the pressure thingys.

p.s. What's the model of your Resmed machine?

[trish6hundred]

Hi lakegirl12,
WELCOME! to the forum.!
What retired_guy said.
Best of luck to you with your CPAP therapy, don't give up and hang in there for more suggestions.

[justMongo]

I'm only on my first week with my ResMed machine. The first night I had a panic attack when I put the mask on. Now when I first put the mask on I have trouble breathing out and start to panic so start taking more deeper breaths in. What am I'm doing wrong.

Some people do experience what you are experiencing.
Retired_guy's advice is sound.

You specifically say, "I have trouble breathing out" -- some people have trouble breathing out when on a fixed pressure CPAP machine. There are some ways to relieve the exhale resistance. One is a setting called pressure support then lowers the pressure you exhale against. For people who are non-compliant on CPAP, there is bilevel PAP where a lower exhalation pressure can be set. (Bilevel is also for other reasons.)

As for that feeling you get from wearing the mask... you might try wearing it while awake during the day without the hose connected. Sort of a desensitization exercise.

[lakegirl12]

thank you for your response. I have a ResMed S9 autoset. I don't think I can adjust the pressure manually. You're right I was mistaken, the 3.5 was the humidity level. I have been sitting on the edge of the bed to calm the panic attacks. I'm going to call tomorrow and ask about the pillow mask. Thank You again.

[retired_guy]

thank you for your response. I have a ResMed S9 autoset. I don't think I can adjust the pressure manually. You're right I was mistaken, the 3.5 was the humidity level. I have been sitting on the edge of the bed to calm the panic attacks. I'm going to call tomorrow and ask about the pillow mask. Thank You again.

I think it's probably likely they just left your machine with the factory defaults, which call for a minimum pressure of 4 and a max of 20. They count on the machine figuring out where it should be for you over a period of time.

That's all well and good, but in my experience 4 is too low to begin with. When I was at 4 I didn't think I was getting enough air. But I was able to "tough" it out until it ramped up to something more liveable.

So.......... Call tomorrow and ask to have your pressures set to the prescribed amounts from your sleep study, if they have those, but with a minimum a bit higher than whatever it is now, and a max substantially less than 20. Then get the pillows mask for comfort.

Mongo suggests the possibility of setting your EPR on. That's probably a good idea. With EPR on, the machine lowers the pressure when you exhale, which makes it easier to do. It can be set to level 1, 2, or 3, which means how much lower should the pressure be on exhale? 3 for instance, means 3. So if your actual pressure is say 8, your exhale pressure would be more like 5.

So talk to your techies about that too.

But mostly tonight, just relax.

[DeepBreathing]

G'day lakegirl12, welcome to the forum.

Just following on from the previous responses, I also experienced problems breathing out at first. It felt like I was "drowning in air". There are a number of things you can do to overcome this...

1. Turn on the EPR (exhalation pressure relief) and set it to 3. This causes the machine to reduce the pressure by 3cm when it senses you're trying to breathe out. Once you get used to it you might find a lower setting (1 or 2) is beneficial, but try 3 to start with.

2. Turn on the ramp. This causes the machine to start at a low pressure (4 cm) and gradually build up to its full working pressure over a period of time. The idea is that you will fall asleep before the pressure gets very high and it won't worry you when you're asleep. (It doesn't always work like that). You can set the ramp to any period between 10 and 40 minutes (if I remember correctly). Some people don't like the ramp as it starts at a low pressure and they feel they're not getting enough air - but I think you have the opposite problem, you're getting too much.

3. As mentioned by the others, try using your machine while reading or watching TV, just to get used to the sensations. Just breathe slow and steady and try to relax and work with the machine.

The EPR and Ramp are (I think) covered in the S9 user guide. However they may have been disabled, in which case talk to your respiratory therapist and get them enabled. Alternatively get hold of the clinician's manual and learn how to do all this for yourself. Instructions to obtain the manual are here: http://www.apneaboard.com/adjust-cpap-pr...tup-manual

CPAP therapy does take a bit of getting used to. Some people take to it immediately, but most of us take a while (even weeks or months) to adjust. Your body is learning to breathe in a whole new way, with a plastic alien strapped to your face! It's enough to give anybody a panic attack. But if you persevere and get past this stage you'll find the health benefits are well worth the effort.

[lakegirl12]

Thanks for all the great support. Last night was a little easier and I slept a little longer.

[jeffy1958]

lakegirl12;
The EPR setting is somewhat important for people like us. I had the same issues trying to exhale against a pressure of about 12, guess I'm a wimp. But once I learned my machine, set the EPR to 3, things got much, much better. Also..

I cannot express how important it is for you to become as familiar with your machine as you are familiar with all the rest of your body parts. That mask and hose are now a very important part of you and your life. Do not put to much faith and trust in the DME techies. They deal with many different people along with several types of machines. In my experiences they become "Jack-of-All" and "Master-of-None"!!! You need to become the "Master-of-One"!!! There are enough individuals on this Board and enough information for you to achieve this. And please do not feel you aren't savvy enough. YOU ARE, and we will walk you through this.

4+ years ago I was a complete idiot when it came to CPAP. With the help of these good people, some very serious discussions / debates, and all the info you can find here, and a positive mental attitude you WILL overcome any obstacle you may face.