Daunting first night experience leaves ???s

[JumpStart]

Wow! My hat is off to all of you who have been using CPAP for years. No - make that for even one full night. My initial experience: Innumerable problems with leaks at the inception (45 min), then a brief interlude of mostly uninterrupted sleep (about 2 hours), broken only by occasional wakings with a feeling of inability to breath. Each time when I awoke enough to overcome the panic that feeling created, I was far more aroused than any apnea or hypopnea has ever caused. I was able to take sufficiently deep breaths to get back in check, without removing my mask, but that is undoubtedly a most unpleasant experience. Then, on my last such awakening, I disconnected to go to the bathroom. While I believe I reconnected, my next conscious act was about an hour and a half later, when I discovered my hose was disconnected from the mask (where I may have failed to fully reconnect). I again couldn't breath, my machine was no longer on, and I gave up the project for the night. I will try again tonight, and will again experiment with mask fit before beginning.

Does anybody have a suggestion for dealing with the irregular shortness of breath issue? Could it be something to do with the "flex", which is theoretically reducing pressure only during an exhale, but perhaps is doing so during my inhale cycle? Any suggestions would be welcome -- including just returning the equipment to the DME!!! :grin:

[JudgeMental]

Jumpstart.. Sorry to read about your first daunting night. Trust me when I say that we've all had them (many of them)..The good nights will come to those with perseverance and it does take a lot of that. Something foreign as a mask on your face while trying to sleep is not an ez endeavor. Mask leaks are the devil in the night. Hope you find one soon that is comfortable and leakfree. THe nasal pillows design appears to most to be the most leak free. Just don;t try to tighten the straps to tight. The mask should just "float" on your face. The air pressure will make it seal.

Some folks turn the machine off/on after P breaks. I just pull the mask off and put it back on. It really don;t alter the AHI numbers much at all if you were concerned about that.

(In my opinion) The panic of short breaths or irregular breathing to the new user is caused by the flex built into the machine. My old machine worked with me on the breathing cycle, however I never really found my nitch on my new machine (one like yours) , so I don;t even use the flex. The A-Flex,C-Flex stuff is for your confort, so you may have to experiment a lot with those. Try not to make the changes to rapidly, so as to give your body a chance to adjust for a few nights with each change. You'll find the one that fits.

I see you have posted two pressure settings, so I am assuming that you are using the machine in the APAP mode. That 10 might be a hard sell for you to get started with unless you are using the ramp feature.

Stay with it and let us know how you are doing. We are here to help if we can. Our suggestions and offerings are just opinions and may not fit your problem, but as any forum, someone else that reads this thread may be helped by it.

[greatunclebill]

whatever you do, do not give up. it is easy to just not use it but it is the wrong answer for so many reasons. if things don't get better, you do need to return to the doctor so he can help you through it.

you could have as yet undiagnosed underlying medical problems regarding the shortness of breath. the cpap may turn out to be a huge blessing to you. i no longer see my apap as a nice to have thing that makes you feel better. a trip to the ER during a period of non-compliance showed me that it is life saving equipment.

good luck. post often, letting us know how it is going. we post because we care.

[DCwom]

Wow! My hat is off to all of you who have been using CPAP for years. No - make that for even one full night. My initial experience: Innumerable problems with leaks at the inception (45 min), then a brief interlude of mostly uninterrupted sleep (about 2 hours)...

Its a bear to start with, but it gets better. Some folks find an immediate improvement, others like myself don't, but I stuck with it to humor my doctor, and now I do see an improvement in my sleep. Its one of those things that will probably be worse before it gets better, I remember only getting a couple of hours of sleep the first night, by the end of the first week exhaustion overcame the distraction of the CPAP and I slept. I remember the first long periods of sleep where I dreamed vividly, that's when I knew it was worth it.

[Ltmedic66]

Ditto what has been said so far. Actually, if you start with a few hours a night, and gradually work yourself up to wearing CPAP for the whole night, consider yourself successful! It certainly may take you some time to get there. A cfew suggestions that seem to help:

1. Try wearing your CPAP during waking time, like while watching TV or reading. It helps you get used to it.

2. You might look at trying different settings with the comfort fetures, such as ramp or exhalation relief (C-Flex in your case). These are often regarded as comfort features that do not affect overall treatment. Some people like em, some people hate em.

3. My initial issue was feeling as if I could not exhale against the pressure of CPAP. My pressure was 11cm. The doc backed me down to 8cm, and we worked out way up every couple of weeks. Now I do not even notice the pressure at 11 cm.

4. Make sure that you have dealt with other "sleep hygeine" issues- a comfortable bedroom, going to bed and waking up at consistent times, going to bed when you are tired, minimizing caffeine and food before bed, for example.

Hope these help!

[CHanlon]

Jumpstart - first thing... don't give up. :-)

I started this about 20 months ago, and I'm a sort of strange case in might first night, and first couple of weeks were perfect. I put the mask on the first night, slept 9.5 hours without so much as turning over. That was on an older Remspironics APAP machine. I didn't have issues until my Respiratory Therapist decided to try me on a fixed CPAP (on the same machine) at 18 cm H2O...blew the mask off my face, made me wake up feeling inflated, etc. Hated it so much I decided then and there that I would never accept a fixed CPAP machine, and I didn't. I have the same machine you do, and my pressure range is a bit higher then yours, I'm set at 12 to 20.

So, all that said, here's a couple suggestions. First off, why a full face mask? I'm an avid scuba diver, and I'm very used to having strange stuff on my face for breathing (although its sort of opposite...) but I don't think I could ever get used to the full faced mask. I also have a moustache and full beard. My RT took one look at me and suggested the Mirage Activa nasal mask. I've *never* had an issue with leaks, even when the moustache has grown out a bit and is in dire need of a trim. With the full faced mask, I'd imagine that if you start to breathe through your mouth, you'll be totally wasting your time on CPAP. To me, they'd also be harder to get a good seal - less seal area on a nasal mask means less area to try to keep sealed.

The Activa mask actually lets you keep the straps pretty loose - the seal is a bellows arrangement, when the pressure comes up, the very soft silicon seal inflates and creates the seal - the mask can actually move around a bit ("up" and "down", towards and away from your face, it sort of floats) and not break seal. My suggestion would be to not get married to a specific mask until you experiment a bit.

You mention 45 minutes at inception - do you mean you have it set to ramp up over that time? I found with mine, at the pressure range I'm on, that the ramp up was actually more of a pain then a blessing - I tried various settings from 5 minutes to 45 minutes, and came to the conclusion that all that did for me was give me that many minutes to fall asleep before the pressure came up enough to find the leak, which would wake me up. I have far more success with no ramp, full (at the low end of my range) pressure right from the start, check the seal, then go to sleep.

I doubt that the shortness of breath is from the flex setting - more likely it's either an issue with the mask, with mouth breathing, or with the pressure. I'm a tinkerer - I knew how to program my machine (and get to the clinicians menu) before I ever bought it - so I actually tweaked up my range until I got my AHI under 1..usually a lot under. Prescribed range was 10 to 18, I'm now at 12 to 20 because I have the data to show that I'm never under 13, and *often* over 19, though that seems to be coming down lately, as I've lost some weight. You might find that nudging up the bottom of your range will help.

The big thing is, if you've got sleep apnea, you really do want to treat it. I got lucky, and saw after one night how *huge* the improvement was. I actually find that now I have a harder time sleeping without my machine then I ever have had with it. Work with your DME to come up with a mask/machine/pressure combination that works for you, it's well worth the time you spend.

PS: I chose the S9 Autoset after months of research on APAP machines. I have no doubt that it's the best APAP machine out there. I don't think the machine itself will be your issue... but stranger things have happened. :-)

[PollCat]

Apparently all of you who had trouble getting used to using a CPAP where not given the incentive my doctor gave me back in 1995! I have slept through every night since that time with a CPAP; I don't remember ever having to get used to the machine or the nasal pillows.

I believe that it's just a matter of setting your mind to the fact that you need to do it. However, I was given two nights at the sleep center. The first was done is see if I needed a machine and the second, about a month later, was to "fit" me with the appropriate machine and mask.

While I'm sure the doctor had his tongue fully planted in his cheek, his incentive was quite effective: "If you don't use the CPAP, you'll soon wake up dead!"

[CHanlon]

I believe that it's just a matter of setting your mind to the fact that you need to do it.

Absolutely true.

While I'm sure the doctor had his tongue fully planted in his cheek, his incentive was quite effective: "If you don't use the CPAP, you'll soon wake up dead!"

Heh, yeah, that's about it, too.

[CHanlon]

Jumpstart - just dug this up again, it's an excellent write up of how to fit your mask...

http://www.apneaboard.com/forums/Thread-...t=mask+fit

[JumpStart]

Well, much longer usage my second night (6:59), but not greater efficacy. AHI 29.2, Leak (95th) 55.2, and Pressure (95th) 14.9. With that leak data, none of the others are useful readings, as I understand it. The best thing was the absence of the shortness of breath issues. Before use last night, I reduced the EBR from 3 to 2, and since have not had a single instance of inability to catch my breath. The worst thing was that I was unaware of the mask leakage (except occasionally, when I readjusted it) which had to be both significant and continuous to get that kind of reading. My ResScan and Sleepyhead detailed leak graphs also indicate long periods of significant leaks. It seems that until I master the leak issue which, during the night, I thought was doing OK, nothing is going to work.

BUT - my deep and grateful thanks for all the words of encouragement, and the detailed suggestions to assist. Your time spent to help a stranger is truly appreciated. I will keep trying. I was able to get an appt for Monday with the RST sleep tech who administered my PSG at St Luke's hospital in Houston. I feel very comfortable with her demonstrated skills, and expect that she can help me solve the leak issues. My mask is the same one used during the PSG test, so I expect it is largely a matter of an inept user (me). My DME is not of significant help, other than in getting the equipment I wanted.