[Treatment] Struggle to breath in with CPAP

[davroman]

Hello everyone,

I am in Ontario, Canada. I was recently diagnosed with Sleep Apnea (AHI = 46/Hour). Sleep Clinic prescribed CPAP/APAP to 7 cm after the titration session.

Four days ago I received my ResMed AirSense 11 (with the AirFit N30i mask.) which was configured by the DME. However I've been struggling with the therapy as I feel it is hard for me to breath in. I have been able to fall asleep but feel that I wake up often and/or way too early due to the required effort for me to breath in, which makes me uncomfortable and feel the need to remove the mask to get some fresh air.

I called the DME and they agreed to increase therapy to 8 cm. While I feel improvement, I still struggle. So I called them again and they said they need to check with the Sleep Clinic in order to increase it further.

Additionally, I feel that the air feels too warm. Any recommendations of what to do in the meantime ?

Attached are screenshots from OSCAR.

Thank you in advance!

[mesenteria]

I am loath to suggest fiddling with the machine's settings, or second-guessing a new prescription, but something doesn't add up here.  You have almost no EPR (pressure relief) for when you exhale, if I'm reading correctly. Also, the max pressure of 8, which has served me well for almost 6 years, is working poorly for you.  I can't help but wonder why they set your rate so low.  If I were you, and it wouldn't stub any toes in your chain of professional care, I would raise the max to about 12 for a week or two and see how you get on. I would set EPR to 2 cm for now, and it might stand going up to 3 if you don't develop central apnea as many do with their new therapy. It almost always disappears in time, but the centrals show, and they could cause some low level anxiety.

Also, your lowest setting should probably be 6.  Consider changing that.

Before doing ANYTHING, though, please wait for other considered opinions besides mine.

[Cpapian]

Maybe you could call your sleep doctor directly and tell them what you are experiencing.   

You could tell them that since the purpose of using the machine is to prevent you from waking up (one purpose anyway).  Waking up disrupts sleep  architecture,  possibly REM sleep, which is one place the body does it's renewal functions.  So in effect defeating the purpose of the machine.

If they don't budge with that logic, then you can tell them you aren't comfortable using the machine and may consider discontinuing. 

Note : Of course the machine is also there to prevent apneas which make you wake up.

Your DME can fix the temperature without talking to the doctor.  

You can always go rogue and change settings yourself,  but in the long run, having your sleep doctor on your side may be in your best interests.   Since we get 75% coverage from the Province, we need our sleep doctor to process the documents.   If you had to buy independently,  not only would you miss out on the government paid portion,  but also on the government price.  Regular price is about double the government price.

Other provinces do not have the same government support that we in Ontario have.

[Nightynite]

Well I’m no expert either but without a sleep report we’re all guessing what would be a good pressure for you. My thought would be to put it in apap mode with a min of 7 …….max of 15 …..EPR of 2 and let the data from Oscar give the answer. After zeroing in on an average pressure, switch it back to a fixed pressure and fine tune from there.

[staceyburke]

IF you feel like you are not getting enough air then raise the pressure.  9 or 10 is no problem.  The only thing that might be a problem is getting more large leaks.  You need to increase the pressure until you feel comfortable inhaling.   The third night you turned the EPR off I would turn it back on full time set to either 2 or 3.