Full Face Mask and Sensation of Suffocating

[Dreams of Green]

I have a family member with very severe apnea I am helping with CPAP treatment.  He has enjoyed OK success with the Dreamwear, but that masks comes off very easily, and he is a very restless sleeper and it always comes off in his sleep without him even being aware of it.  He tried a Wisp mask and couldn't tolerate it, I can't remember what the issue was.  Since he also often has issues with nasal congestion he is now trying a full face mask.

Now he has an Airfit F20 full face mask, which he likes because it can't come off, but he says he'll go to sleep with it on and wake up 15 minutes later feeling like he's suffocating.  As far as I am aware he never experienced this with the Dreamware.  EPR is on and set to 3, range is 4 - 16.  It was 7 - 16 but he could not start out at 7, it was too much for him, though again it wasn't an issue starting at 7 when he used the Dreamware.  I don't have a full face mask but I recall seeing other people on the forums describe waking up feeling like they are suffocating.

Can anyone offer any advice?  So far we're in a catch 22, the one mask he can tolerate falls off, and the ones that don't fall off he can't tolerate.  He likes the fit of the Airfit F20 and the fact that it doesn't come off if there is any way he can get it to work.

Thanks

[Gideon]

The data collected on the SD card and displayed will tell a lot.  So please post the SleepyHead data.  Pay attention to the organization and that will tell us what is happening and what his settings actually are.  See my sig for how to.

Wear the xPAP while watching TV or reading to get used to it.  Keep in mind the pressures used are not enough to blow up a child's balloon.

If EPR is on pressure will not go below the min setting, but if the ramp is set at 4 (very common) that is not enough pressure and that is where most complain of suffocating.

Fred

[silversnore]

With a starting pressure of 4 and EPR of 3 most people are going to feel like they are suffocating, there is simply not enough air being pumped in the mask. I think that you probably need your family member try to acclimate using higher pressures at least 6 or 7. I would let them watch tv or read during the afternoon with the mask on and get used to the pressures. The other choices, Dreamwear has come out with nasal pillows mask (you can order the pillows to retrofit the existing mask), people indicate that the mask is much more secure and does not move as much. I use a F & P Brevida mask, it is a nasal pillow mask that sort of encapsulates the end of the nose. I find that it is fairly secure and can resist some rolling around. Good Luck

[Sleepster]

Use the ramp feature.

The feeling of suffocation is in my opinion entirely due to anxiety. I say that because we live our lives at a pressure of zero with mask off and we don't suffocate or feel like we're suffocating. The full face mask covers his mouth which means that air can't escape out the mouth like it can with a nasal mask.

Wearing the mask while awake and engaged in some activity is a good idea. It helps with the anxiety.

[Dreams of Green]

Thanks everyone. A little more info. He has asthma and often a lot of congestion. Since he could not handle starting at 7 I'm trying to reconcile that with the fact that he says he's waking up feeling as though he is suffocating with the pressure currently set at 4 - 16, which some of you are suggesting could be due to the low setting of 4. It's a bit of a catch 22. I do need to get the data so I can see what it's reporting when this happens. In the meantime I'm considering:
- Range of 7 - 16
- EPR on and staying at 3, I just don't think he can tolerate it with it off. Of course he can experiment himself.
- Ramp Time - how well does auto work? Or should we just set it to 15 minutes?
- Start Pressure of 4 just so he can acclimate, since he could not tolerate a start pressure of 7 with the full face mask. But that way it will shoot up to 7 and hopefully avoid the feeling of waking up feeling as though he is suffocating.

This would get his starting pressure back at 7, but give him a little time to acclimate with a start pressure of 4 and a ramp time of auto or 15 minutes?

All comments welcome.

Thank You

[Sleepster]

He can experiment with ramp times, but acclimation while engaged in other activities is essential for dealing with the anxiety. Just my opinion.

[PaulaO2]

He may also want to consider turning the exhale relief down, not up. Say to 2 instead of 3. I have experienced this with several masks, where I feel as if I am suffocating. In messing with settings, I found I breathed better with some on 2 or even 1 EPR vs 3.

Have him also sit up with the mask on. He can feel the ramp, feel the exhale relief, etc. If this is anxiety related, he'll get accustomed to the sensations.

I am not a fan of the ramp. I wasn't when my pressure was at 8 and certainly not now at 14. I feel suffocated at anything less than 12. It is what we get to be used to, I suppose.

[Gideon]

Can you get him to run the xPAP and watch TV or read?  Don't worry about sleeping, this is just to get him used to the machine (and see it will not suffocate him.)
A ramp starting at 4 is ok, but let's get his therapy up.  Set the min at 5, or even 4.5,  raise it every few days, but follow the watch TV routine.

[Hydrangea]

When I change from DreamWear to a FFM (mine is Amara View), my min pressure needs to be much higher. For example, if my min with DreamWear is 7, with FFM I need 9 (to get the same AHI).

Additionally, when I don't get enough pressure, I feel like I'm suffocating.

So for those 2 reasons, I'd suggest trying a higher min pressure.

One other thing to consider is adjusting the mask setting on the machine. On the DreamStation, the setting is x1 for DreamWear, but I believe it's x2 or x3 for FFMs.

[ajack]

Thanks everyone.  A little more info.  He has asthma and often a lot of congestion.  Since he could not handle starting at 7 I'm trying to reconcile that with the fact that he says he's waking up feeling as though he is suffocating with the pressure currently set at 4 - 16, which some of you are suggesting could be due to the low setting of 4.   It's a bit of a catch 22.  I do need to get the data so I can see what it's reporting when this happens.  In the meantime I'm considering:
- Range of 7 - 16
- EPR on and staying at 3, I just don't think he can tolerate it with it off.  Of course he can experiment himself.
- Ramp Time - how well does auto work?  Or should we just set it to 15 minutes?
- Start Pressure of 4 just so he can acclimate, since he could not tolerate a start pressure of 7 with the full face mask.  But that way it will shoot up to 7 and hopefully avoid the feeling of waking up feeling as though he is suffocating.

This would get his starting pressure back at 7, but give him a little time to acclimate with a start pressure of 4 and a ramp time of auto or 15 minutes?

All comments welcome.

Thank You

I'd go back to the doctor, asthmatics do better on bipap/bilevel, they need a lower breath out level
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