Gasping for air with FF mask

[Jskier]

I started therapy not quite a month ago. Been using a P10 mask and my numbers look good. Ahi typically below or around 1.  My only leaks are from opening my mouth. Tape or no tape, I'm awakened a few times a night as when my mouth is open. My settings are 11-15.

I've attempted to use both an F20 FF mask as well as the F30 Hybrid mask.  I changed the setting on the Airsense 11 from pillows to FF but I have a hard time falling asleep with either of these masks.  With both of these masks I find as I'm dozing off to sleep I am suddenly awakened gasping for air. It feels like I'm suddenly suffocating. My heart starts racing and it takes me a while to settle down until the whole sequence starts over.  I haven't made it past 2 hours with either of these before I give up.

Do I need to adjust my settings upwards, beyond just changing the pillows to FF setting?

I'm going to need to use a FF mask in a few weeks as I'm having some Basal Cells surgically removed on the side of my nose just above where the pillows rest. I'd like to try to get used to one of these now as opposed to waiting until the night after the surgery to deal with one more thing.

[ejbpesca]

I have been using FF masks for 15 years.  My first months with one was a difficult adaptation to the irritation of the headgear and mask.  I never changed any pressure settings but I did try ramping to allow lower pressure for a few minutes of the session.

I would wake from wearing the mask and having air pressure on my face.  I would have to remove the mask to get back to sleep.  Upon waking due to the mask on I would feel panicky.  Sometimes I would yank the headgear off in my sleep finding it next to me upon waking.

I think these panic reactions to a mask are natural because CPAP is not natural and is something each will have their amount of adaptation time to it.  Some don't adapt.

There is also an EPR setting on some machines like the AirSense 10 that can make the therapy more comfortable.  That setting may be an option to help relieve the feeling of suffocation.

The also could be a need to lower pressures and then work up to the prescribed pressure gradually to help you adapt to the therapy and mask.

Hope that helps.

[Jskier]

I should have mentioned I have my EPR set at 3 with the pillows as otherwise I have a hard time falling asleep with that mask. Ramp is off. You're suggesting lower pressure with the FF mask? It seems to me like the pressure is not high enough. Feels like there isn't enough air in the mask when it happens. I know that's not really the case, but hard to tell your brain that when you are gasping for air.

I also should mention, I think my breathing just really drops off as I drift off to sleep. On two different at home sleep studies I had issues when dozing off. As soon as i started to drift off the monitor would beep to tell me to breath or adjust the sensor. Same results there. I would eventually give up after a few hours of that. Luckily last time they managed to get an actual reading and diagnose my sleep apnea.

[mesenteria]

Some new users develop central apnea to a degree that must be controlled with adjusted settings, or they just grow out of them in a few weeks.  But a great many users always have 'sleep onset' centrals, and they manifest exactly as you are experiencing...gasping for air just as you want to drift off. It's disturbing, as you fully appreciate. This can also come and go, often with changes of routine, stress, diet, medications, illness, etc.

[ejbpesca]

I am currently increasing my minimum pressure to a level I never expected to go.  What I was suggesting is that an expert here may advise some pressure adjustments to make the mask more comfortable and then work up to the prescribed pressure.  I am not an expert so I may be incorrect on that.

I was concerned about your adapting to a full face mask.  It was after I adapted that I raised the pressures (by advice here) and still raising them in small increments to adapt and observe by OSCAR reports how I react to the raises.

I guess you know to post OSCAR reports here to get some expert advice.  Please disregard my suggestion if it is confusing or does not apply to your situation.

[StratCat48]

May not be the reason for gasping for air and it wasn't mentioned, but if you haven't done so yet take a look at air filter in your machine. If the filter gets plugged up with dust it can reduce the volume of air delivered and may feel like the mask is not giving enough air. Usually at about a month the fine filter on my Resperonics machine is due for a change and I do notice a somewhat reduced air flow when it's getting dirty.

[robbob2112]

You should post your Oscar data and your sleep study results (redact the personal info). Then an expert will give you an opinion.