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05-22-2024, 10:41 PM (This post was last modified: 05-22-2024, 10:43 PM by swissmix.)
Gasping when nodding off
Hello everyone,
I've been using a CPAP for 10 years, and for the last two years, I've been using an Aircurve 10 BiPAP. I've always had trouble gasping for air right before I fall asleep, and it happens several times, more than 10 times every night. Once I'm asleep, I'm good for the most part. I'm writing here because the gasping has gotten much worse over the past few months, and I am frustrated. If anyone can help me adjust my settings, I would be very grateful. I have attached all of the data and graphs from my daily view on OSCAR. Thank you.
I've been using a CPAP for 10 years, and for the last two years, I've been using an Aircurve 10 BiPAP. I've always had trouble gasping for air right before I fall asleep, and it happens several times, more than 10 times every night. Once I'm asleep, I'm good for the most part. I'm writing here because the gasping has gotten much worse over the past few months, and I am frustrated. If anyone can help me adjust my settings, I would be very grateful. I have attached all of the data and graphs from my daily view on OSCAR. Thank you.
First, I would fix the leaks, and then see how it goes. Per Oscar, you have large leaks much of the night. This will interfere with your therapy.
Could you maybe elaborate a little on what exact mask you have, what some of the issues are, etc.? There may be some help for that here, too, as far as user tips.
I appreciate the analysis. I currently use the DreamWear mask with a medium frame and medium cushions. My primary concern is that just as I'm about to drift off to sleep, I'm abruptly awakened, gasping for air. This tends to happen multiple times before I can finally fall asleep. It's been a persistent issue for me over the years, and I've reached a point where I can no longer tolerate it.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Welcome to ApneaBoard. A similar thing used to happen to me. Just as I was about to fall asleep, I would have the feeling of not being able to breathe. I got so tired, I eventually ignored it and usually fell asleep pretty quick. It seemed like when I had good energy though and tried to either nap or fall asleep, I noticed it more and would keep nodding off then jolted awake; nodding off and then very quickly jolting awake.
There is something called "sleep wake junk". It can happen during the transition from sleep to wake or wake to sleep. Usually central apneas (CA's) are involved. The "handoff" that occurs in the brain and CNS is not 100% efficient. Instead of a perfectly some transition from voluntary to involuntary breathing, some glitches occur.
But I notice a few OA's at the very beginning of your one chart you posted. There is the possibility that you are obstructing just as you nod off to sleep also. A soft cervical collar has helped me with this particular problem. In regards to CA's, a machine with a back up rate pretty much cured that (a back up rate is either a dynamic or pre programmed rate set into the machine to force a breathe by pressure support).
The RT doing my PSG sleep study noticed both CA's and OA's just as I was going to sleep in the lab. Also, she said my mouth would drop wide open.
Like HalfAsleep said also, try to work on the leaks and optimize your therapy with your current machine as much as possible to see if this makes it tolerable and sustainable long term. If not, other options are available.
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It would help a lot if you fixed your charts. It's best if you post just the first page, and it should contain, in this order, Event Flags, Flow Rate, Pressure, Leak Rate, and Flow Limits. This will help us help you.
I appreciate the help and suggestions. I hadn't considered using a soft cervical collar, but I'm open to giving it a try. I recently acquired my machine last summer and I'd prefer not to go through the hassle of another sleep study just to potentially get an ASV machine. Once I fall asleep, I generally do well. I'm hoping to receive some advice on trigger/cycle/EPAP and ti min max adjustments that could potentially help. I'll also be attaching a more concise version of my stats as per Deborah's request. Thank you all for being patient and supportive. Your responses to my questions show the willingness of people in this community to help others. We need more individuals like you in the world. Thank you.
