It feels like the CPAP is trying to make me breathe too fast

[RealityShifter]

Hi Everyone,

I was recently diagnosed with mild OSA (my AHI in the lab study was only 6.6) and my doctor prescribed a CPAP. I got the Resmed AirSense 10 Autoset For Her and have been trying to use it for the past week but I’ve encountered a problem and I’m hoping someone here can offer advice. I breathe very slowly compared to most people (not just while asleep, also while awake) and my exhalations are quite long. I feel like the machine is trying to get me to speed up my breathing. The pressure backs off slightly on the exhale but not for long enough, so it already starts pushing air at me again when I’m still only partly done exhaling.

Is there a setting I can adjust to slow the speed down or improve the machine’s sensitivity to better detect my exhalations? I’ve already tried using the three different EPR settings but that didn’t help. I also adjusted the ramp time to the max 45 minutes to see if the lower pressure as I fall asleep would make it less of a problem, but it still feels like the machine won’t let me breathe at my natural slow breathing pace. So far, I haven’t been able to fall asleep with it at all, despite keeping the mask on for up to 7.5 hours on some nights. (I've had to take daytime naps to compensate for the lack of sleep, which isn't something I can keep doing every day for much longer.)

[Sleeprider]

It would help to see some charts from OSCAR, and in your case, we should look at a zoomed in view (2-minute segment where waves are visible) that includes Events, Flow Rate, Mask Pressure, Flow Limitation and Leaks.  Your profile shows your pressure is 5-15 and I suspect you must be using EPR because you describe a reduction of pressure during exhale.  The way the Resmed works with EPR is much like a bilevel. As inspiration ends and flow rate rapidly drops to exhale, the Resmed will reduce pressure by up to 3-cm. The minimum pressure is 4.0, so at your current minimum pressure you only get 1-cm of pressure relief, and until you reach 7.0 cm, you don't get the full benefit of EPR.  As the machine detects inspiratory flow, the pressure gradually increases to the set CPAP pressure and reaches a peak just before expiration.

If you have a very slow breath rate, the Resmed Autoset still follows your respiration with appropriate pressure changes, it never leads or tries to make you breathe.  However, if your cycle time in exhale approaches 10 seconds, the Resmed will start evaluating your airway using the "forced oscillation technique (FOT)". This is an oscillation of 1-cm pressure at 4 times per second. Some individuals are sensitive to FOT and perceive it as the machine trying to make you breathe.  There is no way I know of to turn it off. If you look at the detailed flow charts, you can see FOT during expiration if it is occurring.  Here is an example of an image showing the flow rate and mask pressure during an apnea where FOT is shown at 04:47:40.  Look for this pattern in your own chart.

[nevermind]

This might sound silly, but... did you try sleeping with earplugs? I found that the inhaling/exhaling noise of the machine somehow made me loose my natural breathing  rhythm, because I adapted to the sounds of the machine. Earplugs helped me big time to "decouple" my own breathing from whatever the machine is doing.

[RealityShifter]

Thank you for the information and for the suggestions. I turned off EPR last night and wore earplugs, and that combination solved the problem of feeling like the machine was rushing me to breathe faster than my natural pace. I was finally able to fall asleep with the machine for the first time. If my mask hadn’t started leaking a lot and woken me up about 2 1/2 hours later, I think I might have been able to stay asleep for even longer. I’m still working on dialing in the right adjustments for the mask.

[3rdMarDiv]

I found that the machine sounds really affected me when I was new to CPAP. I was desperate to just go to sleep, but the machine sounded like my breathing was getting faster. It amplified my anxiety.

I was able to use that sound to actually help me get to sleep. I soon learned that I was breathing heavier due to my stressing out over all the new aspects of CPAP and started controlling my breathing by deliberately slowing it down.

Hearing the motor noise slowing down was very relaxing much like breathing exercises are used in yoga.

Now, I generally am sound asleep within 10 minutes of "Mask On".

I could hear the sounds slowing down as I relaxed myself and soon the rhythm of a calm smooth breath became like a sleep noise, similar to any other sleep noise like ocean waves, frogs chirping, etc.

My wife also used the CPAP sounds, combined with knowing I was using CPAP to improve my health, helped her make the sound even more relaxing. The sounds actually also helped her go to sleep and stay asleep, just like a sleep noise helps many other people. Win, Win..!

Doing this will not only help you go to sleep, but when you have an awake moment during the night, it will help keep you from "waking up" and work as an inducement to just keep sleeping. You need to learn to make the machine your friend and train your mind get in sync with all the nuances of CPAP.

I'm a believer in resolving CPAP issues naturally, making as few physical changes (or equipment additions) as possible.

IE., earplugs, mouth tape, chin straps, on and on.

[Nightynite]

I listen to audiobooks with ear plugs, It really helps to get your mind off your breathing and every day stressful events.

[3rdMarDiv]

I listen to audiobooks with ear plugs, It really helps to get your mind off your breathing and every day stressful events.

Glad you found something that works for you.

If you ever watch NOVA they have a show with recent information about sleep health. 

It's called "Mysteries Of Sleep"...

[princejmy]

Resmed is trying to upsell its customers. It seems like common sense that you should be able to adjust the inhale time. I use the Resmed Aircurve 10 Vauto and I have the ability to change the inhale time. My max inhale time is 3.0 sec, and my min inhale time is 1.0 sec. It was defaulted to 2.0 sec inhale which was way too fast.

[CorruptAlligator]

When I first started CPAP, I had the same feeling like the breathing didn't sync with my natural breathing rhythm, and then after some usage, I didn't notice that issue anymore. Perhaps I adapted. No idea.

Same for pressure early on, and then I got used to it. I guess it takes time for body to adjust.

[Lucid]

Hi, RealityShifter  Early on, I experienced the feeling you describe of the machine trying to get me to breathe faster.  Generally, if I persisted in breathing slower, I could get to slow down.  After a month or two, I no longer had this problem.  I don't know if I simply got used to the machine, or whether it was getting my pressure settings dialed in and dispensing with Ramp solved the problem.  Perhaps both.