Struggling to exhale

[NapsAreMyHobby]

Hi all, newbie here. I’m struggling to exhale on the minimum setting (4; my machine is set to a 4-20 range) with EPR set to 3. Is this something I’ll have to “get used to”, or is it a sign that I should try a different type of mask? I have a P30i and ResMed AirSense 10 Autoset.

I tried a nasal mask, and nasal pillows with larger holes, and had even more trouble exhaling. After wearing the machine for a few hours tonight, awake on a pressure of 4 to get used to the feeling, I took it off and immediately had a dizzy spell. Room spinning for quite a while.

Does all of this sound “normal” at the beginning, or is something not right?

Thank you!

[SarcasticDave94]

Hi NapsAreMyHobby and welcome to the Apnea Board. Can you post your redacted detailed sleep study and some OSCAR graphs so we can see what's happening when you're using the CPAP? A different mask may help, but it would be good to see some data as your low pressure of 4 with EPR of 3 can't go lower.

PS I don't think we can chalk dizziness as normal.

[NapsAreMyHobby]

I’ll work on the redacted study results tomorrow. I can’t do OSCAR data because I don’t have an SD card, but I’ll get one in a few days. In the meantime, what should I do? I can’t sleep with the mask on at all, it’s that hard to breathe. So I won’t have any data to give you. If I’m getting dizzy, could it mean that too much CO2 is building up in my blood stream? And remember, this is awake.

[jaswilliams]

It sound to me like your finding it hard to breath due to the lack of sir. I suggest you raise the minimum pressure to 7 then you will get the full effect of EPR and should find breathing easier

Follow this link to request a manual https://www.apneaboard.com/adjust-cpap-p...tup-manual
The manuals are sent by hand so won't be instant

[mesenteria]

The lower pressure of 4.0 is simply too low.  If that's all your machine was giving you when you were attempting to inhale, you're going to feel, or actually BE, starved for air.  No wonder you felt dizzy.

We recommend an initial setting of at least 5.0, and would suggest strongly something higher than 5.5 to see how that goes for a couple of nights.  You should be able to adjust your own pressure limits by getting into your menu.

Is your 'ramp' feature turned on?  That's where the initial flow upon donning the mask is kept low so that you can get used to it, and after a few minutes it begins to ramp up the pressure to where the machine thinks you are being properly ventilated.  If your ramp feature is on, or whatever it's called in your menu, consider turning it off, particularly if you can get your lower pressure up around 6 to start with tonight.

[Gideon]

On advanced machines exhale pressure or EPAP is considered the thearaputic pressure. That is 4 on your machine. Inhale pressure should be set to EPAP + EPR or 4 + 3 which is 7.

Your min pressure should be 7 (inhale) which will then provide 4 for exhale

[ragtopcircus]

I find the P30i to be pretty good for keeping the sinuses open. If going to a larger pillow made it worse though, which is backwards, I wonder if turning up the humidity would help. I use a higher humidity setting for pillows than for full face.

That is not intended to contradict the advice from others more learned about turning up the pressure.

[Sleeprider]

Naps, it would really help to get OSCAR running so we can see what is going on. Make the SD card a priority. The suggestions to try a minimum pressure of 7.0 with EPR 3 is a good one, and also you are using nasal pillows, and size matters. Too small will not flow as much air and most of us do better with a size larger.

[OpalRose]

Hello NapsAreMyHobby,

I understand that your probably wondering why we recommend raising your minimum pressure to 7cm, as you are having a hard time exhaling with your current pressure of 4cm, and you might be thinking it’s too much pressure, but it’s really not.

It sounds counterintuitive, but the problem being with a minimum pressure of 4 and an
EPR (exhale relief pressure) set to 3 is that you are not receiving exhale relief pressure as the machine can’t go lower than 4cm. Your not receiving any assist in the exhale process.

Most folk feel air starved with a low set pressure, and that is what you are feeling.

Please purchase an SD card for your machine.  In the meantime, download the OSCAR software, set up your profile, then when you have the card in your Cpap for a day or two, you can inset that card in your computer SD card slot, take a screenshot of the daily page and post some data here.  (Instructions in mine and others Signature Lines.)

You can change your pressure now.  Use your machine during the day for a couple hours before bed. Put your mask on, turn on Cpap and distract yourself by watching TV or reading a book for an hour or so.  This will help you get used to the feel of the mask and the air pressure.

[SarcasticDave94]

FWIW that last segment OpalRose mentioned, getting used to the machine, mask, and any increased pressure from this setup really does help. I've been there thinking the pressure was too high that there's no way possible to exhale. Then again my first CPAP machine was a previous generation CPAP with no expiry pressure relief set on 18.

The point is try to get used to the CPAP in settings that minimize the stress of this octopus on a hose that's strapped to your face. The practice will really help out.