[Treatment] Newbie: can't stay asleep longer than 1 hour with mask on

[KianaBeth]

Hey guys,

I'm newly diagnosed and haven't been able to sleep more than 1-2 hours with my Resmed Airsense 11 (had it for a couple of weeks). 

I wake up and feel like I can't breathe with it on and pull it off my face so I can actually sleep. The nights I tried really hard to leave it on I'd just lay staring at my walls for 5 hours until 2 or 3am came around I finally gave up and took the mask off. Normally I can fall asleep with it on, I just can't stay asleep with it on.

Lower pressure (up to 8 or 9) feels like I can't breathe with it on. Higher pressure (15) gives me aerophagia. I have the EPR set to 3. I wear the airfit F30i. 

I started with just the nasal pillows but discovered I am a mouth breather (and woke up feeling like I was being waterboarded by air as it flowed out of my mouth). Wearing a chin strap unforunately didn't stop my lips from still opening with air flowing out. If I tape my lips, I still wake up with my mouth ballooning out, filling with air that's trapped in by the tape. So full face mask it is. 

I have a cervical collar I pair with the full face mask as well, to keep my chin from tucking.

I'm hoping you guys could look over my oscar data from last night to let me know what settings I can change to try to make therapy bearable and actually being able to stay asleep with it on my face. 

   

Extra info from my sleep study:
AHI of 13/hr. 24/hr while in REM.  Obstructive events were predominately hypopnoeic in type. Longest duration was 69 seconds. Zero obstructive apneas and 4 central apneas over the 5 hour sleep study. 30 desaturation events. 

Thank you so much,

Kiana

[cyberfiche]

I'm having the same issues. I've been on BiPAP since the end of July, 2024. I really do love the therapy most nights, but lately aerophagia and mouth leaks are my biggest problems. I tried taping for the first time last night. It's going to take some getting used to. For the aerophagia, I think having two pillows to sleep on helps somewhat, as it props my head up a little kind of like a wedge. I'm still trying to figure this out, so I'm eager to hear what others have to say about your post.

- cyberfiche

[Deborah K.]

Change your pressure range.  11 to 13 should help with your aerophagia. You need higher pressure, but try that, post an Oscar, and let us know if it helped.  

If you have a copy of your sleep study, post it with personal information blacked out.  If you don't have a copy, ask your doctor's office to give you one.  Seeing that will help us advise you.

Best of luck with achieving better therapy and comfort!  

[SarcasticDave94]

If I'm reading you correctly, your sleep study states 4 Central Apnea but no Obstructive Apnea. It's possible some of the Hypopnea in the test were Central. If you have the test charts, please post redacted of your personal info.

You'll need to try to avoid CA with this machine, eliminate Ramp if it's on, and if applicable try EPR 1 or 2 at most, maybe the pressure of Max 15.

If you can't get the AutoSet to work well, you're probably needing a different machine, maybe up to the ASV that's specifically used to treat CA. But let's see if we can't help make the current CPAP work.

[FrankFuss]

To get more use to the PAP, try wearing it during the day, like when watching TV.  I also had troubles at first, but after getting use to it during the day, it became much easier.

[KianaBeth]

Thank you so much for your help and advise, I appreciate it. 

Here's the two pages of the sleep study that they sent me. 

   

   

[SarcasticDave94]

OK thanks, it's not definite by any means, but it's possible the Hypopnea have an unidentified mix of Central and Obstructive based events.

Info: there's a progression involved with everyone that has Apnea. The lowest restricted event is flow limits, which are about up to 50% restricted in Obstruction based Apnea, and these aren't time measured. Hypopnea and Apnea are minimum 10 seconds. Next up is Hypopnea, at roughly 50-75% restriction. Finally is full Obstructive Apnea at about 75-100% restricted.

It's typical for Hypopnea to just be all lumped together. My main clue that your Hypopnea may have a mixed amount of Central and Obstructive is that there's no Obstructive Apnea recorded, just the 4 CA.

How's the therapy working?

[KianaBeth]

Oh interesting! If I remember correctly, the sleep tech told me over the phone that my hypopneas were over 90% obstruction (but not full obstruction), I'm not sure if that's the way Australia classifies the hypopneas, or just this sleep lab.

For the therapy, it's been about two weeks, and wearing the mask and having the pressure is fine when I am awake, I can wear it for a couple of hours while playing video games. I can fall asleep with it on just fine, no claustrophobic feelings during that. I just can't seem to stay asleep. 

I will wake up within 30 mins to an hour, feeling panicky and like I can't breathe properly and I want the mask OFF. The claustrophobia only hits when I am asleep. So I'm not sure if that's still a mental thing, or whether something is actually happening in my sleep to trigger that response (I don't know if the central apneas can trigger that and wake me). I've played around with settings a bit from pressure, to EPR, to humidity, etc, but nothing, so far, has helped me to stay asleep with it on. 

But, I will keep trying, it's still early days.

[SarcasticDave94]

When you have some data from a sleep session, load it to OSCAR, and attach the chart in a post. It'll guide us in setting edits to suggest.