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Breathlessness while using CPAP
#1
Hi,

My dad is using CPAP for the first time last night, Resmed Airsense 10 Autoset.

He woke up a few times. First time he woke up he had breathlessness feeling which he did not had without CPAP.

His pressure is set from 5 to 20. EPR at 2.

He had this breathlessness issue during his sleep study titration with CPAP. Report says when he woke up with breathlessness the pressure was at 10. Not sure what was the pressure when he woke up yesterday will install software later and check once the SD card reader is bought.

Any suggestion will be appreciated. Thank you.
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#2
First, download SleepyHead as that may help understand better what is going on. Your dad is using near default open settings on the auto CPAP at 5-20. It's going to be a big benefit if he optimizes that so the pressure changes are not so large. Great machine, and capable of very comfortable therapy, but there is not much of a clue in your post. It would be great to see the progression of pressures and events that led to the arousal.

My signature shows how to organize Sleepyhead data and post it so we can be of more help. One last thought; the first night is not representative of the full experience he will have on CPAP. It's important to try to optimize settings to keep things more stable, but also it is an adjustment process. It needs time.
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#3
I can relate to the breathlessness!! But you get over it quick. I really think it has to do with exhaling against the pressure. You fight that and get behind on your o2. I remember the feeling, but got over it quick.

Honestly I frequently can't even tell if my machine is on. Many times I tug at my mask to hear/feel the rush of air leaking to confirm all is good.

Tell your Dad, he is not alone!
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#4
@Sleeprider Thanks I will prepare the data in about 5-6 hours and post it here.


@Always Curious Thank you. Can you tell me how long it took you to get relief from the breathlessness?

(01-09-2017, 08:46 PM)Always Curious Wrote: I can relate to the breathlessness!! But you get over it quick. I really think it has to do with exhaling against the pressure. You fight that and get behind on your o2. I remember the feeling, but got over it quick.

Honestly I frequently can't even tell if my machine is on. Many times I tug at my mask to hear/feel the rush of air leaking to confirm all is good.

Tell your Dad, he is not alone!

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#5
I remember that feeling well from the sleep study. It was the thing that concerned me the most during that eternity between the study and getting your gear. Was that real? Did I imagine it? Nope, first night at home, there it is again.

Best advice, recognize it, relax, remain calm and breathe thru it.

I was past it in less than a week.
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#6
http://imgur.com/KlXiqll

Hi Sleeprider. Here is the data. He woke up at 1:30 feeling breathless. It seems like pressure went up to 19 at that time.


(01-09-2017, 08:26 PM)Sleeprider Wrote: First, download SleepyHead as that may help understand better what is going on. Your dad is using near default open settings on the auto CPAP at 5-20. It's going to be a big benefit if he optimizes that so the pressure changes are not so large. Great machine, and capable of very comfortable therapy, but there is not much of a clue in your post. It would be great to see the progression of pressures and events that led to the arousal.

My signature shows how to organize Sleepyhead data and post it so we can be of more help. One last thought; the first night is not representative of the full experience he will have on CPAP. It's important to try to optimize settings to keep things more stable, but also it is an adjustment process. It needs time.

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#7
sjishan, this is an unusual case where pressure climbed to high levels, but the only events are snores. Snoring does increase the pressure on auto CPAP, because it is sometimes a sign of the airway becoming obstructed. In this case, the machine went too far. I recommend you set a maximum pressure of 11.0 cm to prevent this from happening. The only reason that maximum pressure would be contraindicated is if numerous obstructive apnea or hypopnea occurred while he is at maximum pressure.

I think the setup looks good and is clearly very effective. He will be more comfortable if you change the settings to prevent the machine from increasing pressure above the level he needs for therapy.
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#8
I noticed two events as I am new to these so I am not sure if they are relevant.

1. There was a 30% mask leak before 0:30 during which the machine stopped. He said he did not removed the mask during that time and was asleep. The machine then started working soon as we can see and there were snoring events.

2. When the pressure kept rising he was having flow limitations as seen from the graph.

I would like to get some feedbacks regarding these. Thanks.

(01-10-2017, 10:00 AM)Sleeprider Wrote: sjishan, this is an unusual case where pressure climbed to high levels, but the only events are snores. Snoring does increase the pressure on auto CPAP, because it is sometimes a sign of the airway becoming obstructed. In this case, the machine went too far. I recommend you set a maximum pressure of 11.0 cm to prevent this from happening. The only reason that maximum pressure would be contraindicated is if numerous obstructive apnea or hypopnea occurred while he is at maximum pressure.

I think the setup looks good and is clearly very effective. He will be more comfortable if you change the settings to prevent the machine from increasing pressure above the level he needs for therapy.

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#9
Your interpretation is correct; however, the flow limitations can be an indication of impending apnea, or can be induced by excess pressure. Thus my suggestion to limit maximum pressure. His 95% IPAP pressure was less than 10, so I think the suggested upper limit of 11.0 is fairly conservative.
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#10
(01-10-2017, 10:41 AM)Sleeprider Wrote: Your interpretation is correct; however, the flow limitations can be an indication of impending apnea, or can be induced by excess pressure. Thus my suggestion to limit maximum pressure. His 95% IPAP pressure was less than 10, so I think the suggested upper limit of 11.0 is fairly conservative.

Thanks.
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