[CPAP] Any advice for a new cpap user who has a fear of things covering her face.

[Kbowie78]

Hello,
I am newly diagnosed with mild sleep apnea. I was given my cpap this past Monday and have been struggling with it ever since. I have a real fear of anything covering my face and this has made my anxiety worse.
I was give nasal pillows because of my fear but still feel claustrophobic and feeling like I'm on the verge of suffocating. My pressures are set to auto (between 5-20) with a ramp down to 4.
Once the pressure goes over 8, I'm awakened feeling like I'm smothering. Always sitting up and ripping the mask off gasping.

Any help is greatly appreciated, I'm desperate for a full night of sleep, I'm exhausted.

[eseedhouse]

The only thing so far as I know that is proven to work for phobias (which seems to be what you are describing) is gradual desensitization. There are therapists out there who do that, but you can try yourself to simply wear the mask for however long you can stand it, even if it's only a second or two, and gradually extending that to the point where you can wear it long enough to sleep with.

Of course there is nothing to actually be afraid of, but since phobias by definition are irrational that doesn't help much. I lived for many many years with the irrational belief and fear that my heart was about to stop, or actually had stopped. This of course was silly, but the fear (terror really) was just as real and debilitating silly or not. Since I did not actually die gradually this fear faded.

[OpalRose]

Hi Kbowie78,
Welcome to Apnea Board!
I was the same when I first started. I am still very claustrophobic. The nasal pillow mask is easier to adapt to. Any other mask covers more of your face.

Try using your mask and machine while sitting up either reading or watching TV. This helps distract you and you will be surprised how fast the time goes by. Do this an hour before going to bed each night.

Don't know what machine you have, but you can set the EPR (ResMed machines) or flex (for Respironics machines.) These are comfort settings and lowers the pressure when exhaling.

A lot of folk feel air starved when they have a low minimum pressure as you have. It would make more sense to have your minimum pressure at 6 and a ramp set at 4 for 30 minutes. This way the machine will start at 4 and ramp up slowly to 6.

You can order the Clinicians manual for your machine here.
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

[chill]

Welcome to the Apnea Board. It will help us if you can completely fill out your profile so we know exactly which machine and mask you have. You can use this to help identify your machine: http://www.apneaboard.com/cpap-machine-p...ur-machine

I agree that 4 is too low, I've heard that called the children's setting. Yes, children can have sleep apnea too. I'd also reduce your maximum pressure for now. A setting of 4-20 is "wide open". I think it would be easier to adjust to a lower maximum setting, even if this is below what you need. When you had adjusted to the mask, you can gradually increase it if needed. What did your prescription from the sleep study say?

Chuck

[IDRIck]

Changing your starting pressure could make a huge difference. Everyone is different of course but for me, I felt like I was suffocating with initial pressures of 4 cm and a slow ramp. This went away with adjusting the starting pressure to 8 cm and decreasing the ramp up time. Now that I'm used to a cpap and need a very high pressure, my initial setting is set even higher at 15 cm.

[MitchS]

Hello, Kbowie78. Welcome to the board.

All of the advice given above will help you get started.

When I first started out I had the same problem you are. I found by restarting the ramp feature I could usually get back to sleep. If restarting the ramp didn't work I would get up and read a few minutes before going back to using the CPAP.

When I started using nasal pillows, I found I would sometimes knock them out of position causing either a large leak or flow restriction when I rolled over. By gently pulling them away from my face and resettling them I can get them positioned where they belong again and resolve the problem.

Sleep well,

[trish6hundred]

Hi Kbowie78,
WELCOME! to the forum.!
When I switched over to a FFM, I just had to work through it. For a while, I went back and forth between the F&P simplus full-face mask and the Resmed AirFit P10, but after a while, I had to completely get the other masks out of my drawer so I wouldn't give in and use the pillows mask instead, I have finally crossed over to the FFM and haven't looked back.
I wish you much luck in getting through this problem so you can get better sleep.
Hang in there for more suggestions and much success to you.

[cate1898]

Welcome to ApneaBoard Kbowie78!

Masks are such an individual thing. Look through the supplier's list at the top of the page and spend some time visiting each one's web site. Some offer mask return policies.

Not everyone is suited to using nasal pillow masks. People who open their mouths at night also referred to as mouth breathers need a full face mask as trish6hundred was talking about. There are also nasal masks which cover just your nose. Another one you might want to take a look at is the DreamWear as it rests just under the nose covering just the nostrils and the hose connection is at the top of the head which is great for keeping it out of the way (out of sight-out of mind).

Easing yourself in to help overcome claustrophobia is a great idea. A lot of CPAPer's have some degree of claustrophia probably due to being oxygen deprived for so long until diagnosis. Keep plugging away. OpalRose's suggestion of wearing it while awake and gradually getting more used to it is a great idea.

Don't give up. The benefits of being properly treated for your sleep apnea far outweigh the difficulties adapting and all you will go through to get comfortable with it. And it might take many months to get comfortable. Keep persevering, it's worth it!

[Sn00zeAlarm]

Make you are relaxed and breathing easily before putting on the mask. I find reading a bit does this.

[kowlooner]

When I did the sleep study, they used an auto PAP for the titration to determine the best pressure. It started with the ramp but I guess it shot up to whatever pressure it needed as soon as there was an apnea event. The problem was I had (have) severe apnea, and the AHI was around 45, so basically one every minute or so. On the first try, the pressure changes kept waking me up, and each time I felt like I was being increasingly suffocated. About 20 minutes in, I called in the technicians in kind of a panic. They just said that's the way it is. They restarted the machine, and the second time I was able to stay asleep.

I was afraid it would be like that at home, too.

BUT, when I finally got my own machine, it was set to a constant pressure of 13 and I was too lazy to change it to auto PAP. It felt a bit weird having that much all at once, but it wasn't as bad as I thought it would be (it also has the expiration breath relief thing, which helps a bunch, and I really love my Sleepweaver fabric nasal mask, which helps make the pressure seem workable). And because there were no sudden pressure changes, I had no problems going to sleep and staying asleep. First night. Zero problems. AHI was something like 2.5 and it's never been higher. Most nights now it's zero point something. I'm happy.

By the way, that exhalation relief thing I think might be more important with constant PAP so it's easier to exhale through the nose and not the mouth. You might still need a chin strap to help with that though.

Mind you, I've only been in this for less than a month, but I was afraid of the suffocation thing and claustrophobic feeling of the mask too. I might try out the auto PAP a bit later, but at present I kind of enjoy being able to sleep well so don't really want to bother with it.

So, to sum up, maybe you could try changing the setting from auto to constant and start at a medium pressure. Hopefully your doctor gave you a constant pressure number? If you can get to sleep and stay asleep, you won't have the feeling of suffocation and the claustrophobia will probably go away too since you'll start associating good things (like sleep!) with the mask.

Don't know if that will help, but good luck.