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[CPAP] Mask panic after long term use
#1
Rainbow 
After successful use of CPAP for the last 11 years I have recently become unable to tolerate the treatment.
This began 3 months ago when I had a cold lasting 2 weeks, I have always had to suspend CPAP during a cold. There then followed 5 weeks of insomnia with only 3 or 4 hours broken sleep per night, with minimal use of the CPAP.
As sleep has become easier I started to try the CPAP again with limited success.
The best I have achieved is 3 consecutive nights with 3 then 4 then 5 hrs of CPAP use. That was 2 weeks ago since then I have been unable to cope with the mask due to feelings of panic when trying to get to sleep with the mask on.
I can tolerate the mask if I wear it to watch TV or read but I don't fall asleep, as I would if not wearing the mask.
If I try to fall asleep with the mask on i.e. Switch off the light put down the book etc I begin to feel panic, heart racing, rapid breathing etc and very quickly wrench the mask off. This can take between 5 and 30 minutes to kick in.
I have tried various sleep/relaxation aids, from warm milk, through breathing exercises, kalms sleep, even as far as a large Scotch at bedtime.
Nothing seems to work.
The problem seems to be getting worse as the anxiety of not being able to use the mask is adding to the panic I experience when I try to use the mask.
I would appreciate an help or advice on how to deal with this situation
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#2
I'm no expert; but I think you need cognitive behavior therapy to get past what seems to be a phobia.
From the description it might even be diagnosed as panic anxiety disorder.

Time to see a professional.

BTW -- Scotch fragments sleep as it is a biphasic drug. (First sedative then a stimulant.)
And avoid benzodaizapines -- it's easy to get hooked in a short time.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
Thanks for the reply.
GP appointment booked for tomorrow.
I hope he comes up with something but I'm not going to hold my breath waiting
Or maybe I am.
I'll update with the outcome.
Ryan63
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#4
Your machine is getting a bit old. So take it to some DME and ask to have it's pressure checked. You might be panicking because you aren't receiving enough air, or maybe too much air, or perhaps the pressure support isn't performing properly.

Also, consider a different style mask, specifically a pillows mask. The nice thing about those is there really isn't anything much on your face to panic about.
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#5
Retired_Guy read my mind. You need a new machine, and it would be especially good if you could get some feedback on your therapy. It could be your current machine is doing nothing to help you, and it may be way out of calibration for pressure. You have no idea whether there are benefits to CPAP because your machine doesn't give you useful data. Time to change.

You're using a large heavy full face mask. Have you ever tried anything else? The nightweight nasal pillow masks are a lot nicer if you can avoid mouth breathing.
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#6
The P10 twins... The Mirage Quattro is a great mask.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
Hi ryan63,
I'm sorry to hear that you are starting to have mask panic.
If you can swing it, you should get a new machine, as you would be much better served with the newer technology. Just make sure it is a fully data-capable machine.
Good luck to you with getting this straightened out.
trish6hundred
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#8
I agree that the initial setting may be a bit too low. Lack of adequate air push can cause that unknown source of anxiety. I had it when I got my machine. Once I adjusted it up a notch or two I felt much more relaxed. My own congestion changes with the seasons, so I periodically adjust the machine start pressure until it feels right.
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#9
I talked this through with my GP today.
He initially offered citolopram but said it could take 3 to 4 weeks for the effect to begin!
He then suggested a 2mg dose of benzodiazepam to control the mask panic and break the cycle of increasing anxiety caused by failure to tolerate the mask.
Only 10 doses were supplied and I must see him again if the problem is not resolved before they are all used.
I have just taken the first dose and will update on results tomorrow.
Thanks for all your advice
Ryan63
Ps I have some highly accurate pressure recording equipment I use for my job, I will use this to check machine pressures.
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#10
Tried the "benzo" last night, no change to the mask anxiety!
Checked the pressures being delivered by the machine using a calibrated digital micro manometer.
Highest pressure achieved is consistently 1.4cm lower than the set pressure.
The exhale pressure reduction should be 3cm but is only dropping by 1cm.
Going to try a higher set pressure tonight and contact clinic for repair/replace of machine ASAP.
I'm in UK so no cost for this service but choice of machine/mask is limited.
Pros And Cons of National Health Service
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