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Having trouble adjusting to CPAP. Any advice?
#1
A bit of history: I've probably had issues with sleep apnea for 10+ years, but it was only recently that chronic nasal congestion was causing me to have pretty severe episodes multiple times a week, where I'd wake up in the middle of the night and feel more or less fine, but my heart would race the second I took a deep breath, and I'd feel like I was having a heart attack if I stood up and moved around at all before I calmed down.

I had surgery to fix a deviated septum about two years ago and that helped a bit, but my sleep troubles/daytime exhaustion never really went away completely. This past december they came back as bad as ever, so I went and had a sleep study done. Although the sleep study only said I had mild OSA, the doctor still proscribed me a CPAP with an autoset 5-15.



I was finally able to pick it up last week, and I still haven't really been able to fall asleep with it on. I've never really been the sort of person to have trouble falling asleep on a typical night, unless my congestion is so bad I can't breathe through my nose. With the cpap, though, it seems to be like I've got bad congestion pretty much every time I put it on. I feel short of breath while wearing it unless I put a considerable amount of effort into breathing, which makes it nearly impossible to relax enough to fall asleep. The one time I did manage to fall asleep, I think I was only out about an hour before I woke up feeling like I wasn't breathing. I'll generally wear the mask for 30-60 minutes while lying in bed, trying to sleep, before taking the mask off with the intent to get up and do something else for awhile so I can come to bed even more tired. If I take the mask off without getting out of bed, though, I wind up falling asleep pretty much instantly.

Did anyone else have such trouble sleeping at first? If so, was there anything you were able to do to make it more tolerable, or did you just keep at it until you got used to wearing it?
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#2
#1 item for comfort is finding the right mask for you. Everyone has their own favorite. Some people love pillows... myself, I like the full face mask. Helps to breath through the mouth when congested. Starting pressure of 5 will make some people feel as if they are not getting enough air.

There is an EPR feature on the machine that will provide up to 3 cm relief of expiration. So, people need it; some don't.

The humidity setting can make a difference, More humidity helps some people with nasal congestion. You have to find the "sweet spot" in that setting.

Many people have trouble at first; and even take their mask off without realizing it.

So there are several small tweaks one could make to improve comfort. Getting to try different masks would be a plan.
The main thing is to stick with it. It's like a new pair of shoes -- soon they'll be broken in; and feel comfortable.
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
Hi SleepyDoc,
I can relate to your problem as many others can too. WhenI first started therapy, I would get panic attacks trying to sleep with mask on, but took advise from folk on this forum. I moved my machine to the living room and sat up in recliner and either read or watched TV for an hour before bed just to get used to the feeling of wearing the mask and the feel of the pressure.
Then there was my Doctor who took a more serious approach by telling me if I didn't use CPAP that I wouldn't be alive in 5 years. That approach worked!

The bottom line, as justMongo says, find a mask you are comfortable with. I also suffer from nasal congestion. Make sure you use the humidifier, and a nasal rinse helps too. It takes time, but you can do it!
Bed
OpalRose
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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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#4
Download the SleepyHead program and look at the data your CPAP machine records.

It might give you some clues.

Without CPAP, most people will open their mouth and breathe that way if nasal congestion blocks their airway. In theory, you'd find that in an in-lab sleep test, but sometimes you don't sleep the same in the lab as you do at home.

Did they wake you up and put a CPAP mask on you during the sleep test and find the right pressure (split night study)?
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#5
Hi SleepyDoc,
WELCOME! to the forum.!
I know CPAP therapy can take some getting used to.
What you might try is to wear your mask, use your machine as you read or watch tv during the evening, and see if that will help you get used to this new way of sleeping.
You also might try to use a sinus rens before you go to bed.
Just stick with it,it does get better.
Hang in there for more suggestions and much success to you as you get settled into and continue your CPAP therapy.
trish6hundred
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#6
Thanks to everyone for the replies so far. I adjusted my air up to 7-15 and tried to nap this morning, it seemed to help a bit. I guess I'll just keep at it.

(03-05-2015, 10:27 AM)archangle Wrote: Without CPAP, most people will open their mouth and breathe that way if nasal congestion blocks their airway. In theory, you'd find that in an in-lab sleep test, but sometimes you don't sleep the same in the lab as you do at home.

Did they wake you up and put a CPAP mask on you during the sleep test and find the right pressure (split night study)?

No, apparently the sleep study that was requested by my sleep doc didn't include the titration for some reason. I'm sure the different environment changed how I sleep, though. Normally, I fall asleep pretty much immediately when I lay down, and then sleep (from my perspective) pretty soundly until an apnea episode wakes me up. During my sleep study, I tossed and turned for like 4-5 hours, but felt like I slept unusually well for the last 3-4. My AHI was 5.9 with no OSAs, but I never achieved the deepest stage of sleep they list on the report.

I think my sleep doc just set me up with an autoset CPAP to see if it helped rather than force me to wait another 3-6 weeks for a second sleep study.
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#7
(03-05-2015, 10:50 AM)SleepyDoc Wrote: No, apparently the sleep study that was requested by my sleep doc didn't include the titration for some reason. I'm sure the different environment changed how I sleep, though. Normally, I fall asleep pretty much immediately when I lay down, and then sleep (from my perspective) pretty soundly until an apnea episode wakes me up. During my sleep study, I tossed and turned for like 4-5 hours, but felt like I slept unusually well for the last 3-4. My AHI was 5.9 with no OSAs, but I never achieved the deepest stage of sleep they list on the report.

What do you mean "No OSA's?" Did you have all hypopneas or CA's? Do your have a copy of the sleep report?

You definitely need to get SleepyHead and check your data.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
Post Reply Post Reply
#8
Another thing that will make you feel like you're short on air as you fall asleep is if the "ramp" feature is on. The default ramp starts at 4.0 cm and gradually increases to the therapy pressure over 45 minutes. Best bet is to turn off ramp, or increase the minimum pressure of ramp and reduce the ramp time to 5 minutes.
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#9
(03-05-2015, 11:31 AM)archangle Wrote: [quote='SleepyDoc' pid='103238' dateline='1425570604']
What do you mean "No OSA's?" Did you have all hypopneas or CA's? Do your have a copy of the sleep report?

You definitely need to get SleepyHead and check your data.

Yeah, I was looking at my sleep report when I was responding. I had no recorded OSAs, light snoring, and my AHI was a result of a small number of CSAs, and a large number of hypopneas.

I'll take a look at sleepyhead, thanks for the recommendation.

(03-05-2015, 11:54 AM)Sleeprider Wrote: Another thing that will make you feel like you're short on air as you fall asleep is if the "ramp" feature is on. The default ramp starts at 4.0 cm and gradually increases to the therapy pressure over 45 minutes. Best bet is to turn off ramp, or increase the minimum pressure of ramp and reduce the ramp time to 5 minutes.

I turned the ramp off after the first night or two. I've tinkered with the comfort setting that reduces the pressure on exhale too, but I think that works better when it's off for me as well. I might try increasing the minimum pressure and then turn the comfort setting up, to see if the comfort setting helps, but it was just lowering the pressure too much when it's set to a minimum of 5.
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#10
at the low pressure I use, I was the happiest when I had inhale pressure equal to exhale pressure.
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