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Just got my machine - can’t breathe - any suggestions?
#1
Just got my machine - can’t breathe - any suggestions?
I just received my Airsense 11 auto set. Last night was my second using it. First night I was able to wear it for 2 hours, but was waking up a lot restless and maybe feeling like it was difficult to breathe. I mostly took it off because the nasal cushion was pressing into my skin too painfully. Last night I didn’t wear a chinstrap and woke up once realizing I had been trying to mouth breathe.  But even when awake, I felt like it was so difficult to get air and that I had to really excessively breathe and couldn’t go back asleep with it on. I had changed the ramp time from 20 mins first night to 45 minutes on the second night because when awake the previous night, I felt the air flow was too intense to fall sleep easily.  I did fall asleep easier the second night but couldn’t breathe later.  Wore it 3 hours before removing.  Chest also ached and I assume that’s from not being used to breathing so deeply?   But the mask was comfortable the 2nd night.  I sleep on my side and really can’t fall asleep sitting up or on my back, though sometimes I can go back to sleep in those positions once I have some sleep inertia.

Mask fit is reported as 20/20 on MyAir app both nights.

Settings set by prescriber from the hidden clinical menu:
Pressure range: 6 to 12
Auto set response: standard
Start pressure: 4
EPR on
EPR type: ramp only
EPR level: 2


My settings:
Humidity: 8
Temp: 82

My sleep study had reported 1 central apnea and 3 hypoapneas.

Any advice on what I can do to breathe better with the mask I currently have?  Tonight I will wear the chinstrap, and eventually I’ll try a full face mask, as well as have a follow up appt with my prescribing sleep specialist in about 2 weeks, but I need to get to 4 hours of use a night  in 2 weeks for my insurance to cover it.
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#2
RE: Just got my machine - can’t breathe - any suggestions?
Welcome to the forum

Because you are having difficulty breathing change your settings to the following

Range 8-12 increase min by 2 to make it easier to breathe. EPR also needs aon of 7 to fully work.
EPR=3, Fulltime, NOT Ramp Only. Too many people say to use EPR Ramp Only because EPR may, only may cause an increase in Central Apneas and Central Apneas do not occur during the ramp which is totally false. Events, including Central Apneas are not REPORTED during the ramp, they definitely can occur. EPR of 3 Fulltime will feel more comfortable to you. Should an excessive number of CA events occur the good folks here will catch it and work on helping you to reduce them.
Finally, turn the ramp off, or if you 4eally want the ramp set it to 8

In summary
Range 8-12
EPR=3, Fulltime
Ramp= off or if needed Ramp pressure =8

Please post a copy of your Daily Charts from OSCAR so we can see what is actually going on
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#3
RE: Just got my machine - can’t breathe - any suggestions?
Tigress, the problem you're having is your EPR is set for ramp-only. That means it is not available after ramp ends for your therapy. Setting it to full-time is the key. Gideon's suggested settings should help, but the main thing is to set EPR for full-time.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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
RE: Just got my machine - can’t breathe - any suggestions?
Thank you for your suggestions!  The higher pressure and full time EPR indeed made it much easier to breathe.  This time I wasn’t able to fall asleep with it on, even with a 30 min ramp time. I’m now experiencing a racing heart and limb restlessness. Almost like the oxygen is giving me a ton of energy and preventing me from sleeping. I’m not normally prone to panic attacks and I already take propranolol at night before bed for morning migraines (one of the things we are hoping the cpap will alleviate). So the heart rate changes are in spite of my beta blocker med!

I also found my nose totally stuffs up sometimes, even after I took a xyzal before bed and Xclear nasal spray per some recs I saw.  Maybe a full face mask will help all these issues.
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#5
RE: Just got my machine - can’t breathe - any suggestions?
It would help if we could start seeing some Oscar charts. If your settings were 8-12, EPR 3 and you found that too stimulating to fall asleep, Let's cut back to Autoset Soft Mode, minimum 7 to 9 EPR 3. If you also find that prevents sleep reduce EPR to 2.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#6
RE: Just got my machine - can’t breathe - any suggestions?
Laugh-a-lot
Hi, I wanted to update on my progress!  I went through a few different masks and pressure settings before I have found one working for me.  Took me long enough to get used it and find what works for me that I was deemed non-compliant by my DME/insurance.  After trying to appeal, I was unsuccessful and was told I'd have to do a new sleep study to re-qualify.  Well, my Oura ring was reporting more and more breathing disruptions than before I got my first study, so I was pretty sure a new study was not going to change anything and with my current insurance, a new study would cost me $1000 out of pocket, which is obviously more than the cost of a brand new CPAP machine.  So long story short, I'm now the proud owner of my own machine to use as much or as little as I please.  Ironically, I've been 100% compliant since getting my own machine - I really had needed just a little more time to get used to it.  I'm using it most of the night and I'm not having issues waking up feeling like the pressure is too little or too much.  I don't think I'm waking up much more than I would have without it so that's all good progress!

Anyway, I have a few questions for you folks.  I've been looking at my OSCAR data and I think things look good.  But I wanted to ask, in the first screenshot, it appears that my breathing is getting more shallow, my CPAP machine increases the pressure, and it seems that it has prevented me from having a full apnea event.  Am I interpreting that graph correctly?

In the second screengrab, can you help me interpret what's going on with the mask leak and the apnea?  It seems like a small leak but did my CPAP misintepret the leak as an apnea event or did the increase in pressure possibly cause my mask to leak?

And finally in the third grab, what's happening with my breathing around the clear airway event?  It looks like my CPAP machine "missed" it and didn't increase the pressure, is that right?


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