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New Member having big problems
Hi everyone.

Just wanted to say hello and hopefully get some help.

I was recently diagnosed with severe OSA.

My cardiorespiratory examination in normal but I have a narrow upper airway with a long and thick uvula.

My sleep study revealed I suffer around 82 apnoeas per hour and major oxygen desaturation to 41%. My sleep efficiency is 80%.

I have been trialling a Resmed S9 Autostart with a variety of masks, with very little success. We started my pressures 'wide open' with low pressure at 4 and high at 20. Since then we've narrowed the range, with my current set-up at: HIgh 20, Low 8, start 6 with ramping of 20 minutes.

It's made no difference. I still wake up soon after I've fallen asleep seemingly gasping for air and ripping the mask from my face. I'm currently using a Mirage Quattro FF mask.

I'm feeling quite depressed and very furstrated. I just don't seem to be able to adjust to this. I know it's only been about three weeks, but my current energy levels and quality of life feel worse thant before I commenced treatment. I've not had one good night's sleep since commencing this treatment.

I'm hoping someone out there can share their experience and help me through this.


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Welcome, OzzieMatt, hasve you looked at the EPR settings? On the Autoset they range from 0 - 3, try it at 3, you obviously know you have to use it so need to get it sorted out with your Dr. The high of 20 may also be too high, do you know what your AHI has been on average, if it is low, under 5, you maybe able to reduce the high a bit, good luck with it and I'm sure you will get more suggestions.
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Matt, I strongly recommend downloading SleepyHead and familiarizing yourself with it and looking at your data if you aren't already. Specifically, I'd be interested to see whether you are having large and/or frequent leaks.

Do you find the mask uncomfortable? The Quattro Air and Quattro FX are both similar to the Quattro but 'lighter' on the face if that makes sense.
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I agree that you need to look at your data in ResScan and Sleepy Head. Also, if your O2 was dropping so low, maybe you need some help there. I would think that should be monitored and maybe you need oxygen assistance as well.

As previously suggested, leaks could be part of the problem. download your data in the programs and see what it shows you. Post your data here if you feel comfortable with that and maybe we can help you more.

Look at what kind of apneas you are having and see if they are occurring when you have a leak.

Sorry you are having this problem. Finding the right mask is one of the biggest issues with CPAP adjustment.

Also, during your sleep study, did they put you on a CPAP machine and tell you an optimal pressure setting? If so, what was that?
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G'ay OzzieMatt

Some people adjust easily to CPAP treatment but most of us take a while to adjust. I've been at it since August so I'm a relative newby, but I've turned the corner. When I started I had exactly the same problem. I had the feeling of drowning in air and kept pulling the mask off.

It took me a few weeks to get used to it, but I still pull it off occasionally. She Who Must be Obeyed keeps an eye on me and nudges me if she notices it's off.

One thing that helps a lot of people is to start the therapy while reading or watching TV to help your body get accustomed to the mask and the airflow.

You need to make sure you're comfortable with your mask - I tried four before I got one which was suitable and didn't leak. Everybody's face is different, and there is a huge variety of masks out there, so keep trying till you get one to suit.

You might also need to vary the pressure - maybe drop it a bit and then increase it until your AHI comes down. And also check your EPR setting, as advised above. And try using SleepyHead software which will help fine tune your therapy.

CPAP therapy can be really hard to adapt to. Your body is learning to breathe in a whole new way, with a plastic alien strapped to your face! But you've passed the hardest part. From here on it gets a little easier, night by night.

Apnea Board Moderator


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Hi OzzieMatt,
WELCOME! to the forum.!
CPAP therapy can take some getting used to but just hang in there with it. You haven't been at it very long and it does get better as you and your body get used to it. You might try to mask up and use your machine during the evening while you read or watch tv to further help your body get used to the therapy.
You might also try a different mask. Some people have had to try quite a few masks 'till they found the right one for them. Don't be shy about asking to try different ones.
Good luck with your CPAP therapy, don't give up and keep us posted.
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Consider when you are ripping off the mask - if it is near the outset of the session, as you seem to indicate, it may well be because the start ramp pressure is too low and you are not up to speed by the time you slide down into the first phase of sleep. If that it the case, you may wish to up your start pressure. If it is happening later, then you need to examine the data to see at what pressure this reaction is being triggered. You might want to also adjust the escape mechanism as discussed above (the EPR settings), which provide a bit of a pressure relief during the outbreath.

If your mask is leaking massively, you will also feel that there is not enough pressure and start to have the choking sensation you are describing.

Take a good calm look at how the problem develops each night, note how long it is from putting your head on the pillow and go from there. This may be an adjustment issue, an issue of fine tuning the pressures or the mask fit,or swapping out mask types, or it could be something else. Try to be as methodical as possible with this and the solution will present itself.
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Hello - welcome to the forum, and to OSA.

A few things to think about?

I bought a CMS50F Oximeter that records data, has a rechargeable battery, has an alarm function ( you could have it wake you if your O2 goes too low), comes with software so you can see for yourself how your O2 stats are doing.

Before I had my nose surgery, I had real issues getting enough air. I had to teach/train myself to believe that it would and could work. I also went with a nasal mask - greater comfort, less leaks - easier to take on and off, and less bothersome overall. So possibly a change of masks may be a help to you as well. I found that personally I hated the ramp, and I wanted my full pressure at the time I first put the mask on.

Your new life can be frustrating, but you need to teach yourself, that you have no choice, that this is now part of your new life, and the sooner you can keep the mask on all night, the better life will be. So, what can you change to achieve that goal? Possibly reducing the ramp? Possibly a different style of mask? (many of us have tried 10+ different masks - what works for you won't work for me, and vice versa)

Know that you are not alone~! After 12+ years of this, I still have bad nights, and rarely now, but from time to time I must take a Xanax to calm myself prior to going to bed. Figure out what helps and do it Smile
*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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Sounds like you need to ditch the ramp up function.
Your minimum pressure is 8 and that is not too bad if you hook up and sit on the side of the bed a few minutes each night you'll adapt to the pressure more quickly.
After a few minutes your muscles adapt to the new situation and you'll feel like the machine is not doing anything.
Wave a hand in front of the exhaust vents and then you'll feel the air blasting out.
Then you're good to go and NO gasping for air.

I finally adapted to 15cm (start pressure) this way and it works like a charm.
gives you a chance to check for leaks and correct them too.

Good luck & Sleep-well
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

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You need to get SleepyHead or ResScan and see what's happening at the time you have to pull the mask off. It will tell you a lot about what's going on. i.e. is your pressure low, did you have a bad apnea, etc.?

In theory, your doctor or DME should look at this data, but many of them are uneducated and don't do this.

If you can avoid it, try to control your panic and don't rip the mask off.

Consciously breathe in and out. Feel the air going into and out of your lungs. Breathe deeply. You always have more air with the CPAP, not less. It's some sort of psychological thing that makes many people think they're not getting enough air.

Look at the display on your machine and figure out the pressure when this happens.

See if you can figure out anything specifically wrong at that time.

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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