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Presure on Exhale
#1
Presure on Exhale
Hello - So fortunate to have found this group! I am a new CPAP user and finding it frustrating. It's been about a week and a half now and I am having one main problem. I use the DreamWear Nasal Gel Pillow CPAP Mask and I find that when I exhale there is to much resistance. Can anybody tell me what setting I need to adjust to fix this? My machine is the Dreamstation Auto with humidifier.  Also I seem to be breathing a lot deeper than necessary and it's hard to take shallower breaths.

I really want this therapy to work as my AHI is 86/hour without CPAP and 68% oxygen levels. With the CPAP my AHI is 2-8 which I know is better but I just can't get past this resistance on exhale thing. It almost makes me panic. Last night I just gave up a slept without... Sad

Any help would be greatly appreciated.

Thanks in advance!
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#2
RE: Presure on Exhale
PR machines have an exhale relief called Flex. There should be a setting available to you in the settings. I don't have their machine so I can't tell you how to access it. Check the manual that came with it and look for the Flex setting. The numbers means how much of a difference between the inhale and the exhale. So if your inhale is 12 and the Flex is 1, the exhale would be 11. Start with 3 which is the highest you can go.

Also sit up with it on (both mask and machine) during the day to get used to breathing against it.
PaulaO

Take a deep breath and count to zen.




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#3
RE: Presure on Exhale
Hi vincentbizz,
Are you using an Auto cpap, and what pressure range are your using? If using a straight cpap, is is set to 6cm?

There is an AFlex setting to help when exhaling. You can set it to 2 or 3 and see if that helps.

As far a mask resistance setting (which is different from flex settings) there should be a number on the mask packaging.

Order the Clinicians manual for your machine:
http://www.apneaboard.com/adjust-cpap-pr...tup-manual
OpalRose
Apnea Board Administrator
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: Presure on Exhale
I use the Dreamwear mask. I have it set on A-flex with a flex of 1 with 3 being the easiest on exhale. To access these settings push top right button along with front menu button for about 6 seconds. Then go to comfort screen where you will find these settings. I would take note of all settings before changing them for a reference . This is found in the"provider" guide.
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#5
RE: Presure on Exhale
also don't try to breath out, just let it happen, The lung doesn't fully empty because of the pressure splint to keep your throat open. It can feel funny at first. Don't worry, you are getting plenty of air in and out. Get some sleepyhead charts up and the forum will help you fine tune.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#6
RE: Presure on Exhale
Ditto.

It can be frustrating at first. You're connected to the machine, and if you don't sleep with a fan (the kind that moves air Wink ) all you are hearing is air moving through the tube, so you become VERY aware of your breathing. Slight discomfort can easily lead to panic... I went to the ER twice because my heart rate and BP shot up, and I felt that I was not purging the CO2.

Once you fall asleep, you will exhale normally against the pressure without being aware of it.
Work with your Flex/EPR and ramp settings to find what works. It may be that your machine is set for a fairly high pressure, and even with Flex on, if the ramp is turned off, it may be too intense when you first go to bed.
-- Rich
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INFORMATION ON 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 WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Presure on Exhale
Hi vincentbizz,
WELCOME! to the forum.!
I know that CPAP therapy can be frustrating and difficult to get used to, but just stick with it, it does get better over time.
Good luck to you on your CPAP journey, hang in there for more responses to your post.
trish6hundred
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#8
RE: Presure on Exhale
Thank you every one for your suggestions. I will persevere and try turning the flex to 3. I think its at 2 now. It's really gotten to the point where I dread going to bed because it has become such an effort. Hope it doesn't take to long to adjust! 

Thanks again - you are all a great bunch. Very helpful!
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#9
RE: Presure on Exhale
Turn the pressure down for a week. min 6 max 7. The main thing is when you are in bed, the mask is on, no excuses. There is an adjustment curve and some have a harder time. Take it one step at a time. You could even start with using it while you watch TV, to get use to it.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#10
RE: Presure on Exhale
There are also two flex modes, A and C (I think that is the names).  I found one much more comfortable than the other, but I can't recall which.  Try both and see.  It does take some getting used to, but once you are over that you will no longer notice it unless you concentrate on it.  Give it time.
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