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[Symptoms] I feel like I'm suffocating... not enough airflow.
#1
I feel like I'm suffocating... not enough airflow.
I often wake up with the feeling that I'm suffocating. Since starting on PAP about 3 months ago I frequently feel like it's hard to inhale enough air. At first I was using a Phillips Nuance nasal pillow mask and I thought it was the restriction in size of the nostril orifices, but I've since switched to a ResMed AirFit N20 and I still feel like I'm having this problem.

The problem happens mostly in the mornings, I keep on getting woken up by the feeling I'm not getting enough air, then I fidget with the mask which helps a little then fall back to sleep, this repeats a few times and then I give up and take the mask off because I can't sleep anymore.

I've had the problem with both a Phillips DreamStation Auto and ResMed AirSense 10 AutoSet, currently I'm using the ResMed device (I have both machines still) and I have it set to start at 9 cmH20. My AHI score at this setting is under 1 so I'm hesitate to increase it higher to force more air through the system.

What do you recommend I do?
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#2
RE: I feel like I'm suffocating... not enough airflow.
lol. You sound almost exactly like me. I am also looking for a solution. I'll let this community know what happens when I get back from my ASV titration in April.
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#3
RE: I feel like I'm suffocating... not enough airflow.
There are two possibilities.
1. your pressure is too low and not satisfying your needs.
2. you are using the Resmed P10 and the exhaust vents are becoming blocked by a buildup of moisture during the night. This results in you re-breathing your exhaled CO2. The problem and some solutions are discussed in this long thread http://www.apneaboard.com/forums/Thread-...YPERCAPNIA
Sleeprider
Apnea Board Moderator
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____________________________________________
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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: I feel like I'm suffocating... not enough airflow.
(03-20-2019, 03:49 PM)nbritton Wrote: I often wake up with the feeling that I'm suffocating. Since starting on PAP about 3 months ago I frequently feel like it's hard to inhale enough air. At first I was using a Phillips Nuance nasal pillow mask and I thought it was the restriction in size of the nostril orifices, but I've since switched to a ResMed AirFit N20 and I still feel like I'm having this problem.



(03-20-2019, 05:35 PM)Sleeprider Wrote: There are two possibilities.
1. your pressure is too low and not satisfying your needs.
2. you are using the Resmed P10 and the exhaust vents are becoming blocked by a buildup of moisture during the night.  This results in you re-breathing your exhaled CO2. The problem and some solutions are discussed in this long thread http://www.apneaboard.com/forums/Thread-...YPERCAPNIA

Since the op said he is using an Airfit N20 (before that he had a Nuance Pillow Mask), point #2 and the extremely long thread attached does not apply...

Two months ago, the guys here said your pressure is dialed-in fine, but since two months have passed, things certainly could have changed.  I'd recommend re-posting your Sleepyhead charts so that a more informed solution could be suggested. - - That's just my opinion of course.

See the following link to your original thread here...
http://www.apneaboard.com/forums/Thread-...y-settings

Look at the bottom of Bonjour's post where he has links to how to organize your charts and how to upload. He has other helpful information in his signature. - As he said there, they prefer to have daily charts uploaded in order to give you good information. Since your situation sounds severe, I'd upload your chart(s) ASAP. Good luck to you!
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#5
RE: I feel like I'm suffocating... not enough airflow.
I was looking at the profile for the mask information. Nbritton, use this link to update your profile information http://www.apneaboard.com/forums/usercp.php

Most of the same links are also in my signature.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

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: I feel like I'm suffocating... not enough airflow.
(03-20-2019, 08:20 PM)Sleeprider Wrote: I was looking at the profile for the mask information. Nbritton, use this link to update your profile information http://www.apneaboard.com/forums/usercp.php

Thanks, I updated my profile. I have also made some changes...

1. I swapped the ResMed AirSense 10 AutoSet back to the Phillips DreamStation Auto because I remember liking the A-Flex feature. A-Flex is set to 3.
2. I Increased pressure from 9 on the AirSense 10 to 9.5 on the DreamStation.
3. I bought some Breathe Right Extra nasal strips because maybe these will open up my airway more.
4. I adjusted the harness fitting on my AirFit N20 mask.

I'm going to try these four things for a few nights and then I'll report back.


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#7
RE: I feel like I'm suffocating... not enough airflow.
Hello nbritton,
We really get a better feel for what’s going on when we can see the Daily page with the graphs, including the left sidebar.
See my signature line below for directions.

I’m going to try to address your comments.
1.  From experience, I would tune down the Flex setting.  For me, a Flex setting of 3 made me feel as if the machine was forcing me to inhale/exhale sooner than ready.  
This could be why you are feeling “air starved.”  I would tune in down to a Flex setting of 2.
Remember EPR (ResMed) and Flex (Respironics) work differently.

2.  If your are going to use the DreamStation instead of the AirSense, you will need a slightly higher minimum pressure as the Respironics machines are a bit slower to react to apnea events.  You may want to work your way up to a minimum pressure of 11cm.  I’m going by your 90% pressure reading.

3.  Breath Rite strips are ok to use if they help.  Also try using a nasal rinse and sprays.  A good one to try to called XLEAR. (Found on Amazon)

4.  Adjust straps as needed, but too tight is sometimes worse than too loose.  
Read this for help.  http://www.apneaboard.com/wiki/index.php...ask_Primer
OpalRose
Apnea Board Administrator
www.ApneaBoard.com
Dreaming


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php...ganization
Using Attachments to Post ScreenShots.
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Machine Choices



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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#8
RE: I feel like I'm suffocating... not enough airflow.
(03-21-2019, 07:17 AM)OpalRose Wrote: Hello nbritton,
We really get a better feel for what’s going on when we can see the Daily page with the graphs, including the left sidebar.
See my signature line below for directions.

I’m going to try to address your comments.
1.  From experience, I would tune down the Flex setting.  For me, a Flex setting of 3 made me feel as if the machine was forcing me to inhale/exhale sooner than ready.  
This could be why you are feeling “air starved.”  I would tune in down to a Flex setting of 2.
Remember EPR (ResMed) and Flex (Respironics) work differently.

2.  If your are going to use the DreamStation instead of the AirSense, you will need a slightly higher minimum pressure as the Respironics machines are a bit slower to react to apnea events.  You may want to work your way up to a minimum pressure of 11cm.  Im going by your 90% pressure reading.

3.  Breath Rite strips are ok to use if they help.  Also try using a nasal rinse and sprays.  A good one to try to called XLEAR. (Found on Amazon)

4.  Adjust straps as needed, but too tight is sometimes worse than too loose.  
Read this for help.  http://www.apneaboard.com/wiki/index.php...ask_Primer

I will work towards getting the data you and others have requested. I forgot to put my mask on at the beginning of last night, but I did put it on in the middle of the night and was able to log three and a half hours.

Since the ResMed AirFit N20 was new I guess the mask harness straps loosened up after breaking it in for a month. Adjusting my straps appears to have fixed my leak problem, my average leak rate was 2.85 and 90% leak rate was 7.2, but now it's 0.02 and 0 respectively. I think the leaking was one of the things that would arouse me because today I don't remember prematurely waking up to fidget with the mask to stop it from leaking. I wear ear plugs, so I don't think it's the sound of the air escaping but rather the sensation the air creates as it blows over my skin.

The Breathe Right strips appeared to help a lot. When I was looking in the mirror as I inhaled deeply I notice that my nostrils get sucked in and then restrict the airflow. I put the breathe right strip on where my nostrils were getting sucked in and I immediately noticed it was easier to breath through my nose.

My RERA Index increased over 60% last night, my running average is 0.31 and last night it was 0.83. I researched what that means and it appears there is too much resistance in my airway. My average EPAP is 6.61, however, last night it was 7.94. I think this suggests my lungs are struggling against the pressure necessary for exhalation.


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#9
RE: I feel like I'm suffocating... not enough airflow.
I felt like that once I adjusted to CPAP therapy. I concluded I probably needed a higher pressure. Sure enough, I raised my pressure from my prescribed 5 to a 6.5 or 7, and sure enough no more suffocation feeling.
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