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Anxiety Medications and CPAP - TBonz - 12-08-2017

Hi all. I've not updated in a while because, well, things seem to be going well. I'm in my eighth week of using the CPAP.

Except for one thing - anxiety. I never had any prior to this but I've not been able to get rid of the "I'm suffocating" feeling. I'm NOT - I know intellectually, but I feel like I am. If I wake up in the morning, I have zero trouble breathing/going back to sleep. I have to assume this is just anxiety since I'm a touch OCD and do twitches and other stuff when anxious.

Anyhow - I was on Xanax for 3 weeks. Perfect! I fall asleep in the normal manner each evening and even though I think "I'm suffocating," I don't seem to care.

But just heard today that it's not good to be on it long-term, as it's addictive. Who knew? It wouldn't be my drug of choice for addiction, as other than the cessation of anxiety, it doesn't give a "high." But I'm no doctor.

I start Hydroxyzine tonight. Hopefully this will work.

BTW - I DID try after day 7 on the Paxil to start going off of it, figuring I'd be OK with the CPAP. It was a disaster. I had to resume it. Then a few days later I had another horrible night which scared me since I had taken the anti-anxiety pill. Except next day, when I read my journal (I'm keeping a log on this to see how I'm doing and because my memory is crap), and counted my pills (I noted each day when I took it) it became clear that I had forgotten to take it that night. So it wasn't just a placebo; I really did need it.  I changed my routine to make sure I didn't forget again.

So the good news is that I'm doing the CPAP and used to it. The bad news is I require a pill to do so. I don't like that and I'm assuming my primary didn't think that I would need one for more than a short period. I'm disappointed in myself, but what can one do?

Once I get used to this, I will try again. I mean, I've been doing this for a month and a half now and don't mind it when going to bed. If I could just get rid of the pill, it would be ideal.

Have any of you ever had issues with anxiety? I *never* had it before this, other than doing an MRI (have to be medicated for that and it's a much worse situation - the CPAP mask I can easily remove, you know?) I only seem to have the problem at bedtime; I have no anxiety the rest of the day. This is a new (and unwelcome) thing.


RE: Anxiety Medications and CPAP - Gary1of2 - 12-08-2017

May i make a suggestion raise your min pressure to 7 or maybe 8. Most ofuse feel air starved with pressures low. The feeling stops about 6 to7


RE: Anxiety Medications and CPAP - kiwii - 12-09-2017

Gary1of2 makes an excellent point [edit: although I wouldn't just arbitrarily raise the pressure so quickly - post SleepyHead charts and ask for help]. Also, it could be that you are using a nasal pillow that is too small.

I just trialed the AirFit P10 - Regular and For Her - checking out each size with each headgear. The different pillow sizes definitely affect whether or not you feel air starved. I can use sizes XSmall, Small, and Medium. XSmall = air starved; Small is better, and I could use it; Medium is perfect (and Large is too big for my nostrils).

This is something that I've seen mentioned a lot: use the largest pillow that fits. This gives you a larger opening for the air to come through.

eta: disclaimer about raising pressure


RE: Anxiety Medications and CPAP - kiwii - 12-09-2017

(12-08-2017, 09:46 PM)TBonz Wrote: Hi all. I've not updated in a while because, well, things seem to be going well. I'm in my eighth week of using the CPAP.

Except for one thing - anxiety. I never had any prior to this but I've not been able to get rid of the "I'm suffocating" feeling. I'm NOT - I know intellectually, but I feel like I am. If I wake up in the morning, I have zero trouble breathing/going back to sleep. I have to assume this is just anxiety since I'm a touch OCD and do twitches and other stuff when anxious.

(snip)

Have any of you ever had issues with anxiety? I *never* had it before this, other than doing an MRI (have to be medicated for that and it's a much worse situation - the CPAP mask I can easily remove, you know?) I only seem to have the problem at bedtime; I have no anxiety the rest of the day. This is a new (and unwelcome) thing.

I was reading over the responses you've received on the other board.

Please note the parts of your original post that I bolded. I may be in the minority, however it seems to me that anxiety, if not outright panic, is a normal response to feelings of suffocation. You have anxiety at no other time, nor had you had it previously.

To my mind, the first step would be to attempt to fix the feeling of suffocation by what has already been mentioned here in this thread:

1. Are your pressures set properly for your needs? (post SleepyHead charts)

2. Is your nasal pillow properly sized?


RE: Anxiety Medications and CPAP - Sleep2Snore - 12-09-2017

Hi TBone,
I don't know what you machine normally sits at when running, but your low pressure is very low.
If you find you are breathing harder than the machine is supplying air it is to low.
I would put it up to 8 and leave the high where it is at the moment.
Also, if you are using Nasal Pillows it is common to select a size to small, it is better you start with the large size and come down in size if it is to big.
The nasal pillows should rest against the outside of your nostrils and not in any way go inside, only the tips should go inti your nostrils.
Finally, if you find it hard to breath out when using your machine, turn on EPR (Expiry Pressure Relief) which drops the pressure when you breath out, the higher the number the more relief you get.

Yes, I can fully understand the feeling of panic when going for an MRI.  They just couldn't get me into one even with medication.
They had to be content with a CT scan and x-rays.  I just can't handle confined spaces these days, well I can if I am in control, what does this say, I don't trust anyone?  I don't know, but I used to crawl into spaces some others would not go into, but now, no way!!


RE: Anxiety Medications and CPAP - Ghost1958 - 12-09-2017

2nd 3rd and 4th to raise your min pressure.
Likely you won't need the pills.


RE: Anxiety Medications and CPAP - CB91710 - 12-10-2017

(12-09-2017, 11:52 PM)Ghost1958 Wrote: 2nd 3rd and 4th to raise your min pressure.  
Likely you won't need the pills.

Ditto.
Your machine being set on 5-20 is effectively "wide open"... your DME did not program it to a "prescribed" pressure.... they are simply allowing the machine to self-regulate.

While not everyone requires a minimum pressure of 8+, the minimum levels are generally considered to be pediatric pressures and are a frequent source of anxiety.
Also good point on the mask size.  I've personally experienced much easier breathing with the large P10, and while the DME set my wife up with the small, she now prefers the medium.


RE: Anxiety Medications and CPAP - TBonz - 12-18-2017

Thanks for the responses. Sorry I took so long to return. The holidays are a busy time.

"May i make a suggestion raise your min pressure to 7 or maybe 8. Most ofuse feel air starved with pressures low. The feeling stops about 6 to7."

See, I feel like the air being forced up my nose and down my throat is suffocating me. So what everyone seems to be asking is counterintuitive.

"Your machine being set on 5-20 is effectively "wide open"... your DME did not program it to a "prescribed" pressure.... they are simply allowing the machine to self-regulate."

I called Lincare to get it changed a while back. "Can't do that without a note from the doctor." I put in a request and has it happened? Noooooo. My pulmonologist's office SUCKS and I'm in no position to change doctors. My primary has been a help, but the CPAP machine stuff comes from the  pulmonologist. I may well just change the thing myself; I do know how to do it.

"I just trialed the AirFit P10 - Regular and For Her - checking out each size with each headgear. The different pillow sizes definitely affect whether or not you feel air starved."

I did not know this was a possibility. It makes sense too. I will definitely check into this.

I'm still adjusting to the new meds, but after talking with you guys and those on the other board, I have things to try. I'll let you know, which, if any, end up working. Sooner or later I have to hit the right combination.

The irony is that even though I score 99s and 100s regularly, I'm still tired, sore and exhausted during the day. That is really disappointing. I know I have fibromyalgia and that could account for it, but I expected *some* improvement and other than possibly a bit more energy - nothing. It's very frustrating given how hard I'm working to stick this. I regret the day I ever went to the doctor and said I felt like a zombie. Now I'm an ANXIOUS zombie!

P.S. Can't do sleepyhead. No card reader.


RE: Anxiety Medications and CPAP - DeepBreathing - 12-18-2017

Quote:See, I feel like the air being forced up my nose and down my throat is suffocating me. So what everyone seems to be asking is counterintuitive.

There are two quite different feelings of "suffocation" which people feel when going onto xPAP therapy:

1. Can't get enough air - treated by increasing the minimum pressure, as suggested by several people above;

2. Drowning in air - inability to exhale against the pressure. This sounds like your problem, and is best treated by increasing the EPR setting and/or limiting the maximum pressure (if EPR fails to help). Try increasing your EPR to 3 (assuming you have a Resmed machine) and see how that goes.

Quote:P.S. Can't do sleepyhead. No card reader.

You can get one for a few dollars at any electronic or office supplies store. If you really want to get on top of this therapy (and not be dependent on a non-responsive doctor's office) you must be able to monitor your progress in detail. Sleepyhead is the key, and we can help.


RE: Anxiety Medications and CPAP - kiwii - 12-18-2017

(12-18-2017, 02:41 AM)TBonz Wrote: See, I feel like the air being forced up my nose and down my throat is suffocating me. So what everyone seems to be asking is counterintuitive.

The mask can make a huge difference in the way it feels.

Between two nasal pillows, the Swift FX and the AirFit P10, one delivers 'forceful' air and the other does not. At least for me. One is almost unusable, and one could not be more comfortable.



What I don't understand is, why is your team focusing on finding the 'right' medication instead of finding the right mask and settings?