First few nights: ok. Last few nights? So, so bad.

[IvanaSleep]

Overall     Details      Worst night yet     


Background
I have a history of waking up in the middle of the night and not being able to get back to sleep. My family also says I snore constantly when I am asleep ("we can hear you through the walls") and my wife said I often wake up gasping for air.

I recently did a home sleep test with identified my AHI as 12.5 and RDI as 14.5 for the test night. As a result of this, I got an Airsense 11 with climate line and an Airfit F20 full face mask (I'm often stuffy at night and mouth-breathe as a result.). The Airsense was set to ramp-up, 4 - 20 pressure setting, and auto climate control.

First Few Nights

• Night 1: I wore the mask for about 30 minutes before I settled to sleep in order to get used to it. Because of my stuffy nose, it seemed hard to get a full, deep breath with the mask on and I was a little panicky. I left the mask on though and fell asleep. I woke up in the middle of the night because of this alien on my face and decided to take it off and walk down the hall and back to relax a bit. I was up for 2 hours before falling back asleep. Since I went to bed earlier than normal, I woke up feeling rested-ish. I didn't feel amazing, but I felt a little better than normal.
  

• Night 2: Similar to night 1 except I woke up and was able to get back to sleep within 20 - 30 minutes. I still get panicky before going to sleep because of the mask. I woke up feeling rested-ish.
  

• Night 3: Using myAir i saw there were several leaks during the first 2 nights so I tightened the mask. The result was a significant drop in leaks going forward. I didn't wake up at all during the night and in the morning I still felt ok, not great.
  

Last couple of nights
I still get the panicky feeling every time I put the mask on and try to go to sleep. I still wear it all night, but it's annoying to say the least.  I turned off the ramp-up, set the minimum pressure to 5 and the EPR from 1 to 2. I've slept very lightly each night and awoke for short periods of time. Last night was the worst. I slept lightly, I woke up at midnight for 30 minutes. At that time the Airsense had 3 short beeps (which happened as I was waking up) and when I woke up this morning, my first thought was "well, that was dogsh*t."

Plea for help
I'm not going to give up, so I'm coming to you experienced folk to get suggestions in the hope that I can turn this around and get some better sleep (and as a bonus, if anyone knows how to reduce / eliminate the stupid panicky feeling, that would be great!).

[2old2work]

Hi ... I've been wearing a mask for 23 years now and here are a few things I learned.
For panic - the mind will object to almost anything it isn't used to. To train your mind to accept a mask
wear it during the day for short periods (say 5 - 10 minutes), slowly increasing the time until you are
comfortable wearing the mask for at least an hour.

The type of mask also has an effect. I could not sleep comfortably with a full face mask. I tried three
different masks and settled on nasal pillows, which I used for almost ten years. As I aged my mouth
was getting harder to keep closed (my wife says that started before I aged). I now use a Resmed AF30
nasal mask. It is the most comfortable mask I have used and it acts like a nasal pilllow mask yet also covers
my mouth when it won't stay shut. That made a chin strap unnecessary, which was nice.

I hope that gives you some ideas.
John

[super7pilot]

As you will find oft repeated on this forum. Throwing you out the door with a 4-20 setting is simply laziness on the sleep Dr's part.

4cm is for a very small person (child) and often makes an adult feel starved for air. Not a great way to try and fall or stay asleep. With your setting at 5 the EPR will only be at one as the machines min pressure is 4cm.

A better way to go is to set the minimum very near to your median pressure (8cm) and you can set some EPR for comfortable exhaling. And of course it's a rare CPAP user that hasn't had to deal with the frustration of finding a mask that works and is comfy. I went from a P10 to F40, N30I, P30I, N30. AND I ultimately came back to the P10 and it has worked fine.

Also, Be aware that even with a lower AHI than your sleep study. I just takes time to adapt to sleeping with higher than atmospheric pressure. And with a low minimum pressure setting. the sudden large increase in pressure to stop an apnea event can awaken you. Which is why you want your min pressure near to the therapeutic pressure.

[IvanaSleep]

Thank you for the suggestions @2old2work.

[IvanaSleep]

As you will find oft repeated on this forum. Throwing you out the door with a 4-20 setting is simply laziness on the sleep Dr's part.

4cm is for a very small person (child) and often makes an adult feel starved for air. Not a great way to try and fall or stay asleep. With your setting at 5 the EPR will only be at one as the machines min pressure is 4cm.

A better way to go is to set the minimum very near to your median pressure (8cm) and you can set some EPR for comfortable exhaling.  And of course it's a rare CPAP user that hasn't had to deal with the frustration of finding a mask that works and is comfy. I went from a P10 to F40, N30I, P30I, N30. AND I ultimately came back to the P10 and it has worked fine.

Also, Be aware that even with a lower AHI than your sleep study. I just takes time to adapt to sleeping with higher than atmospheric pressure. And with a low minimum pressure setting. the sudden large increase in pressure to stop an apnea event can awaken you. Which is why you want your min pressure near to the therapeutic pressure.

Thank you. I was trying to slowly ramp up the minimum pressure (I didn't want to make drastic changes all at once so I could see what worked and what didn't.). I will take your suggestion on setting the minimum being 8. I'll leave EPR at 2 and see if that works.
I don't actually find the mask to be uncomfortable (though obviously it's a little strange). I just have this feeling like I'm restricted from moving (due to being linked by a hose / mask) and I won't be able to breathe. I'm guessing it's like claustrophobia though I've never had that in confined spaces so I'm not sure.