Breathing Wrong?

[phonebeard]

I have been using a CPAP machine for two months, with no noticeable improvement and am getting frustrated. I changed my doctor and liked the new guy. He explained a lot more and made some tweaks to my machine, increasing the initial pressure.

My first night with the new settings was a bad experience. I woke up feeling even worse than before.

Some background. I am mostly a mouth breather. I use a full face mask. Over the two months I have been using it I have been gradually increasing the tightness of the fit because of small leaks which wake me up. But I think my main problem is the way I breath. I start out breathing through my mouth because my nose is usually stuffy when I go to bed. My natural breathing pattern is to breath in slowly and out fast (I didn't know that this was not the right way to breathe!). This is fine at low pressure, but gets harder as the pressure increases. I work up this morning breathing shallowly, finding it difficult to breath out enough to empty my lungs to then get another breath in. It was a relief to take off the mask, but it took a while for my breathing to settle down to something like normal (i.e. to breath without noticing.)

So, what should someone like me, who breaths in slow and out fast, mostly though my mouth, do? Are there settings on the machine that will help?

I have another appointment with the doctor in a month, but I think I need help quicker than that.

[LSAT]

Most machines have a pressure relief to help when exhaling. If you would give some information regarding the machine you are using we may be able to help you. Go to the control panel and fill in your equipment profile.

[vader06]

Do you have a humidifier with your machine? Setting the humidity level can help clear the congestion.

[chunkyfrog]

If you had an abnormal breathing pattern, it would have been noted in your sleep test.
What you describe is likely only happening while you are awake, because of anxiety.
It gets better.

[phonebeard]

Most machines have a pressure relief to help when exhaling. If you would give some information regarding the machine you are using we may be able to help you. Go to the control panel and fill in your equipment profile.

I joined this morning and haven't had a chance to fill in all the details. I put in my machine (I am pretty sure it's that one, I don't have it with me.)

[phonebeard]

If you had an abnormal breathing pattern, it would have been noted in your sleep test.
What you describe is likely only happening while you are awake, because of anxiety.
It gets better.

I did a home test, which I think didn't work very well, but was all that was on offer. But you are right that I can only notice how I breath when I am awake. Does the machine make measurements of breathing patterns?

[Julie]

You are not supposed to breathe in any particular way but your natural one, as you would if you weren't on Cpap. It's quite possible that your efforts to do otherwise are affecting things... the machine should adapt to your pattern, not the other way around, and it will report any abnormal pattern that might need addressing by other means rather than your trying to breathe one way or another. You should however, look into the EPR (or 'flex') feature on your machine if exhaling is difficult even when breathing normally. I believe the effort of trying to breathe 'abnormally' for you may cause your anxiety.

[greenall]

I agree with the humidity comments. I have really bad hay fever this time of year and the only way I can use my full mask is to have the humidity and heat cranked up fairly high. It might not work for you, but it definitely does for me

[Wulfman...]

I have been using a CPAP machine for two months, with no noticeable improvement and am getting frustrated. I changed my doctor and liked the new guy. He explained a lot more and made some tweaks to my machine, increasing the initial pressure.

My first night with the new settings was a bad experience. I woke up feeling even worse than before.

Some background. I am mostly a mouth breather. I use a full face mask. Over the two months I have been using it I have been gradually increasing the tightness of the fit because of small leaks which wake me up. But I think my main problem is the way I breath. I start out breathing through my mouth because my nose is usually stuffy when I go to bed. My natural breathing pattern is to breath in slowly and out fast (I didn't know that this was not the right way to breathe!). This is fine at low pressure, but gets harder as the pressure increases. I work up this morning breathing shallowly, finding it difficult to breath out enough to empty my lungs to then get another breath in. It was a relief to take off the mask, but it took a while for my breathing to settle down to something like normal (i.e. to breath without noticing.)

So, what should someone like me, who breaths in slow and out fast, mostly though my mouth, do? Are there settings on the machine that will help?

I have another appointment with the doctor in a month, but I think I need help quicker than that.

What are (ALL OF) your settings?
Are you doing nasal cleansing before bedtime (so you can breathe through your nose)?
If you're using a higher humidity setting, that can contribute to nasal congestion.

Are you using software to monitor your therapy? If not, get it and use it ( "Sleepyhead" ).


Den

.

[phonebeard]

I was too anxious to use my machine last night. Tried for over 40 minutes and gave up. I am going try to reset the machine back to the way it was before (whatever that was); even though I don't think they were working for me, at least I didn't wake up in a panic. The technician at the doctor's office said he would send instructions.

[phonebeard]

What are (ALL OF) your settings?
Are you doing nasal cleansing before bedtime (so you can breathe through your nose)?
If you're using a higher humidity setting, that can contribute to nasal congestion.

Are you using software to monitor your therapy? If not, get it and use it ( "Sleepyhead" ).
.

I am beginning to realize there is a lot more to this than I first thought. The person who dropped off my machine gave me 15 minutes of instruction. I don't know how to find out what my setting are (but I will). I don't know what "nasal cleansing" is (but I will find out). I don't know what my humidity setting is, but did run the tank on empty one night and had a clear nose in the morning. But doesn't that contradict other advice that higher humidity will help? I have never heard of "Sleepyhead" (but will look for it now.)

There is far too much here to absorb; I thought that's what I was paying the experts to do, but I guess like everything else, if you want it done right, do it yourself. Sigh. I just have too much going on right now to deal with this. I might have to give up and come back to it later.

[grayghost4]

this is a link that will tell you about sleepyhead :

https://sleep.tnet.com/resources/sleepyhead

[Julie]

About humidity - it is NOT therapy and is meant only to be a convenience, a facilitator for Cpap. Some people like it, others never use it. You may live in a relatively humid place (WA. state, New Jersey, etc) and rarely feel the need of it, but if you're in Arizona or Colo, might want it all the time, or in New England where central htg is an issue in winter... it's entirely up to you how much to use. If you find a higher setting causes congestion, lower the setting or turn it off entirely. If you have other issues that respond to more humidity, raise the setting. It's all up to you.

[Sleeprider]

I think your question regards the I:E ratio (inspiration/expiration time). "Normal" respiration is typically considered to be an I:E range of 1:1.5 to 1:2 (this may also be expressed as a ratio i.e. 1:1.5 =.667). We occasionally see users like yourself, that have an inverse I:E ratio with longer inspiration than expiration resulting in a higher expiratory ratio, for example I:E of 2.5:1.0 (I:E=2.5). There is not much documentation on this, and generally we don't even know if it is a "bad" thing in CPAP therapy. My observation has been that people posting Sleepyhead data with an inverse I:E ratio tend to have much higher incidence of hypopnea events recorded, and they are very hard to extinguish using various pressure settings.

In Robysue's Beginner's Guide to Sleepyhead, she concludes, "We have no idea if there is any clinical significance to this number or not. For most of us, it's likely not a very useful number to worry about."

I really don't know why some people seem to have very short expiration time in their breath cycle. It is not uncommon, and I am yet to see good research or answers as to whether it is important and why. Most internet articles on this subject are dealing with invasive mechanical ventilation.

[Wulfman...]

What are (ALL OF) your settings?
Are you doing nasal cleansing before bedtime (so you can breathe through your nose)?
If you're using a higher humidity setting, that can contribute to nasal congestion.

Are you using software to monitor your therapy? If not, get it and use it ( "Sleepyhead" ).
.

I am beginning to realize there is a lot more to this than I first thought. The person who dropped off my machine gave me 15 minutes of instruction. I don't know how to find out what my setting are (but I will). I don't know what "nasal cleansing" is (but I will find out). I don't know what my humidity setting is, but did run the tank on empty one night and had a clear nose in the morning. But doesn't that contradict other advice that higher humidity will help? I have never heard of "Sleepyhead" (but will look for it now.)

There is far too much here to absorb; I thought that's what I was paying the experts to do, but I guess like everything else, if you want it done right, do it yourself. Sigh. I just have too much going on right now to deal with this. I might have to give up and come back to it later.

I've been saying for years that most of the users will know more about their other electronic devices (phones, video recording/playing, etc.) than they want to take the time to learn about the equipment that will keep them breathing through the night. Yes, this is another thing that the users need to know more about, but it's like anything else......it has a number of words and phrases in the terminology that aren't difficult to learn.
I've always said "It's so easy, a caveman could do it." (that was back when GEICO was using them in their commercials).

Hang in there, keep reading, get the software and look at your own data and you'll get up to speed in a hurry.


Den

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