Do you ever have trouble pulling in air?

I’ve had this happen a few times, again last night, no congestion or cold. Last night it was when I was just dropping off to sleep (Ambien) following a comfortable few minutes of doing puzzles while wearing my mask. I found myself having to work way too hard to get air. I repeatedly struggled to get enough breath in, then would begin to drift off, again and again until I realized something was wrong and woke up. I took off my mask, walked around and drank water, put the mask back on then fell back to sleep. No idea if it I slept through the bad breathing or if it improved.

Another oddness, I occasionally have apnea events that wake me powerfully, with near panic and pounding heart as if my autoPAP wasn’t pushing air as I would think it should.

Most of the time it works well as far as I know. Does any of this sound familiar to you?

What are your pressure settings and have they changed at all recently? They may just be too low. Any new meds? Weight gain? Sleepyhead reports to show us?

Since you describe this as being soon after dozing off, I have to wonder if it was during ramp time. Are you using the ramp feature? If so, you may want to consider if your ramp pressure needs increased. Not familiar with if your machine has a ramp that responds to needs or not, but even if so, too low a starting point can make it take a while to increase where to you need. Those who fall asleep quickly can be at a disadvantage if their ramp continues after they are asleep and begin having events. If this is not during your ramp time, I would wonder if your pressure is adequate.

When I had something similar during the night, I changed my EPR from 3 to 2.

Dave

brightcrow wrote: ↑

Thu Apr 05, 2018 8:48 pm

Do you ever have trouble pulling in air?

I guess you mean inhaling. What are your pressure settings and pressure relief settings? What are your ramp settings?

If you use Sleepyhead, you can see breath by breath what is happening - viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html

What size nasal pillow are you using? Still the P10?
I have had what you are describing happen with the P10...the nasal pillow tried to climb up in my nose and got compressed a bit and the air flow got shut off or greatly reduced. Solved by moving up a size in nasal pillow so that it can't get sucked up my nose and compressed.

Pugsy wrote: ↑

Fri Apr 06, 2018 8:18 am

What size nasal pillow are you using? Still the P10?
I have had what you are describing happen with the P10...the nasal pillow tried to climb up in my nose and got compressed a bit and the air flow got shut off or greatly reduced. Solved by moving up a size in nasal pillow so that it can't get sucked up my nose and compressed.

Op, I was having the same problem the other night, I decided to try my nuance pro again, but tried the small pillow because I thought maybe the medium was too big, causing me nose pain. So I think what pugsy said is what was happening to me.
But, I also have something similar as the last topic you wrote about, happening on a more regular basis. I wake up suddenly, feeling like I can't breathe, so I rip off the mask. Heart beating fast. Weirdly enough, sleepyhead never shows any events happening immediately before I wake up and tear the mask off.

After you put your mask back on and lay down, do you ever feel lightheaded or faint? I have this, and at first I wasn't sure what it was, but something just felt wrong, and I couldn't fall back to sleep very easily, and when I did, I would wake up feeling faint again, having to get up and walk around. This happens to me about one a month or so now.

Cpap lowers blood pressure, and if yours is already on the low side, you'll feel a bit lightheaded when you first awake... don't jump out of bed, but go slowly for a minute.

I am having a similar problem with my Airfit P10. The difference is that it's a couple of hours after I've gone to sleep. I wake up and even though I'm already awake, I'm having trouble pulling in air. I stop the machine and start again and it seems fine. I can't help but think that there is something gumming up the mask itself (diffusion part?), but am puzzled as to what it is. I'm trying a different mask tonight. This mask is only a couple of months old, so gumming up seems a bit early.

SewTired wrote: ↑

Fri Apr 06, 2018 4:04 pm

I am having a similar problem with my Airfit P10. The difference is that it's a couple of hours after I've gone to sleep. I wake up and even though I'm already awake, I'm having trouble pulling in air. I stop the machine and start again and it seems fine. I can't help but think that there is something gumming up the mask itself (diffusion part?), but am puzzled as to what it is. I'm trying a different mask tonight. This mask is only a couple of months old, so gumming up seems a bit early.

Next time this happens just try pulling the pillows out briefly and then put it back on and see if the feeling changes.
This is what was happening to me. I had immediate relief just by pulling it out and putting back on and eventually I was able to notice that the pillows were actually up in my nostrils just a bit and compressed just a bit. That's when I opted to try the Small (had been using the XSmall) and it never happened again.
Up to that point I would sometimes have it happen maybe 2 or 3 times a night...some nights not at all but it was annoying when it happened.

It was already suggested that you diminish the ramp (or disable it completely). It was also suggested that you might need to raise the pressure and/or adjust (or disable) the exhalation relief.

Another thing I suggest is disabling the auto off feature. It might be wrongly detecting that you removed the mask and shutting off.

brightcrow wrote: ↑

Thu Apr 05, 2018 8:48 pm

I’ve had this happen a few times, again last night, no congestion or cold. Last night it was when I was just dropping off to sleep (Ambien) following a comfortable few minutes of doing puzzles while wearing my mask. I found myself having to work way too hard to get air. I repeatedly struggled to get enough breath in, then would begin to drift off, again and again until I realized something was wrong and woke up. I took off my mask, walked around and drank water, put the mask back on then fell back to sleep. No idea if it I slept through the bad breathing or if it improved.

Another oddness, I occasionally have apnea events that wake me powerfully, with near panic and pounding heart as if my autoPAP wasn’t pushing air as I would think it should.

Most of the time it works well as far as I know. Does any of this sound familiar to you?

i've had this happen to me twice. and i'm embarrassed to say that it happened twice!

upon checking, i found that i hadn't closed the humidifier lid all the way down.

it's just silly that this happened again. think i'd learn the first time.

I apologize for not responding sooner. I appreciate all your suggestions.

I think that my nasal pillows must be compressing in my nostrils and restricting air. I don’t know how often this is actually happening because I may be sleeping through this occurrence and may actually not be getting a healthy amount of airflow on a regular basis. Scary that I could be getting less air than I would with no CPAP. The next pillow size up is very big. The problem may be that the teeny bit of lanolin that I use for a seal may actually be helping the pillow to go up in my nostrils.

I will need to learn more about ramping, I think mine is set on automatic, and I also need to understand exhalation settings. I didn’t meet the clinical criteria for apnea, but am prescribed the autoPAP to treat poor oxygenation. However without the device, I am quite aware of my sleep being interrupted frequently by apnea.

As for the scary heart-pounding, almost-died sensation along with deeply inhaling on my own, that doesn’t seem right. It shouldn’t let me get to that point, right?

I have no knowledgeable respiratory therapist to consult. The dude in the small office who dispenses equipment doesn’t know much, and the company’s respiratory therapist doesn’t return calls.

Don't refrain from trying another type a mask, such as a regular nasal mask (or a full face mask, as a last resort).

Perhaps the nasal pillows are not the best for you. Choice of a mask is a very individual thing.

brightcrow wrote: ↑

Thu Apr 05, 2018 8:48 pm

I’ve had this happen a few times, again last night, no congestion or cold. Last night it was when I was just dropping off to sleep (Ambien) following a comfortable few minutes of doing puzzles while wearing my mask. I found myself having to work way too hard to get air. I repeatedly struggled to get enough breath in, then would begin to drift off, again and again until I realized something was wrong and woke up. I took off my mask, walked around and drank water, put the mask back on then fell back to sleep. No idea if it I slept through the bad breathing or if it improved.
Another oddness, I occasionally have apnea events that wake me powerfully, with near panic and pounding heart as if my autoPAP wasn’t pushing air as I would think it should.
Most of the time it works well as far as I know. Does any of this sound familiar to you?

It sounds to me like you have some pressure settings that are too low. I presume you know how to get into the Clinical Menu, and have the Clinical Manual? What is your minimum pressure set at? Maximum? Is your Ramp Off, or on Auto, or is a time set? What is the start pressure? See page 16 of the manual to see how to set things up. Say for example your minimum pressure is 8 cm, I would set it up as follows:

Ramp Time: Auto
Start Pressure: 6 cm

When set this way you will get 6 cm of pressure until you fall asleep and then it ramps up at 1 cm per minute to your minimum pressure of say 8 cm. Most people will find 6 cm comfortable, but if you feel it is not giving you enough air then go a bit higher. How that helps some, and I can be more specific if you can say what the machine is set at now.

On your second issue, it is possible your machine has the default minimum of 4 cm. That is low and for some people not enough air. If you really don't have apnea or snoring or flow limitation, then the machine will ramp down in the night to the minimum pressure, and you may be feeling you are not getting enough air. The solution is simple. Increase the minimum to say 8 cm.