Would raising the initial setting make it easier to breathe?

[ellen1159]

I've had my machine for one week now, and so far I've not been able to go longer than one hour with the machine. My pressure settings are 25/15 (though even after one hour I've not see the top number go past 20) and the ramp up starts at 4 and lasts 45 minutes.

I notice that I'm fighting the feeling of suffocation when I first start out, is that because the pressure setting is only 4?

I've tried to nap with the machine on and sit up and watch tv with it on, but I just can't get past an hour. I seem to be getting leaks along the bottom edge of the mask no matter how much I fool with the straps, and if I pull them tight enough to prevent leaks then the mask feels too tight (I haven't figured out to put the pressure up to max when I first place the mask on my face, so that it forms a good seal and the straps are at the proper tension).

I know I have a good mask, the Quattro IV full face version, but I seem to have trouble situating it on my face so that my nasal passages feel open. At first I thought the mask was too small but the maker, Resmed, has a template you can print out and it seems to be the correct size. The doctor's assistant showed me how to put the machine on, then she had me tip the top of the mask almost perpendicular to the bridge of my nose, and slide down almost halfway before swinging the bottm part shut against my jaw. It feels like it shouldn't sit so low on the face, but sometime I'm able to breathe through my nose with the mask on, so I guess the placement is correct.

I just can't seem to get all of the bits together (placement of mask on face, straps adjusted, pressure settings correct) enough to actually fall asleep with the mask on. Last couple of times I noticed while sitting up wearing mask that my jaw ached a little after from air blowing in my mouth. I also had a slight headache. My jaws tend toward achiness from years of nightime bruxism (teeth clenching and grinding); I've also heard of jaw pain being a sign of a heart that isn't pumping adequately, a scarier scenario but one that seems possible given my obesity (264 lbs. on a 5' 5" frame) and sedentary lifestyle.

I know the sleep deprivation has a lot to do with it, but I've been feeling really depressed and pessimistic the past few days, like I'm never going to get the hang of this machine.

[Pugsy]

I notice that I'm fighting the feeling of suffocation when I first start out, is that because the pressure setting is only 4?

Yes. For most people that 4 cm setting just simply is not comfortable. Technically we won't suffocate at that setting but it sure feels like it. There's just not much air movement.
I once did a screening on my sister and her husband and neither could tolerate anything less than 6 cm to start with.
Increase the ramp's starting pressure to 6 or 7 cm and you should be more comfortable.
You might also decrease the ramp time.

[pandatx]

my doc started me at 4 and I raised it to 6 and it made a world of difference. I felt suffocated at 4-5.

[Denial Dave]

+1 to Pugsy's recommendation to reduce the ramp time on your machine

I've got mine set for 5 minutes. It's just enough time for me to get settled into bed, etc...... Quite a few folks here have the ramp time turned it off completely

Dave

[chunkyfrog]

You mention,"I seem to have trouble situating it on my face so that my nasal passages feel open."
Some people feel restriction inside the nose with certain cup-style masks.
It appears to happen with the pressure in a certain place
If you find this to be the case with you, there are the Liberty and the original Hybrid mask,
which combine nasal pillows and a cup around the mouth.
Many with "nose squeeze" issues are able to use one of those masks.

[Pugsy]

I think the 760 has a mask fit feature but it may need to be turned on in the clinical menu.
Press and hold ramp button should activate it so that the machine will briefly give you your higher pressures so you can make adjustments.
At least I think the ramp button is the trigger....someone correct me if I am wrong.

[RogerSC]

Yes, similar experience here, sleep doctor put me 4 - 10cm with a 30 minute ramp initially, and I didn't feel comfortable breathing when I was going to sleep until I turned off the ramp, and raised the initial pressure to 8cm. Those were the first adjustments that I did with my cpap, and my doctor was fine with it. After noticing that my pressure hung out at about 10cm nearly all the time, decided to raise it (incrementally), and am now on 10-14cm, which covers the territory much better.

Still getting complementary centrals (no charge for those, I guess), very few obstructive apneas, though. My AHI is as likely to be .3 or .4 as 1.9 these days *smile*. Seems to cycle up and down, the variable is how many centrals I get. The average AHI is now closer to 1 than the initial 1.5 that I experienced, and it looks like it won't be getting much better than that. Unless the centrals (which were not reported in my sleep study) go away. Getting off the original question, though *smile*...the mind wanders.

[RandyJ]

At my titration anything less than 8 cm felt like not enough air... I think if you increase it a bit (anywhere between 6 and 8 cm) and decrease the ramp time (as Pugsy suggests) you will be all right.