Problem Breathing With CPAP
Question:
On 9 Sep 1998 02:36:17 GMT, mrw…@aol.com (MRWMIW) wrote: >I have been on CPAP 5 days. The pressure I was given was 15. They have >given me a Mirage Mask. During the night I usually have to remove mask >several times a night. Sometimes I have to leave it off. When I am on CPAP >I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is this >normal?
Yes, 15cm is a high pressure and therefore not easy to adapt to when you first start using CPAP. Breathing out against 15cm is not easy and you may well benefit from a bi-level PAP, which gives a high pressure when you are inhaling but a lower pressure to exhale against. Bi-level machines are much more expensive so your doc will probably want to see how you get on with CPAP first. The Mirage is an excellent mask with a wide range of adjustments. Check that the cushion is ’standard’, rather than ‘large’ size – very few people need a large Mirage. Check that the forehead support is correctly adjusted, and that the headgear is not too tight. Tight headgear invites leaks. You may also find that you are suffering from an allergic reaction which swells your nasal membranes, making breathing out against the 15cm pressure more difficult. Ask your specialist to prescribe a nasal spray such as Beconase. Alternatively, many people find an in-line heated humidifier helps greatly. Contact your local AWAKE group for support. Pester the sleep lab. Buy a book on OSA and CPAP – I would recommend "Phantom of the Night" by T Scott Johnson and Jerry Halberstadt. Jerry spent years fighting every problem CPAP could bring, and won. The book is very informative about the condition, machines, masks, and all the problems you can have. Hang in there. CPAP is worth persevering with. Regards, Tony Polson Scarborough, N Yorkshire, UK email: news[at]polson[dot]demon[dot]co[dot]uk
Response:
Alfredo, Let’s try some common ones: OSA = Obstructive Sleep Apnea … The airway (throat) collapses and obstructs the flow of air during sleep. There is also Central Sleep Apnea, which results from the Central nervous system "forgetting" to breathe. CPAP = Constant Positive Airway Pressure … The original device, which delivers a constant positive flow of air into the airway. BiPAP = CPAP revised to allow a different amount of pressure during inhalation than exhalation. Some people find exhaling against pressure (even moderate), makes it difficult to sleep. At increased pressure with some individuals, the exhalation pressure can lead to Central Apneas (or so I’ve been told). (Hence reduced pressure during exhalation with the BiPAP unit). Smart PAP or DPAP (Demand PAP) = CPAP units that monitor the airflow, supposedly detecting any respiratory disturbances. Should it detect some it automatically increases the pressure. xPAP = Any of the Positive Airway Pressure devices. RDI = Respiratory Disturbance Index … essentially the number of times the airflow was distrubted by obstruction in the airway. RLS = Restless Leg Syndrome … Some people face sleep problems caused by legs movements as they fall asleep. PLMS = Periodic Leg Movement Syndrome … Supposedly the same thing, but occurs when the person is asleep. Hope that helps … and isn’t too inaccurate. Do check out the site suggested by BigAl : http://www.newtechpub.com/phantom/faq/osa_faq.htm Regards, =jbf= John B. Fisher
Response:
Thanks to all for your advice. I will be trying all of it. I called my Sleep Ctr and talked to therapist there. They offered no real help. They said I would need to work with things for up to two months before they would consider changing machines or reducing pressure. They said when I feel like I stop breathing it is just that my body does not know what to do on CPAP. I am not very knowledgeable with this yet.. As I was told it was imperative I go on CPAP and they would explain things later to me. I still have yet to get the results of my sleep studys other than the fact I have OSA. I don’t have any details about it. So your advice is very much appreciated Thanks again.l
Response:
ajc wrote: > Sorry… but I’m new to this group and can’t follow what abbreviations like > RLS and CPAP mean. > Is there a FAQ or a web site which has a list of these abbreviations and > their meanings? > Thanks, > alfredo > __________________
Try http://www.newtechpub.com/phantom/faq/osa_faq.htm — BigAl db-g…@bigfoot.com
Response:
On 9 Sep 1998 02:36:17 GMT, mrw…@aol.com (MRWMIW) wrote: >I have been on CPAP 5 days. The pressure I was given was 15. They have >given me a Mirage Mask. During the night I usually have to remove mask >several times a night. Sometimes I have to leave it off. When I am on CPAP >I feel like I cannot Breathe. Sometimes I feel like I stop Breathing.
CPAP responses seem to vary widely. >If I loosen mask it leaks if I tighten it I can’t breathe. My machine >offers a ramp up option I have tried this and when pressure gets up to the >prescribed 15 the breathing problems occur? Any suggestions would be >appreciated.
Is the exhaust valve clogged? The SULLIVAN V (you don’t say what flow generator you’re using with your machine) can go up to 35 in certain static conditions. I personally don’t like the ramp because it feels like "I’m sucking the machine!"
Response:
MRWMIW wrote in message <1998090902361700.WAA04…@ladder01.news.aol.com>… >I have been on CPAP 5 days. The pressure I was given was 15. They have >given me a Mirage Mask. During the night I usually have to remove mask >several times a night. Sometimes I have to leave it off. When I am on CPAP >I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is this >normal?
Following BigAl’s train of thought — I sometimes feel like I can’t breathe if my nose is a little stuffy (which CPAP can bring on). I breathe in fairly well, but can’t breathe out for beans. I have enlarged turbinates, which contributes to the problem, but using decongestants and prescription nasal sprays helps. DO NOT use over-the-counter nose sprays like Dristan or Afrin for relief from nasal congestion. They do far more harm than good. If you think congestion might be your problem tell your sleep doc and see what he will prescribe for you. I use Vancanase AQ nasal spray and Claritin D tablets when I find I’m having problems. Good luck! /s
Response:
- Hide quoted text — Show quoted text -Steve Early wrote: > MRWMIW wrote in message <1998090902361700.WAA04…@ladder01.news.aol.com>… > >I have been on CPAP 5 days. The pressure I was given was 15. They have > >given me a Mirage Mask. During the night I usually have to remove mask > >several times a night. Sometimes I have to leave it off. When I am on CPAP > >I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is > this > >normal? > Following BigAl’s train of thought — I sometimes feel like I can’t breathe > if my nose is a little stuffy (which CPAP can bring on). I breathe in fairly > well, but can’t breathe out for beans. I have enlarged turbinates, which > contributes to the problem, but using decongestants and prescription nasal > sprays helps. DO NOT use over-the-counter nose sprays like Dristan or Afrin > for relief from nasal congestion. They do far more harm than good. If you > think congestion might be your problem tell your sleep doc and see what he > will prescribe for you. I use Vancanase AQ nasal spray and Claritin D > tablets when I find I’m having problems. > Good luck! > /s
I use Atrovent 6% nasal spray (prescription only). — BigAl db-g…@bigfoot.com
Response:
I have been on CPAP 5 days. The pressure I was given was 15. They have given me a Mirage Mask. During the night I usually have to remove mask several times a night. Sometimes I have to leave it off. When I am on CPAP I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is this normal? If I loosen mask it leaks if I tighten it I can’t breathe. My machine offers a ramp up option I have tried this and when pressure gets up to the prescribed 15 the breathing problems occur? Any suggestions would be appreciated. Sincerely MW
Response:
Sorry… but I’m new to this group and can’t follow what abbreviations like RLS and CPAP mean. Is there a FAQ or a web site which has a list of these abbreviations and their meanings? Thanks, alfredo __________________ alfredo.nos…@media1.net // remove the .nospam if e-mailing… MRWMIW wrote in message <1998090902361700.WAA04…@ladder01.news.aol.com>… >I have been on CPAP 5 days. The pressure I was given was 15. They have >given me a Mirage Mask. During the night I usually have to remove mask >several times a night. Sometimes I have to leave it off. When I am on CPAP >I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is
this <snip>
Response:
>I have been on CPAP 5 days. The pressure I was given was 15. They have >given me a Mirage Mask. During the night I usually have to remove mask >several times a night. Sometimes I have to leave it off. When I am on CPAP >I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is >this >normal? If I loosen mask it leaks if I tighten it I can’t breathe. My >machine >offers a ramp up option I have tried this and when pressure gets up to the >prescribed 15 the breathing problems occur? Any suggestions would be >appreciated. >Sincerely >MW
Try using the ramp for the longest period (on my CPAP, a Sullivan V, it’s 20 minutes) — it should give you a chance to adjust to the pressure. Hopefully you can fall asleep BEFORE it reachs 15 cm. Jeff Lunden
Response:
MRWMIW wrote: > I have been on CPAP 5 days. The pressure I was given was 15. They have > given me a Mirage Mask. During the night I usually have to remove mask > several times a night. Sometimes I have to leave it off. When I am on CPAP > I feel like I cannot Breathe. Sometimes I feel like I stop Breathing. Is this > normal? If I loosen mask it leaks if I tighten it I can’t breathe. My machine > offers a ramp up option I have tried this and when pressure gets up to the > prescribed 15 the breathing problems occur? Any suggestions would be > appreciated. > Sincerely > MW
Does it feel like you can’t exhale or is it any type of breathing? For exhalation problems, ask your sleep doc about a bilevel machine if you can’t adjust after a few more weeks. Here’s some instructions on adjusting the Mirage mask written by someone else: I found the Mirage the most comfortable mask in 4 yr and 4 different masks but getting rid of small leaks around my nose was a matter of getting the straps just the right snugness. Attempts to fit it at night when I am tired were not successful. I needed someone else to do it. My husband(an engineer) who has rigged all sort of things for the hose etc in the past, has written down the steps we used to make it fine for me. I can turn over and sleep freely now. I hope this will help you get through this situation. Maybe later I will get the hang of it myself. Right now I am going to another sleep study because the good Mirage mask wasn’t able to overcome RLS and unrefreshed sleep. To cope now I wash the mask with the headgear attached! – not a good long term solution Steps To Fit Mirage Mask Without Leaks (just the way we managed the situation, not an official method! 1. Loosen the straps on the headgear. 2. Turn on the air flow. The mask must be extended by air pressure for this to work. 3. Hold the mask on your face adjusting to the most comfortable position. Have your partner check that the mask fits and clears comfortably around the nose without leaks. 4. While holding the mask still, have your partner adjust the mask pad above the eyes to just snug the support to the face. Increase the offset (shift adjustment to centre) to stop leaks at the chin side of the mask, reduce offset (spread out adjustment) to reduce leaks near the eyes. 5. When finished, the mask should be held with very little pressure against the face * the pad above the eyes should rest at a comfortable pressure above the nose, * the mask should not pucker or leak, * the mask edges should clear (not cut into) the bottom of the nose. 6. Have your partner gently tighten the straps. To prevent shifting use one hand to hold the strap eyelet area of the frame while the other pulls the strap through. Do not try to tighten fully on first adjustment. Work on the top straps both sides first, then the bottom both sides. Have your partner continue to tighten the straps in several steps until you can let go of the mask and move comfortably without getting leaks. 7. It is normal for things to shift a little while adjustments are made. No need to start over! Just lift the mask away from your face using the elasticity of the headgear, then settle the mask in place until the leaks stop. Have your partner check positioning again (point 6). In particular, make sure that the mask settles down evenly with minimal wrinkles. 8. If at all possible, do this with a partner. It is necessary to hold the mask while you adjust the bridge pad and the straps. That takes 3 hands. It also helps a lot to have someone else look at the nose clearance, tilt toward chin or eyes, and upper bridge pad position. 9. When you have it right, you can use the elasticity of the headgear to remove the mask without loosening straps. If you need minor adjustments, go ahead, but if the mask gets puckered, wrinkled, goes askew, or gets too tight, call your partner and start over. Good luck, I hope I haven’t made it to complicated. Barb H — BigAl db-g…@bigfoot.com
