Problems getting to sleep

[Clara B]

I’ve recently done a sleep test which indicated severe sleep apnea. I’ve purchased a Sleepcube and after a bit of experimentation with masks (tried the Amara view, but it made me feel claustophobic and the air being expelled was going into my eyes) I’m currently trying the Phillips fitlife full facemask which definitely feels better (although still seems to steam up). I’m a mouth breather, so have no option other than the full face mask.

I’m still in the early days of trying this, but it’s not going well. I’m struggling to get past the feeling of suffocating on the exhalation - I’m very aware I’m breathing within a small, restricted space. I’m using the ramp setting, but despite being able to relax (as much as is possible wearing that amount of kit) just as I’m about to drop off to sleep, my body suddenly seems to become aware that my breathing is being constrained and snaps me awake again.

Apart from the first night, when i did manage to get a little sleep (but kept waking up) I haven’t managed to successfully even get to sleep with the mask on.

Normally I can go to sleep in less than a minute. With this, not at all. I’m willing to continue to try, but my question is how long is a reasonable amount of time to give it each night to try to go to sleep? I’ve been trying for an hour, but even when i then remove the mask i find i can’t go to sleep very quickly.

Wearing the mask and not being able to sleep is just stressing me out and making me more tired. I’m also concerned that like an insomniac staying in bed and not being able to sleep, I’m going to quickly have negative associations between the mask and not being able to sleep.

Other than wearing it during the day, is there anything else I can try? Like another poster, I have found using white noise is quite helpful in drowning out the noise of the machine and my breathing!

I’ve read that it can take some people over a year to get used to sleeping in a mask. I really can’t persist for that long with less sleep. Any tips appreciated.

[Reno]

Hello Clara! Welcome to the club. Most mouth breathers prefer full face as it simpler, but it isn’t the only option. Some use nasal masks with a chin strap to keep their mouth closed, I’ve heard of others using medical tape over there mouth too!

Cool thing about the SleepCube is the SmartLink app tells you how many times you’ve opened your mouth with a nasal mask (Exhale Puff Index) so you can track if it’s a concern or not.
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But, problem with nasal is if you get a cold, you cant do CPAP. So some nasal users keep a full face around so they can still get a good night sleep if they get sick. Like I said, full face is simpler.

Unfortunately, full face makes it a bit harder with the panic feeling, so I’m told. I don’t use a full face, but when I first started I found it really hard. You might’ve read my post about the topic. I think the biggest thing that helped me was this video. I did have a hard time staying calm, so I did breathing exercises to try and not hyperventilate, but I decided to be stubborn about it. CPAP or no sleep. This article was also helpful.

There is also hope. I am so used to CPAP now, sometimes I put my hand in front of the mask’s vent to make sure the machine is on! Wasn’t like that at the beginning.

[Kelly @ Intus]

Good Morning,

Thank you for your post.

With the Sleepcube CPAP machine can I kindly ask you to check your SmartFlex setting. Exhalation relief technology has been used by several CPAP manufacturers, but DeVilbiss' SmartFlex system takes it to a new level. You can customise both how much relief you want, and how sharp you want the transition between inhalation and exhalation to be. You can opt for a drop in pressure of either 1cm, 2cm or 3cm, and there are five stages of transition to choose from – between sharp (very quick drops and increases) to smooth (much slower change). That leaves you with 15 possible combinations, ensuring that whatever level of relief you require there's a setting perfect for you. You should be able to adjust the setting to make it easier for you to breathe out.

With regards to masks, the Philips FitLife mask is a total face mask as it covers the area from your forehead to your chin, where as the full face mask normally cover your nose and mouth like an oxygen mask. Perseverance and the right mask is key to CPAP therapy. With which ever mask you opt for if you are struggling to get use to the mask then we suggest disconnecting the mask from the tube and wearing it for 30 minutes a day whilst watching TV or relaxing. Just to get used to the mask on its own without the machine. Once you get comfortable with this, the try popping the mask on and the machine of for 30 minutes before you got to sleep. If you have an auto CPAP machine, then this will stay at the lower pressure setting until you fall asleep.

There is always an adjustment period when you start CPAPA therapy or change your mask or your machine. I would give the mask 10-14 nights to see how you get on. I feel that changing the smartflex setting to allow you to breathe out easier will help.

Please let me know how you get on, or if you have any questions.

Kelly

[Clara B]

Hi Kelly

Thank you for your reply.

it’s not that i feel like i can’t exhale, that feels completely fine. What is bothering me is that whether the mask is covering just my nose and mouth, or whole face, the exhalation breath is not being clearerd away quickly enough.

Rather than breathing out into the atmosphere, I am exhaling into a tiny space which my hot breath seems to be filling up without escaping quickly enough.That’s why i feel like i’m suffocating,

Not sure what the solution to this is? I’m sat here now in the full face mask and it is so steamed up i can barely see my phone screen!


Claire

[Reno]

Hi Claire,

I think I understand. Unfortunately, I don’t have much experience with full face, specifically.

I did have a similar feeling, like the air wasn’t fresh enough after I exhaled. it actually got easier for me when my pressure was increased. I went from a starting pressure of 4cmH²O to 6cmH²O and I felt so much better. I guess because it pushes the valves open a bit more or washes away your breath faster. I’m not sure. It’s probably why I personally felt Flex exhalation relief was hell. I also found it helpful to not force the breath out, but instead to relax my chest and let my breath “fall out,” so to speak.

Sorry if that’s not much help,

James

[Clara B]

Hi James

Thanks for that advice! I did wonder whether the low pressure was actually making the sensation worse.

I think I’m going to go back to the nose and mouth mask and try increasing the start pressure a bit

Claire

[Reno]

I hope it works for you. gl

[Kelly @ Intus]

Hi Claire,

Thank you for your post.

If you look at the front of the full face mask and total face mask you will see small holes in the mask for the exhaled air to leave the mask. Due to Covid, we are working from home so I do not have access to the stock in our warehouse to compare masks. I would suggest going back to to the amara view mask, as this will have a smaller area than the total face mask for exhaled air to collect before going out the holes in the mask. I would try this mask for a few nights to see how you get on. Please note that the Amara view mask is a hybrid mask, which sits under your nose and covers your mouth, where as a full face mask sits over your nose and mouth. The standard full face masks (such as F20, F&P Simplus & Philips Amara gel full face masks) have more holes in to allow exhaled air to be expelled. If you can see an improvement with the amara view, then I would see how you go and if need be, maybe look for a standard full face mask to try.

Kelly