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Panic Attacks/Claustraphobia/Insomnia

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IntellectualLemonFalcon1027 +0 points · over 7 years ago Original Poster

Newly diagnosed and working through my first week. I had 1 fantastic night of sleep and felt great the next day but this was caused by pure exhaustion and melatonin. Next night, a bad dream woke me up and I ripped the mask off, paced the house, watched TV and went back to bed with the mask but only slept for 1.5 hours. Since then, it's been all downhill. I am claustrophobic to begin with and the thought of sleeping with the CPAP FF mask (Amara view) freaks me out. I did some desensitization such as holding the mask to my face, then wearing it around the house, then wearing it watching TV (hose not connected) and then with the hose connected. I had a few nights of very interrupted sleep and now 2 really bad nights. Tonite, I relaxed (no TV, just relaxation music playing softly) then put the mask--my heart rate spiked and I panicked which resulted in a night without the mask and an extremely bad night. My body will not relax and I am up every 20 minutes--already stepped outside to get some fresh air twice. What have you done or heard people do to work through this? What other resources are available? Any help, guidance and words of advice will be appreciated.

[+] [deleted] +0 points · over 7 years ago Sleep Enthusiast
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SleepDent +0 points · over 7 years ago Sleep Commentator

I am a dentist working in dental sleep medicine. Have you considered an oral sleep apnea appliance instead of the CPAP? Many of my patients have come from an unsuccessful try at CPAP due to panic attacks/claustrophobia. The majority have been able to successfully transition to an oral sleep apnea appliance. In all fairness, a few patients are so claustrophobic that they can not even tolerate the appliance, but that is a tiny minority. Dr. A.B. Luisi, D.M.D.

263 posts
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Ruby +0 points · over 7 years ago Sleep Commentator

An oral appliance might be what you need. A friend of mine had the same issue with claustrophobia. When that horrible feeling hit he would open his eyes and wave his arms around to remind himself that he wasn't confined. I have no idea if that would help you or not and I wish there were a better answer for you. All the best to you!

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Sleep +0 points · over 7 years ago

I would suggest you talk to your doctor to see what recommendations they have for you. Perhaps another treatment for the sleep apnea would help, such as the other's have suggested, an oral appliance? Perhaps a smaller mask (such as nasal pillow mask) might cause less claustrophobia?

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GregariousHarlequinMouse7173 +0 points · over 7 years ago

I too felt claustrophobic with the nose and full face masks. So they (the overnight sleep center) fitted me with the nose pillow mask. I immediately loved it. The nose pillows come in small, medium, and large. Small worked best for me. Now I just have to learn how to keep my mouth closed all night. I refuse to wear a chin strap! Someone recommended medical tape across the mouth. I'm on my third night with the CPAP. First two nights were awful. Last night was 98% better! Don't give up!

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IntellectualLemonFalcon1027 -1 point · over 7 years ago Original Poster

Thanks so much for reading my post and the advice. I talked with my PCP and explained my situation. She listened and knows that I want to do what I can for this to be a successful transition. Here are the changes I made and I hope this helps someone else new to CPAP.

  1. Advice from this forum...keep at it, this is new, you will get used to it eventually so give yourself the time adjust
  2. Kicked my spouse and all animals out of the bedroom for 4-5 nights
  3. Added night lights in the bedroom and just outside the door
  4. Take a few sips of sleepy time tea 1 hour before I want to go to sleep
  5. My PCP prescribed a lose dose of generic Xanax which I take 45 minutes before I want to go to sleep
  6. Get comfy in bed with a book (no TV, no mobile, no iPad). Reading makes me sleepy no matter what the subject.
  7. Put FF mask on & check for leaks when I start to doze off; breathe nice and calm through my nose with my mouth slightly open; settle in to sleep on my CPAP pillow (for side and back sleepers)
  8. Put my ear plugs in (noise keeps me awake, always has) and drift off

I usually am up within 1.5 hours to use the restroom, but that is normal for me. I am able to get to sleep relatively quickly and stay asleep till about 5:30am/6:00am.

My plan is to slowly wean myself from Xanax but will always have some on hand for those rough nights. This has been a huge adjustment for our household. We also got a better bed, adjustable to be elevated slightly. With the new mattress, my hips do not go numb any more while on my side. My spouse snores too but the slight elevation has significantly reduced her snoring so that it is not keeping me up. I also match my breathing with her snoring when I am falling asleep--sounds weird but it works. At the time of this update, the dogs and cats are still not allowed in the bed or bedroom. At least we are both having a good nights sleep. I am logging 7-8 hours a night on the CPAP. Being that the first night was a sketchy, yucky uncomfortable 46 minutes, I'd say this is progress. Again, the purpose of this update is to let everyone know I think I am on the right path and more importantly, I hope this helps others.

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wiredgeorge +0 points · over 7 years ago Sleep Enthusiast

Folks are all different in their ability to tolerate and adjust to therapy. Hope some can take away from your narrative. I found my way to better sleep over about 6 months to a year as I learned what would work for me. I will say that the mask tends to lock a person into a single posture during sleep and this in itself can cause issues (mine was my lower back). I use a wedge shaped pillow with another regular pillow on top to prop me some and this mitigated the issue. I also found that a quality mattress really helps. Sleeping on a not so good mattress even propped up some is still going to result in a sore back. Anyway, I am sure you will find the path to a good night's sleep and what works best over the next few months as you seem to be searching for it intelligently. Good luck.

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barbz +0 points · over 7 years ago

I have a friend who is also claustrophobic and he uses the Oracle Mask by Fisher Paykel. It is a mask that goes in your mouth and for many is not the easiest mask to get used to, but it has its positive sides. I used it for a long time as my sinuses would not let me use any mask that had air going into the nasal cavities. I first started raising the head of my bed when using the Oracle and continue to do so...for me, it is back issues also.

Hope your positive movement forward continues...

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