Go to sleep fine... wake up (for whatever reason)... can't continue

I've been fighting sleeping through the night for years now. I know I snore. I'm 59 and many of my friends said their lives changed with CPAP. My GF tells me that I will stop breathing many times in the night. That was enough to initiate a consult with my PC doc and get a sleep study. I was determined to be borderline need for CPAP but the doc thought it should move forward. Got set up with CPAP early June.

I have a Resmed Airsense 10 and a AirFit F20 mask. I was optimistic after first few nights as my GF said I didn't move, nor snore with the mask on (I am a toss/turner). As with anyone, I expected an adjustment period. But I'm getting more and more discouraged.

1. One night about a week ago, I woke up and the pressure was off the chart, IMO. I felt bloated and my chest hurt. Of course, my thoughts were "am I having a heart attack/stroke?". I finally determined that I was getting so much air forced at me, that it was going down my throat as well as expanding my chest. it was so much that if I opened my mouth just a bit, my cheeks puffed out like a chipmunk full of nuts. I didn't give up and fell back asleep with mask on. Then in the morning, I'm positive the air in my lungs expanded so much that I popped a rib head out. I could barely get out of bed. I've had this before so I know the feeling/symptoms. Eventually throughout the day it popped back in. Gave up on therapy until I called my doc. She adjusted the pressure down. I can't recall what she said she set it at. I've downloaded the OSCAR app but still trying to make sense of the data.

2. Last few nights, I'll wake up for whatever reason.. nose itches, have to go to bathroom, etc.). I take mask off, go to bathroom or scratch my nose. Then when I put mask back on, it seriously feels like I am rebreathing my own exhale and I can't leave the mask on. It is a totally different feeling than when I go to bed. the air feels warm and stale. I can't get it out of my head that I'm breathing my own CO2. It may be 2:00am so I just take off the mask and go back to bed (waking up often as I always do). I swear the machine is behaving differently in middle of night than it does when I put it on. I turned off ramp so it is not that (I'm fine with ramp off going to sleep).

I guess I keep at it, but just feel like this isn't going well :(

When new users require higher pressure swallowing air can be an issue. It takes some time to get used to. However, it does suggest you need a CPAP if pressure is going that high. . I recommend using the AutoRamp feature with a fairly high Ramp Start pressure. I use 9 cm. The machine defaults to 4 cm which I find suffocating. The AutoRamp is not really a ramp. It just holds the pressure at a fixed number until you fall asleep. Just pick a comfortable number for going to sleep. When you get up in the night, it will do the AutoRamp over again when you put the mask back on.

If you want help with OSCAR just post a typical Daily Report screen. On a PC jus press F12 and take note in the bottom right corner of the screen where the screenshot is saved. Use File Explorer to find the saved file, left click on it, and drag it into a message you are composing.

I had the aerophagia problem early in the history of my APAP treatment. Also, one night I awoke trying to exhale against a hurricane of 18cm! The problem was I had sustained a large leak which was driving up the automatic pressure response on the APAP.

But there WAS an easy fix: my sleep tech set the pressures for a narrower range than the machine is capable of—-so they couldn't go so high. My average current pressure requirement is about 12 and I think the machines is set for something like 9 to 15- so it can’t go TOO crazy. I think this was before the advent of expiratory assist availability, too. Using that might also help.

The other approach, of course, is to attack the source of the leak. I did that by adding a chin strap to my nasal mask gear until such time I as learned to keep my mouth shut. (I was assured by the other patents in my patient support group that even a recovering lawyer would eventually learn to do that—and, fortunately, they were right!)