It feels like the CPAP is trying to make me breathe too fast

Hi Everyone,

I was recently diagnosed with mild OSA (my AHI in the lab study was only 6.6) and my doctor prescribed a CPAP. I got the Resmed AirSense 10 Autoset and have been trying to use it for the past week but I’ve encountered a problem and I’m hoping someone here will have advice. I breathe very slowly compared to most people (not just while asleep, also while awake) and my exhalations are quite long. I feel like the machine is trying to get me to speed up my breathing. The pressure backs off slightly on the exhale but not for long enough, so it starts pushing air at me again when I’m still only partly done exhaling.

Is there a setting I can adjust to slow the speed down or improve the machine’s sensitivity to better detect my exhalations? I’ve already tried using the three different EPR settings but that didn’t help. I also adjusted the ramp time to the max 45 minutes to see if the lower pressure as I fall asleep would make it less of a problem, but it still feels like the machine won’t let me breathe at my natural slow breathing pace. So far, I haven’t been able to fall asleep with it at all, despite keeping the mask on for up to 7.5 hours on some nights. (I've had to take daytime naps to compensate for the lack of sleep, which isn't something I can keep doing every day for much longer.)

Some CPAP machines like the F&P and DreamStation try to anticipate your breathing pattern an used a timed approach to switching from inhale to exhale pressure. To my knowledge the ResMed does not do that. It switches pressure based on flow, so you really should be in control.

Do you know what your minimum and maximum pressures are set at?

It may be possible to set up your machine for more comfort however. Here is what I suggest for the ResMed AirSense 10. To make these changes you need to get into the Clinical Menu. To get into the Clinical Menu just hold the Home key and round set key down at the same time for about 5 seconds. You navigate in this menu the same way as in the User Menu. If you need help see this Technical Manual for the AirSense 10.

• Ramp Time: Auto - This will hold the initial ramp start pressure until the machine decides you are asleep
• Start Pressure - I would set this to 7 cm. This will ensure you are getting enough air to not get a suffocating feeling while going to sleep. You normally want the start pressure to be high enough that it feels easy to breath. If this seems like too much then set it lower. The start pressure cannot be higher than your minimum pressure, so to do this you would need to adjust your minimum pressure up to match your start pressure.
• EPR: On
• EPR Type: Ramp Only. This will cut the pressure back on exhale only while you are awake. After you go to sleep it will stop the cutback and make the pressure more effective. Since you likely need so little pressure you could also try it with the EPR on full time. You could also try it with EPR right off.
• EPR Level: 3 cm. This will drop the pressure 3 cm on exhale until you go to sleep. This makes it easier and more comfortable to get to sleep. If you switch the Type to full time, then it will do this all night.

Hope that helps some. If you post your min and max pressures I may be able to be more specific...

I have the same problem! When I sleep, I inhale and exhale very slowly. I was able to drop my pressure down a little, and I turned the reslex to the max which is supposed to allow it to stop the pressure as I exhale. It does stop, but only for a limited time. at the very end, the pressure kicks back in and I can't exhale entirely. Sometimes it wants to kick my mouth open to release the pressure, and then I feel like I am gagging on the forced air. I have the 3B Luna CPAP and it is comfortable enough. I have been doing some googling to see if there is a way to extend the amount of time that is allowed for exhale, but have yet to stumble on anything useful. I have tried it each night for the last week and a half and it is brutal. I end up taking it off and sleeping without it. I certainly want to give it an honest go, but it's not going to work as is. If anyone knows how to adjust the exhale time, that juicy tidbit would be greatly appreciated!