One week into cpap therapy, please tell me this will get better

Barely a week in to cpap therapy and Im struggling. (ResMed Airsense 11, ResMed P10 Nasal Pillow). I find myself almost hyperventilating and my breathing is very labored. When I exhale my nostrils whistle which drives me crazy throughout the night.

I've been trying to lay in bed early and just focusing on my breathing to get comfortable before shutting down for the night but finding the mask is having a negative impact on my sleep. IF I get to sleep with the mask on, I wake up in a panic and cant slow down my breathing, cant slow heart-rate down, cant get back to sleep etc. I find the only time I do get some sleep is without the mask on. Got to bed with mask on, maybe get 30min sleep, wakeup in panic, take mask off, maybe fall back asleep, put mask back in the early morning hours with minimal chance of falling back asleep.

Im not discounting the science behind cpap, but this whole process seems so counterintuitive on trying to get some rest. Im a zombie, getting less sleep than I did prior to cpap therapy.

It does take some time to get used to sleeping with the mask and the machine. I have the P10 nasal pillow mask and the ResMed AirSense 10 machine which should be very similar to what you have. Do you know what your pressure settings are? Are you using the Ramp Time in Auto? And what is the initial pressure for the ramp? Sometimes the minimum pressure is too low, and the Ramp Start Pressure is also too low. That can make the mask feel suffocating. Sleep techs sometimes leave the minimum pressure at 4 cm thinking that a low pressure will be more comfortable. Most often it is not. The pressure has to be high enough that there is no restriction to flow when you breathe in.

The nasal pillows don’t work for everyone. Usually they start people on a nasal mask, with (to avoid mouth leaks) or without a chin strap. Don’t give up without trying a nasal mask first…..much more user friendly, in my experience.

Starting CPAP therapy can be challenging, and it's not uncommon to experience difficulties in the beginning. The sensation of hyperventilation and labored breathing could be due to adjusting to the pressurized air. The whistling sound from your nostrils can be addressed by adjusting the fit of the nasal pillows or trying a different size. It's important to consult with your healthcare provider or a sleep specialist to address these issues. While it may feel counterintuitive at first, CPAP therapy can greatly improve your sleep quality and overall well-being once you find the right adjustments and become accustomed to it.

It’s harder to get a good fit with the full face mask, because there are more points of contact than with a nasal mask. Because a nasal mask doesn’t cover your mouth, however, if you tend to open your mouth during sleep, which many people do, you will get mouth leaks, unless you use a chin strap. And that will drive up the pressure on an APAP.

When first starting therapy, twenty years ago, I was assured by my local hospital sleep lab support group, that I would eventually be able to keep my mouth shut without the chin strap. They were right, although it took a while.

Years later I tried nasal pillows and couldn’t stand them and the claustrophobic sensation they produced. They seem to work for some, but aren’t for everyone. The newer, extremely small volume, nasal masks produced a similar reaction. Recent studies have confirmed my reaction to those. They don’t work nearly as well as the traditional, fuller volume nasal masks in preventing events. (Why that research wasn’t done BEFORE putting them on the market is my question.)

Anyway, I have been told by very experienced sleep lab managers that the best choice for newbie patients just starting therapy is generally the traditional nasal mask.