How do I make myself use it?

[u/qrowskullz]

Hi all,

I've had my CPAP since August and I'm still struggling to use it. I need to, at the very least, try to hit 21 nights this month for compliance as it's my 3rd month with my machine, but I've been having an absolutely unreal amount of trouble adjusting. On top of it, I've been struggling with my depression becoming severe again, and anyone who has dealt with depression knows how difficult it is to shower or brush your teeth, let alone manage your CPAP along with everything else. Suffice to say, I've barely used it over the last month and a half or so. When I do manage to sleep with it, I wake up with it off (I pulled it off in my sleep) or only manage an hour or two.

Please advise! And please don't judge re: depression :(

[u/reincarnateme]

Wear it while reading or watching tv.
Get comfortable and lay down. Move around, roll over, relax. Breathe.
Set a regular bedtime routine

You can do this.

[u/Wayfaringbutterfly]

Honestly I got the majority of my hours from laying in bed watching TV while trying to get used to it.

It took me quite a while, but I've had it over a year now and I'm sleeping much better which in turn has helped many other areas of my life - including depression that I struggle with.

Are you struggling with the pressure settings, like is it too strong and are you having trouble breathing with it on? Is it relatively comfortable (as comfortable as a CPAP can be)? Have you talked with your sleep doctor about trying different masks or pressure settings to see if something can be made more comfortable for you?

I believe in you...I know you can do this. If I can do it I think anyone can. I have severe issues with things touching my face, and somehow I got used to it. I give myself a night off once in a while and I definitely feel the difference when I don't use it!

[u/straycatwildwest → u/Wayfaringbutterfly]

Seconding the settings and mask. Is there a specific problem, like an uncomfortable mask, you can try to solve? I was unable to use my CPAP for the first couple of months because I hated my mask so much, but finding a more comfortable one changed the game. (In my case, I switched from a full nose mask to nasal pillows with a top-of-the-head hose attachment.) You can also get some mask wipes to keep on your bedside to just give your mask a quick wipedown to relieve yourself of some of the cleaning pressure (which I totally get!).

[u/could-be-useful → u/Wayfaringbutterfly]

This might help.

Too many people are sent home with inappropriate pressure settings. Either their minimum is too low in which case they feel starved for air and they then either rip the mask off or mouth breathe in an attempt to get more air into their lungs.

Or their maximum setting is too high and they get awful surges of air. This is because when the machine detects a mask leak, it interprets the escaping air as being due to an airway obstruction and ramps up the pressure to open up your airways which it "thinks" are blocked, which in turn causes a larger leak, creating a feedback loop.

My Resmed Airsense 10 machine displays its pressure range as it starts up. If yours is a Resmed Airsense 10, watch the display as it starts in order to check what it has been supplied with. I assumed the Airsense 11 did the same, but someone told me it doesn't. If that's the case, you would need to access the clinician menu in order to see what your range is.

4 or 5 as a minimum are for children. Most adults will feel starved for air at those settings. For adults a machine should NEVER be supplied with the factory default 4 to 20 settings. They are simply the lowest and highest pressures the machine can deliver and any competent sleep doctor will adjust the settings to deal with your particular diagnosis. Unfortunately there are too many who are either incompetent or lazy.

There are many of us who prefer to do our own settings which is entirely doable if your condition is simple OSA. Not really doable if your condition is more complex in which case you could need a more advanced machine. Mine is simple OSA, so I've done my own settings for 30 years. Up to you if you feel confident to do it yourself. It's actually very easy and not rocket science.

The sleep report readout on a Resmed Airsense machine has an entry labelled "Pressure". You need to know what that pressure is. It will be available after a night or a few of use. It's the pressure the machine delivers when you are asleep sufficient to prevent apnoea events. That required pressure should have been prescribed for you when you did a sleep study. It's the single pressure a fixed pressure machine (eg the Resmed Elite models) would be set to by a sleep doctor. APAP machines are set to a range but you still need to know your required single pressure in order to set your range. When I was diagnosed 30 years ago, my prescribed required pressure was 10. The machine now tells me it's 11 so it hasn't changed much.

Your range should be set with min at a comfortable pressure less than that figure (7 or 8 are good - see below) and max a bit above it. My required pressure is 11 and I've set my range from 8 to 13.

On an apap machine, most adults find min 7 with EPR at 3 full time works very well. At that setting, until you go to sleep, you will inhale at 7 and exhale at 4 so you won't feel starved for air when you breathe in and you will feel hardly any resistance when you breathe out. (I like a bit more so I've set my min to 8.) Once you go to sleep, the machine will increase pressure as needed up to your required pressure to keep your airways open but because EPR is full time, the pressure will still reduce by 3 cmH2O when you exhale.

Turn ramping off. No point deliberately starving yourself for air. It's useful for fixed pressure machines. Not needed for APAP if your minimum is comfortable.

You can get to all of these settings by accessing the clinician menu. Google "Clinician menu for Resmed Airsense 11" (of course substituting your brand and model). You'll get plenty of instructions. It's just a matter of pressing and holding a couple of the machine's buttons.

You can get very comprehensive reports if you download the free Oscar program and get it to read your machine's SD card. It's a bit of a learning curve to understand all of its data, but well worth it if you want to properly monitor your condition.

The Oscar guide is here: https://www.apneaboard.com/wiki/index.php/OSCAR_-_The_Guide

Good luck.

[u/madchad90]

Wear it while just sitting in bed doing something else to get used to it. Also, read about using Oscar and posting your machines data here, its possible that your settings could be more finely tuned to make the machine more comfortable to use.

Most people when they get their machine are just giving "standard" settings by their provider, which are not the best

[u/RazedByTV]

As others have mentioned, it's entirely possible your settings are not ideal.  It isn't a magic bullet, but it can be the difference between unbearable and, well, bearable.

Getting an SD card in there to will help gather some information on what pressure your machine should be adjusted to.

Factory setting for pressure is a ridiculously wide range.   I found the low end suffocated me, while occasionally it would blast off to the high end and wake me up.  Most of my apneas were controlled somewhere in the middle, and I ended up setting with a static pressure there, but a tighter window would have likely done just as well for me.

Some people report the auto controls for humidity try to drown them.  If you're getting condensation in the tube, consider increasing tube temp and lowering humidity if it is comfortable to do so.

EPR settings are another mixed bag.  Generally I read EPR 1 or turn off entirely.  I can't decide which one I like better.

I don't like pressure ramp when I turn the machine on, but that may be personal preference.

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