New CPAP user problems

Hi. I just started with my CPAP last night. I have severe allergies and very sensitive skin, so I’m using a nasal pillow to reduce the chance for an allergic reaction on my face. Because of the allergies, I can’t breathe well through my nose. When I tried my CPAP last night, I could not fall asleep. I used the ramp up function, but I felt like I couldn’t breathe any time my mouth was closed. I also got severe chest pains. I could only use the machine for about 30 minutes and couldn’t take it anymore. I can breathe in fine, but feel like I couldn’t exhale like I should and felt like I was suffocating.

I have chronic idiopathic hives, which means I have allergic reactions to unknown triggers, and it has led to severe anaphylactic shock on more than one occasion. My meds control the appearance of the hives for the most part, but I still have uncontrollable itching all over. I have to take special care with everything that touches my skin. I don’t think I can wear a fuller face mask, the one I have itches like fire where it touches my face.

I am going to keep trying the machine, but I don’t know if I can wait weeks or months to get used to it. Just frustrated and would appreciate any advice anyone might have.

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I would contact the sleep clinic. It sounds like if your having problems exhaling you might need a bi-level pressure instead of regular cpap. For me personally, it took awhile for good sleep to happen. 1) mask comfort…i tried 3 different masks before i found one that worked for me 2) 2 or 3 tries on pressure settings…specifically on the bi level. A bi level machine is timed where the pressure coming in is therapeutic but then hardly any pressure on the exhalation because i was running into issues as your describing. Hope they get it straightened out.

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Thank you, I really appreciate the advice.

I second what the first responder said. I had similar problems. It gets better, but it’s a pain in the patootie for a while. It is definitely worth working to make it tolerable. I get better sleep and breath better. It took a month or more to get it going right.

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Thank you. I really want this to work. I practice while I’m awake and I do okay, but I can’t sleep with the mask on. It’s too hard to exhale, so I feel like I’m suffocating. The mask and strap make my face itch like crazy. I’m going to try to take some extra Benadryl before bed tonight to see it that helps.

BethK I also agree with Fish. My nostrils collapse during the night, and I am unable to tolerate the standard cpap machine with its constant same pressure, but am OK with a bipap that runs at two speeds timed with my average length of inhale and exhale. I’m running at a 12 on the inhale and 8 when I exhale. It’s an imperfect system, but after two years I’m able to breathe comfortably all day due to the therapy I’m getting at night. It took two months to get used to the machine, and it’s still not comfortable, it’s a pain to clean, and I don’t look forward to donning it every night. The benefits however have saved my life and helped fix my afibbing heart.

Contact your doctor and let him/her know you’re wrestling with the exhale constantly.

I feel for you with your allergies, must be tough.

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I agree with many of the others who recommended a bi-level machine. I also use liners because I also have very sensitive skin. I paid for the first ones, but from then on I made a template from that, went to a Goodwill type store and purchased a couple of white tops made from about 96% cotton and 4% spandex and made my own. The liner protects my skin from the mask. I use a full-face mask because I tend to want to breathe through my mouth. Good luck to you in overcoming the problems you outline. You may also want to do some research to find something that will minimize your allergies. There are supplements that I have heard of that have helped others, especially probiotic supplements.

Thank you so much for the suggestions. I sent a message to my sleep clinic asking about the exhale issue. I’m already on 5 different antihistamines daily for the allergies and chronic hives, and there isn’t much more that can be done about that. If I could get my issues down to just the itching from the nasal pillow and straps, that would be awesome. I knew it would take time to get used to the machine, but I didn’t think trying to use it would make me feel worse than I did without it.

Hi and welcome to the forum. A couple of thoughts to ponder:

On the exhale problem, there’s CPAP machines that typically cost your DME supplier not much if any different than standard machines called APAP or auto adjusting CPAP. It emulates a BPAP/bilevel but again at about the same price as standard CPAP. Might be worth asking the DME or doc if it’s an ongoing issue.

Alternate, your own machine, which I’m not sure what you’ve been issued, some CPAP have exhale pressure relief (EPR on ResMed, Respironics may have similar item).

Finally on skin allergy and masks, look up PadACheek to see if they’ve got a mask pad that might be compatible with your allergy if you consider needing a full face mask.

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Hey Beth, I’m sorry for your issues, and honestly - other than the hyperallergic issues - most are fairly common when people first start using a CPAP. I agree with the recommendation to contact your sleep clinic or sleep doc for help asap. There are little felt units you can buy to put on the headgear of your mask. That will help across the corner of the mouth and cheeks, but I’m not sure about anything to help with the nasal cushions (which I use too). There ARE other mask covers that will help with a full face mask to keep your skin from touching anything. Take a look at Amazon and you will see what I mean.

Not to sound discouraging, but it does take a while to get everything set for most of us. Be careful with the ramp and pressure. Mine is set for 45 minutes because it takes me that long to fall asleep once I put the mask on, but if it goes to full ramp while you are awake, for me at least, it was too much. Originally my pressure was 11, I had it moved to 10, then 9 and back to 10 because that is the most comfortable.

Another thing I want to mention: I had surgery, and I started watching my tablet for YouTube videos / entertainment after the surgery. I reached the same point - I was only able to sleep for 30 or 60 minutes at a time. Then my husband suggested that I take the tablet out of the bedroom (we banned cell phones several years ago), and when I did, my sleep went instantly to 6 - 8 hours straight a night…

I wish you luck with your process, but I will tell you this: When I finally got everything straight for my body, it was amazingly, wonderfully effective and now I have trouble sleeping well without it.

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Thank you all so much for the suggestions and support. My sleep clinic decreased the exhale pressure, so that has helped a lot. I can finally fall asleep with the mask on. I’m not sleeping well though, it’s just very uncomfortable and I have to sleep on my back, which I’m not used to, since the mask moves out of place if I sleep on my side. I’m still having issues with the mask touching my face, my skin is really irritated and sore when I wake up in the morning. I really want this to work, and I’m going to keep doing it, but I still feel much worse than I did before I started.

Great feedback, have you considered becoming on of our AWAKE Peer Mentors? https://www.sleepapnea.org/peer-mentors/join-asaa/