Dear Elizabeth,

I am not a doctor or a psychologist or have any kind of medical training. Now that I've made that disclaimer (LOL) I do have a couple of thoughts. It seems that your past medical history may definitely be a factor as to why you are having such a hard time adjusting to your mask. My suggestion would be to speak to the doctor who actually prescribed you your machine and mask or your primary care doctor and tell them about your past history and why you feel the way you do. It may be as simple as getting an anti-anxiety prescription to take at night before bed that would greatly reduce or hopefully eliminate the panick attack you feel with your mask on.

Like I said, I'm no doctor. This is just my opinion.

I commend you for wanting to use your CPAP because you know it will help you feel better in the long run. Your desire to make it work for you is a great thing and that in itself will go a long way in finding a solution.

Please keep in touch and let us know how you're doing. I wish you the very best!
Leah

HI Elizabeth,

I am sorry you are having trouble with this. I am just a little claustrophobic and it's hard for me to wear the mask some nights so I can imagine the feelings you are having. Do you have the nasal pillows? I hear they are pretty cool. Also, I don't know if you are into such things but how about hypnosis for this specific thing? I did hypnosis when I quit smoking. That coupled with Zyban did the trick. Seems to help with old triggers and such and lowering anxiety connected to old triggers like you may have.
One thing I did to get used to the mask was this (okay I know it sounds stupid but it helped some): I left the hose off of it and wore it when I wasn't going to sleep just so I could get used to it without feeling like I was being smothered. I put it one when I was going to watch TV or something pleasant so I wouldn't get so anxious and wide awake each time I put it on. It seemed to help with my claustrophobia. I realize that it doesn't feel the same without the hose as it does with the air pressure but for me it helped with the anxiety.

There's also a web forum where there are lots of people who may have similar issues if we can't help you here. It's www.cpaptalk.com.

I hope you find a way to make things work. Please let us know how things turn out for you and what you try.

Pam

Hey Elizabeth...

Sorry for the late post - and welcome to our tribe. I have become increasingly busy and was not able to invest in a decent reply. I am not a doctor either. And I know the situation is really quite personal and unique to each person so I will just share what have done to overcome the compliance barrier.

Firstly, it took me 3 years to comply with my mask. So, the first thing I would like to encourage you to do is not give up. It is completely unnatural to try and sleep with something tightly strapped to you face so I am usually surprise not at people who have problems adjusting but people who get acclimated quickly - and there are those who acclimate quite well (that is awesome and I am incredibly envious of that!)

Moving on to more of my own personal experiences:

Some issues that complicated my use of the BiPap were:

1) I had lingering, serious insomnia issues after my bout with clinical depression a few years back. I was not getting to bed until 4:00am or later and I had trouble staying asleep. The BiPap mad things even more complicated as it is quite uncomfortable (especially when trying to get used to it enough to comply with the prescribed regimen).
2)I am moderately claustrophobic and at first, I could not handle anything strapped to my face. I would tear it off in angry frustration. Then, when I finally started to try and use it regularly, I would wake up and find it tossed off the bed with my BiPap still churning out air. It got to where this was a regular issue - waking up with the mask tossed. This was after the fact that I finally began to comply after three years. So, I was still quite frustrated.

I really wish I could sedate myself but anything narcotic and a depressant makes apnea worse and I have personally found the few odd times I actually filled out a prescription for anything opiate based (or the like) I started to like my pills and promptly tossed the remainders. Alcohol is also a bad thing for apnea.

I was also interested in the non-narcotic sleep aids such as lunesta, ambien, etc...But they still cause their own type of dependency and if you do not invest a full 7-8 hours you can be a wreck until that passes. I also did not like the list of side-effects so I opted out of that.

Finally, after 3-4 months of research I opted to try medical cannabis. I know this is not for everyone and I am not trying to push its use or use this tribe as a political sounding board here. Just sharing my experiences. Anyway - it is not physically addictive, the side-effects were either desirable or seemed far less negative than the other synthetic sleep meds, and it generally does not produce hangovers. So, I gave it a go - I became California legal and it has helped alot. Firstly, being under the influence of cannabis helped me weather that first unbearable phase of putting on one's mask every night. Combined with my iPod, I would just chill out and get accustomed to mask more easily. Secondly, the cannabis also makes me feel very sleepy about 1-1.5 hours into a session. This allowed me to sleep more when I felt like sleeping. Thirdly, the cannabis - once I got sleepy and feel asleep - helped me to stay asleep longer. So, I am not sleeping a solid 4-6 hours uninterrupted (for the most part). People react differently to cannabis so I am not assuming it will work for everyone.

That is where I am at now. Recently, they introduced another non-narcotic sleep aid called Rozerem which is supposed to NOT cause dependency and have mellower side effects. So, my friend who is a doctor is mailing me samples to try out - I will report on that because if it works, I might be able to stay asleep longer.

Some other practical thing I discovered that help me sleep with my mask:
- I keep clean soft, cotton cloths and rubbing alcohol nearby. Often, when I do wake up in the middle of the night, my mask does not seal so nicely around my face because of skin oils that have accumulated. So, a quick wipe down with a bit of alcohol seems to bring the nice tackiness back. Sometimes, when I get to bed earlier, I might wake up after 4 hours, wipe the mask down, and get 2-4 hours more sleep.

- Sometimes, spray a bit of natural orange oil air freshener in my bedroom a little bit before I go to sleep (10-15 minutes). I do NOT spray it while the machine is on because I am thinking any oils - even atomized orange oil - can't be good for the machine and might contribute to things gunking up over time. The natural air freshener lingers just enough so that my initial experience with the mask going has a pleasant scent associated with it.

- For some, cold air makes sinuses feel a bit clogged up - Darla and I called it the "camping effect" because I remember feeling a bit stuffy sleeping outside in cool mountain air. Anyway - keeping the room and a more comfortable temperature really helps with easier breathing - at least for me.

- I bought some of that non-medication, pure saline spray (Ocean Brand) for when my nose gets really dry - this happens with me often because my medical cannabis use dries up my mucous membranes. That ocean spray is just saline but it does wonders to help free up my nose. I just spray some, and then a short bit later I gently blow my nose. I also keep that nearby when I sleep.

- I am combination mouth and nose breather so I bought a full face mask - it took awhile do adjust to because it made my claustrophobic streak even worse at first. But now that I am used to it, I really like that I can breathe with just my mouth when my sinuses are clogged or uncomfortably dry. But its a beast of a mask.

- As already, music adds to the ability to be distracted away from the discomfort of the mask. There are periods where I listen to my iPod religiously while waiting for sleep to come on.


My best advice to you is to not give up. It is completely unnatural and people who do not use the machine really cannot relate to just how uncomfortable and cumbersome it is to have to use a BiPap or CPap. It really does require a bit of lifestyle adjustment - no more casually passing out in the studio which is still a big problem for me - I will sit on the couch in the studio for a bit late at night and then I will wake up 5 hours later unrested because I did not use the mask. Now, I have to follow a ritual to get everything in order for sleep.

Good luck, Elizabeth. And once again, welcome to the Sleep Apnea Circle.
MC