Claustrophobia and CPAP

One of the first issues I hear when a person comes into a sleep lab to be introduced to a CPAP is that they have claustrophobia; that you cannot stand to have anything on your face.  There is always an excuse for not tolerating therapy.  Most of the reason has to do with feeling out of control.  There are so many ways that can create a successful experience.

Let’s start with the mask.  It is probably the most important piece of equipment you will use and the easiest to change.  If you are unable to use the mask during the night of your study tell your tech, however, what usually happens is that they use the mask for 1-3 days at home and find that it is not the best mask for them.  It may move too much causing leaks, it might cause your skin to mark or breakdown, it might make your eyes dry; all these issues can be handles with a change of mask.  It is also common for people who are claustrophobic to be much more successful with a full face mask due to the ability to breathe through both the nose and mouth which will make anyone more comfortable.  Your insurance will pay for replacement mask during the first thirty days of the therapy.   After the first thirty days a new mask must be ordered.  At many centers they will allow you to trial or borrow masks to find one that will work for you.

Knowing how to perform relaxation techniques will allow you to be successful when you are trying to fall asleep the first few days.  It can also help on days where your stress level is high.  The two techniques I have found that help are progressive relaxation.  This is easy to learn and allows you to focus on relaxing as well as helping you to focus your thinking.

1.       Start at your feet and tighten  them as tight as you can, hold for the count of ten and then allow them to relax and go limp

2.       Progressively move up the body focusing on one muscle group at a time. 

3.       To reach the top of your head should be having spent about 10 minutes on deep breathing and your muscles may be relaxed.  This centered concentration helps increase oxygen levels and allows the mind to camp down preparing it for bed.

Diaphragmatic breathing is another exercise that will allow you to relax and breathe deeply with a technique that takes focus.  Lie flat on your back with your hand on your stomach just below your ribs.  As you take a slow deep breath in push your hand out; when you exhale draw in your abdominal muscles so you are pulling your hand in.  I usually like to hold the breath 3-5 second between peak inhalation and exhalation.  Having to concentrate allows the mind to calm and it increases the oxygen level from doing nice slow inhalations.

If relaxation techniques do not work for you medication or working with a councilor that practices Cognitive Behavioral Therapy.  Your physical can help you to find assistance that will work for you.  It is not unusual for someone to need a little extra support, this is long term therapy and sometimes it takes a little time to become compliant with it.

Some accessories can help you with some of the small issues.  Chin Up strips can help a mouth breather minimize the leak.  A Gecko will help with sores on the nose and leaks into the eyes.  A heated hose might help with mouth drying. 

Overall working with a patient technologist or physician is the best way to be successful when using PAP.  The more you communicate about your issues the sooner a solution to help you be successful on your machine, and sleeping a healthy sleep.