Claustrophobia is an irrational or extreme fear of being confined in small room/space and becoming incapable of escaping from it. This could be triggered in many ways, including being in packed elevators, flights, being in small cars, windowless rooms, as well as tight-fitting clothes among others. Depending on severity, the person can suffer from either all or some of the following symptoms:
  • Panic attacks
  • Increased rate of breathing, heart rate as well as feeling of tightness in the chest
  • Feeling lightheaded or dizzy
  • Fainting spells
  • Excessive sweating
  • Shaking and trembling

Adding to the list of things that can cause claustrophobia is CPAP mask. If the user is afraid of sleeping while wearing a CPAP mask, he/she is said to suffer from CPAP claustrophobia. It can also occur while using CPAP machine. According to a survey conducted by researchers in 2015, nearly 63% of users had CPAP claustrophobia issues. Hence, users who have claustrophobic tendencies need not get discouraged since they are not alone in facing this problem.

This article aims at helping users to either diminish or eliminate the claustrophobic feeling while wearing the CPAP mask.

CPAP Claustrophobia

When a person begins CPAP treatment, his/her body struggles to breathe appropriately every night since it is pumping a lot of adrenaline, which is circulating throughout his/her body. The body takes time to clear out all the hormones from the body, which results in the person taking time to get adjusted to sleeping on a CPAP. Once adjusted to CPAP, the person starts enjoying a relaxing and blissful sleep and overcomes the feeling of being claustrophobic on CPAP.

Causes and Risks of Having CPAP Claustrophobia

The following list of questions would help the CPAP mask user in identifying the cause of CPAP anxiety:
  • Does the fear arise due to the idea of something placed on the face?
  • Does the fear arise due to previous CPAP mask experience?
  • Does the fear arise due to fear of strangulation from the head strap?
  • Does the fear arise due to inability in seeing far-off things while wearing a mask which was otherwise possible?
  • Is the weight of CPAP mask a cause for worry?
  • Does the fear arise due to prior experience of using CPAP mask which resulted in breathing difficulties triggering a panic attack?

Eliminating Claustrophobia

Focusing on the below-mentioned points would help the user to either diminish or reduce the claustrophobic feelings:

Using CPAP Mask With Vents

If the user is wearing a full face mask, then he/she is worried about asphyxiation due to the buildup of CO2. This is an irrational fear of the majority of CPAP masks available in the market come equipped with vents that allow CO2 to escape while allowing the users to breathe normally even if the machine is not switched on. Vents are explicitly designed to release excess CO2 and let users breathe when the CPAP machine shuts off or fails to function correctly due to power outages.

Sometimes when the vent gets blocked, the body’s reflex action kicks in and the mouth opens automatically, and brains prods the user to remove the mask from the face, albeit subconsciously, thereby saving the patient’s life.

Accepting and Adjusting to the CPAP

Many times, users buy CPAP, use it for few days and stop mainly due to fear of being unable to breathe. The user has to understand that the body will take time to get adjusted to the new product which is helping him/her to breathe and not the other way round. Initially, the user may feel claustrophobic, but once the body gets adjusted to the machine, breathing will be more comfortable.

One way of making oneself comfortable with CPAP mask is to wear it for some time before going off to sleep. The user can wear the mask (without starting the machine) and do things he/she likes such as reading a book or listening to music. This will trick the brain to believe that mask is associated with good thoughts and the subconscious resistance can be overcome easily.

Positive Attitude and Patience

One important thing to be kept in mind by the CPAP user is that CPAP will have to be used by the user for rest of his/her life and the quality of life would undergo a significant transformation with its usage. Once this positive attitude is developed, then the claustrophobic feeling would slowly dissipate. Also, some users might find that the CPAP is not working and get discouraged by it. However, patience is the key, and one has to give the body some time to become comfortable with CPAP and over a period sleeping with the mask would become a habit.

Type of CPAP Mask

One crucial factor while dealing with CPAP claustrophobia is the type of mask used. The full face mask has been attributed to be the cause in many CPAP claustrophobia cases. If the user falls under the said category, then he/she can switch to either nasal pillow or nasal mask.

However, chances of mouth breathing are more with these type of masks, which can lead to issues such as dry mouth. However, mouth breathing can be eliminated using a chin strap. In case full face mask is a necessity, then knowing where the vents are and cleaning the vents can help in reducing the claustrophobic feelings.

Getting Used To CPAP Mask

Adjusting to CPAP takes time, but is not an impossible act. A user can wear a CPAP mask for some time before going to sleep to help the brain get adjusted to the new machine. If the user has a panic attack or feels claustrophobic when wearing CPAP while being fully awake, he/she can remove it immediately. This would help the user to relax. Another way of relaxing is following breathing relaxation techniques, which has been known to control these feelings.

Under this technique, the user takes a deep breath, holds it and then slowly exhales it. The user then pauses breathing and slowly starts breathing in. All this is done while counting till 4. The entire process is then repeated.

If a full face mask is used by the user, then the breathing relation technique can be done while wearing the CPAP mask and machine. Repeating this method for few times can help the user mitigate his claustrophobic feelings.

CPAP Ramp Feature

Many modern CPAP or Bi-PAP machines have ramp feature, which essentially is a comfort setting. This feature allows the device to start at reduced pressure with a gradual increase over a prolonged period. The beginning stage of the ramp (lower pressure setting) helps the user to fall asleep and once asleep, the pressure is increased slowly to a degree which is required for preventing upper airway collapse.

However, this feature also plays a part in contributing to the claustrophobic feeling while wearing a CPAP mask. This is because, at low pressure, the user might feel like gasping for air which can result in the user getting panicky. The user can work on overcoming this by experimenting with either switching off/turning up the starting pressure/preceding ramp feature.

Increasing Time Spent with Mask

The user can get used to CPAP mask by wearing it during the day and slowly increase the time while wearing it. This can be done in following ways:
  • Initially wear the mask for one hour daily while awake
  • Start wearing CPAP for one hour during nighttime
  • Increase the time to about 3 - 4 hours
  • Starting using CPAP for a full night

CPAP user should advance to next stage once a particular step can be performed without anxiety. The basic idea of following these steps is to get comfortable and learning to believe that one would not be suffocated and most importantly allowing the brain and body to get convinced that this is something beneficial and not harmful.

As always mentioned, in case of any problem, getting medical advice is paramount and necessary changes to medications, devices or lifestyle should be done under medical supervision only.[/h3][/h3]