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Tips for Dealing With Claustrophobia

Who knew I would have issues with claustrophobia when I started my PAP (positive airway pressure) journey? Certainly not me.

I was somewhat familiar with the equipment having worked in respiratory therapy. I had been stuck in an elevator for over 3 hours. There was nothing to make me think I would have issues. Boy was I wrong.

Starting my journey to find the right mask

I put the mask on for my titration study and felt a ton of anxiety. Still, I was determined to do this as I knew it was important. I was incredibly anxious, so I did some relaxation breathing.

As I started to relax, so did my airway, and the technician attempted to make a pressure adjustment seeing how shallow my breathing was getting. That caused me to sit bolt upright in bed and rip the thing off. Let’s just say the rest of the entire night was not fun for me or for the sleep technologist.

This led me on a journey to find a mask I could deal with (more on that frustration some other time) and eventually to my getting into the sleep medicine field.

Getting in the right mindset

It’s easy, today, to find meditation and various types of relaxation techniques to help you get into a calm space before you even start.

Find what works for you. For me, it’s a basic progressively relaxing of the body muscles I learned from yoga.

Slowly build up your time wearing the mask

Think about just one small step at a time. No need to try and jump into the deep end here. Work to hold the mask up to your face for a few minutes and increasing that amount of time before you ever try putting the straps on (or turning the air on if you are bothered by the air at first).

Work slowly to add the steps and increase the time. Do this while awake and sitting in a comfortable chair. Don’t even try it in bed if you have a severe case. We don’t need you associating your bed with that kind of stress.

Work up to getting comfortable with breathing with the mask while you are awake and slowly increase the time you have it on. Remember, you are the one in control here. Small steps built on top of each other.

Try this breathing technique

There is a breathing technique I came up with that can help. We have a reserve volume in our lungs. (Don’t believe me? Exhale all the way out and then use your stomach muscles and push out more air. See, there was more in there!)

CPAP is basically increasing that reserve of air in your lungs, making a splint of sorts to help keep your airway open when you sleep.

Distracting the mind from the change in breathing

Some can really feel that change even with the machine on its lowest setting. What this breathing technique does is trick the body, so you don’t notice that change so much. Take a deep breath in, and as you let it out, put the mask on your face, then instead of breathing in a normal breath or even a deep breath, take 3 quick fast breaths in and out, then 2 deep slow breaths in and out, 3 quick ones again, and then breathe normally.

What this does is cause your mind and body to not exactly remember what the airway felt like before that weird breathing pattern. When ready, start adding the straps and work from there.

To ramp or not to ramp?

You will hear a lot of people tell you that you can ramp your pressures up slowly, having it change or increase the pressure over time. That works for a lot of people. They can just fall asleep and let it do its thing.

Not me. Remember the sleep tech increasing the pressure and my ripping the mask off? Every single pressure change would cause that. I could not calm down because things kept changing. So, we got rid of my ramp.

I started with 10 cm H20 pressure and that was that. For me, it was way less scary saying this is what it is and will be all night, then having it change on me. So be open to the idea that perhaps, the ramp is not for you.

If you struggle, you're not alone

Over the years I have seen many people have full-blown panic attacks attempting to use the PAP/mask and had my own share of problems. Hopefully, some of these tips will work for you, if not, then perhaps other techniques will. After a couple of decades, I don’t need many of the tips out there any longer. (Well, I still cannot stand and do not use a ramp.)

If you are struggling with claustrophobia, don’t think you are alone, and don’t feel embarrassed. Honestly, a fear is a fear and you should not be embarrassed by having claustrophobia with your therapy any more than someone who has arachnophobia is about being afraid of spiders. There are a lot of different fears out there and yours, towards this therapy, is surprisingly common to one degree or another.

Take it slow and steady and like me, you can overcome the anxiety if you are determined to do so.

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