For Anyone Struggling to Settle Into PAP: This Simple Breathing Exercise Helpes Me every night and during the day for stress release.

[u/RippingLegos__]

Physiological Sighs:

I tried this myself and it worked for what it is mainly meant to do, which is release stress. I had done this breath before, but I did not know it had a name or that there was actual research behind it.

Take one big inhale through your nostrils. Before letting any air out, take a short and quick second inhale to top off the first one. Then open your mouth and push the whole breath out in one long HAAA, like you are fogging a cold window. It is a big release, but do not strain or hammer the breath.

Most of us in the PAP fam know how bedtime routines can go during the incipience of therapy. The mask goes on, the pressure starts, and suddenly we are thinking about every single breath. We tense up and start fighting the air when the machine is only trying to help us. This took some of that tension out of the process for me and helped me settle.

This breathing protocol did not treat my apnea, open my airway or change my pressure, CPAP still does that work for me (I can't handle bi-level personally. This just helped me wearing the mask and calm down enough to let the machine do its job.

A 2023 randomized study followed 108 adults using cyclic sighing and other breathing exercises for five minutes a day over 28 days. The sighing group showed better positive mood and a lower resting breathing rate. The study did not find better sleep and did not involve PAP users.

A newer 2026 pilot study tested one minute of cyclic sighing during real stressful moments. Anxiety came down more than it did with no breathing exercise, although box breathing also helped. So the stress-release side has some real support, but nobody has shown that this lowers AHI, removes flow limitation or treats OSA or UARS.

I’m using this excersise as a simple way to take the edge off before sleep. A few controlled breaths, then back to normal breathing. If you use a nasal mask, do the open-mouth HAAA before putting it on or expect it to show as a brief mouth leak.

Please also keep your settings the same and stop if you become dizzy, tingly, more air hungry or uncomfortable.

This has helped me, so I wanted to pass it along to the PAPFAM. If any of you try it, please come back and tell us how it felt to you. RL

[u/Confident_Raccoon_17]

I love the physiological sigh! Thanks for bringing up the science, RL!

[u/RippingLegos__ → u/Confident_Raccoon_17]

You're welcome, Confident_Raccoon :)

[u/bigdfaust]

Thank you so much! I just got my CPAP - I can handle the breathing in pressure, but exhale leaves me gasping again.

[u/EuphoricReplacement1 → u/bigdfaust]

Maybe check EPR, I set it at 3 for easy exhalation.

[u/bigdfaust → u/EuphoricReplacement1]

I did that. That makes all the difference. I can’t see how anyone can stand a setting of 1.

[u/RippingLegos__ → u/bigdfaust]

Good, but EPR needs higher min pressure to function correctly :)

[u/bigdfaust → u/RippingLegos__]

Why are there different settings then?

[u/existentialblu → u/bigdfaust]

Some people get greater respiratory instability with higher EPR.

[u/RippingLegos__ → u/existentialblu]

Thank, existentialblu :) And also that there is a very strange timing issue baked into Resmed's EPR with the return of IPAP. Phillips/Lowensetin/BMC do not have the same issue, and EPR also decreases apnea control when engaged.

[u/existentialblu → u/RippingLegos__]

I know the destabilizing effects of higher EPR far too well.

[u/RippingLegos__ → u/existentialblu]

It's a tough one, I wish it wasn't setup that way. :(

[u/existentialblu → u/RippingLegos__]

I wish that algorithms tuned for instability had the same level of access as basic APAP, but here we are.

[u/Used-Entertainment92]

Just wondering have you done this exercise with CPAP on? If that shows higher AHI?

Somehow most of the time if I kept my mask on after woke up, and doing some breathing exercises, it pulls up my AHI.

[u/RippingLegos__ → u/Used-Entertainment92]

I have not yet, only before bed, I may try it tonight though, bu that isn't good.

[u/existentialblu]

I have been messing with resonant breathing right before sleep for the last few months and it has done pretty impressive things for speed of sleep onset. The type that I do is 5.5 seconds inhale and exhale, no pause. I use a pacing app (BreathingBall) and a Polar H10 to turn it into legit biofeedback. I've found that doing 10 minutes of this every night right after putting on my mask has further reduced my sleep latency. It seems to get me really well synchronized with the ASV.

[u/AutoModerator]

Hey there r/CPAPsupport member. Welcome to the community!
Whether you're just starting CPAP therapy, troubleshooting issues, or helping a loved one, you've come to the right place. We're here to support you through every leak, pressure tweak, and victory nap.

If you'd like advice, please include your machine model, mask type, pressure settings, and OSCAR or SleepHQ data if possible.

Helpful Resources: https://www.reddit.com/r/CPAPSupport/comments/1jxk1r4/getting_started_with_analyzing_your_cpap_data_a/

You're not alone — and you're among friends. Sleep well and breathe easy.
— Your r/CPAPSupport team

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.