What are the dangers of too much CPAP pressure?
Question:
> I may be wrong but I thought Apnea was due to the airway being blocked > "mechanically" by excess tissue around the windpipe, normally present > in fat buggers like myself. The Brain comes into the equation only > when breathing stops, and a body jerk is activated to begin > breathing…but I do agree that minimum pressure rather than max > should be used to stabalise the condition.
you’re describing obstructive (the most common form) apnea – central apnea has nothing to do with airway obstructions. — Beth in Australia (I am not a medical professional and anything stated in my posts is my opinion only unless specified otherwise) =================== FAQ for alt.support.sleep-disorder can be found here http://talhost.net/sleep Newsgroup Archives http://talhost.net/sleep/archives.htm this site is a work in progress – feel free to submit info/articles Remove my name to reply
Response:
Beginning to see daylight, thanks folks. Now, I suffer multiple chest infections when the temperature turns and I am breathing cold night air. Therefore, I can identify this tendency to lung inflammation early… I am however concerned about bursting alveoli and other bits and bobs within the lungs. I can only deduce from a layman’s logic and as with the eardrums Barotraumas (which sounded quite reasonable) the thought you have prompted that greater pressure in the lung compared to outside could damage or burst them under these unusual conditions is of great concern. So what pressures are we seriously talking for this to enter the ballgame with an otherwise healthy pair of lungs with no weak walls?…following on to this what would be the pressure range in which care was needed to cater for possible weaknesses? You may deduce by now I am attempting to get some idea of ranges for green, amber red pressure ranges…to make my own mind up if its worth the risk of a higher pressure if recommended. One of the biggest bugbears of the English NHS is the medical profession not keeping a patient informed, on the assumption we are too thick to make anything of the information…or it may prolong the public time in favour of private consultancy. (Cynical old sod isn’t I! :O) And BTW, us big buggers are not really fat, just not tall enough for our weight :O) Andy – Hide quoted text — Show quoted text -"dsps77" <priv…@nospam.com> wrote in message <news:u1Dnb.5714$Px2.1715@newsread4.news.pas.earthlink.net>… > Whoa 
Ears? I don’t think the Barotrauma Discussion in this > newsgroup ever got around to ears and eardrums! From what I > remember, divers (and people on mechanical respirators) > sometimes get more lung inflammation–something about air sacs > that don’t normally get fully expanded getting forced open by > overpressure. (It should be noted that this is not something > everybody would include in their definition of the word > "barotrauma," more like something called "ventilator induced > lung injury.") As I recall, Doug wondered aloud if CPAP users, > at the higher pressure settings, might not accumulate the same > tendency toward lung inflammation over the long haul. If divers > tilt toward lung inflammation with repeated dives at high > pressure, might not longterm CPAP users also tilt toward lung > inflammation …eventually? Deep sea divers might use higher > pressures (I don’t know), but they don’t "go scuba diving" eight > hours every night of their lives as do CPAP users. This line of > discussion generated a lot of heat, but not much light was shed > on the subject. Perhaps more research is available these six > years later. General consensus hereabouts seems to be that a > person would first run into trouble with central events if the > pressure setting is too high for the individual’s needs.
Response:
dsps77 wrote: > Theoretically, some people think, it has been talked about > hereabouts, not necessarily my opinion, I’m no doctor, please > don’t stone me for using the word, my fingers tremble to type… > barotrauma > It’s the idea that high pressures can bring about changes in > lung tissue leading to inflammation. (I mention this only in > friendly memory of Doug Ruth.) If you look look up just the word > barotrauma in Google Groups, you will learn a lot about xPAP, > the late Doug Ruth, this newsgroup, and, I suppose, scuba > diving.
Thanks for bringing that up, I remember it now. Also good to see Doug again, even if is from an archive. — Bob
Response:
On 29 Oct 2003 06:03:13 -0800, a…@andycabs.com (Andy) wrote: >You >may deduce by now I am attempting to get some idea of ranges for >green, amber red pressure ranges…to make my own mind up if its worth >the risk of a higher pressure if recommended. One of the biggest >bugbears of the English NHS is the medical profession not keeping a >patient informed, on the assumption we are too thick to make anything >of the information…or it may prolong the public time in favour of >private consultancy. (Cynical old sod isn’t I! :O) And BTW, us big >buggers are not really fat, just not tall enough for our weight :O) >Andy
Andy Why don’t you consider getting one of the Resmed Autoset Spirit machines. These are purchasable directly from Resmed with a prescription from your consultant. This also exempts you from VAT. The whole issue of pressure becomes a non-issue because the machine automatically adjusts to the pressure that you need. This varies over time with various factors such as weight and the position that you are lying in bed. The machine detects when hypopnoea and apnoea events as well as snore are occurring and ramps up the pressure to deal with them. It then reduces slowly over some minutes of not needing such high pressure. On a fixed pressure machine, I would need approx. 11cm H20 to deal with the majority of events, but in reality, during the course of a typical night, for most of the time only 6-7 is needed and with occasional peaks. This makes for much more comfortable use of the machine and not needing to worry about messing around with pressure. Also, there is an optional heated humidifier which plugs onto the front of the machine and also adds to the comfort of use for many people. I tried one of the S7 machines for a bit and although it was OK, the automatic adjustment of the Spirit makes for a much better experience. .andy To email, substitute .nospam with .gl
Response:
I have never read on this newsgroup (or elsewhere) of anyone actually suffering barotrauma or increased lung inflammation from a commercially built CPAP made for home use. I mentioned it only as a *theoretical* possibility which has been discussed on this newsgroup, perhaps another good reason not to jack up CPAP pressure higher than what is prescribed. Unlike some ventilators, respirators, and anesthesia machines, CPAPs do not force breathing, but work only to keep the airway open while the user breathes on his own. CPAP masks also have unsealable outlfow vents that prevent accidental build-up of pressure.
Response:
Excuse my ignorence, I am inexperienced in CPAP thingys, but I have a RES MED S7 on a months patient trial, after the first week I came to the conclusion it was not providing as much benifit as the first machine I had for a weekend. This was supposed to calculate my pressure requirement but because of mask leakage gave inconclusive results and my clinician set the resmed at 8, commenting that I may have to have it increased to 10. Getting in touch with the hospital I find she is on a weeks holiday, and there is no one else qualified to change the pressure…Can anyone please advise me, what are the problems/dangers of setting the pressure too high. I am an overweight Asmatic male, age 52 with no other heart or BP problems. It would also be useful to know how to reset the pressure to make the most of this trial. BTW I am in the South East UK being treated under NHS hospital after referal from doctor and one nights sleep study. Thank you Andy
Response:
"Andy" <a…@andycabs.com> wrote > Can anyone please advise me, what are the > problems/dangers of setting the pressure too high.
Too much pressure can (among other things?) trigger/increase central apneas. Not a good thing. -Quick
Response:
Too much pressure can result in death. No joke. Central apnea is a result, which means that your brain decides you don’t need to breathe, so you don’t, which causes your heart to stop, and removes your need for a CPAP permanently. Sarcastic? Maybe. Am I trying to get the point across? Definitely. It is not good to be on the wrong pressure, but if one must be wrong, it is better to be under than over, as minimally as possible. Gary "Andy" <a…@andycabs.com> wrote in message
news:43e9b5c2.0310271425.43567d60@posting.google.com… – Hide quoted text — Show quoted text -> Excuse my ignorence, I am inexperienced in CPAP thingys, but I have a > RES MED S7 on a months patient trial, after the first week I came to > the conclusion it was not providing as much benifit as the first > machine I had for a weekend. This was supposed to calculate my > pressure requirement but because of mask leakage gave inconclusive > results and my clinician set the resmed at 8, commenting that I may > have to have it increased to 10. Getting in touch with the hospital I > find she is on a weeks holiday, and there is no one else qualified to > change the pressure…Can anyone please advise me, what are the > problems/dangers of setting the pressure too high. I am an overweight > Asmatic male, age 52 with no other heart or BP problems. It would also > be useful to know how to reset the pressure to make the most of this > trial. BTW I am in the South East UK being treated under NHS hospital > after referal from doctor and one nights sleep study. > Thank you > Andy
Response:
Whoa Ears? I don’t think the Barotrauma Discussion in this newsgroup ever got around to ears and eardrums! From what I remember, divers (and people on mechanical respirators) sometimes get more lung inflammation–something about air sacs that don’t normally get fully expanded getting forced open by overpressure. (It should be noted that this is not something everybody would include in their definition of the word "barotrauma," more like something called "ventilator induced lung injury.") As I recall, Doug wondered aloud if CPAP users, at the higher pressure settings, might not accumulate the same tendency toward lung inflammation over the long haul. If divers tilt toward lung inflammation with repeated dives at high pressure, might not longterm CPAP users also tilt toward lung inflammation …eventually? Deep sea divers might use higher pressures (I don’t know), but they don’t "go scuba diving" eight hours every night of their lives as do CPAP users. This line of discussion generated a lot of heat, but not much light was shed on the subject. Perhaps more research is available these six years later. General consensus hereabouts seems to be that a person would first run into trouble with central events if the pressure setting is too high for the individual’s needs. Andy wrote in message
<43e9b5c2.0310280444.2559a…@posting.google.com>… >Blimus! DSPS…thanks, it never occured about burstng ear >drums…scary! >Any idea what pressures approach this, when ear infection is likely to >begin and at what pressure permanant damage could happen, 10,15 20, >30?? >Andy >"dsps77" <priv…@nospam.com> wrote in message
<news:wCnnb.4997$RQ1.1446@newsread3.news.pas.earthlink.net>… – Hide quoted text — Show quoted text ->> Theoretically, some people think, it has been talked about >> hereabouts, not necessarily my opinion, I’m no doctor, please >> don’t stone me for using the word, my fingers tremble to type… >> barotrauma >> It’s the idea that high pressures can bring about changes in >> lung tissue leading to inflammation. (I mention this only in >> friendly memory of Doug Ruth.) If you look look up just the word >> barotrauma in Google Groups, you will learn a lot about xPAP, >> the late Doug Ruth, this newsgroup, and, I suppose, scuba >> diving.
Response:
Ummm, what Victor said. -:) Now you know one (there are more) of the reasons that some people are not titrated (prescribed) to a pressure that eliminates *all* obstructive apnea events. One of the things a sleep lab will look for in a titration is the increase in central apnea events as the pressure is raised. It can be the case that the pressure that prevents all obstructive apnea events can be higher than the pressure at which central apnea events start/increase. -Quick "Andy" <a…@andycabs.com> wrote > Dhorwitz…could you please expand to me what a "central apnea" is and > how it differs from normal/(abnormal?) > Andy > "Quick" <dhorw…@NOSPAMcisco.com> wrote in message
<news:1067294538.575465@sj-nntpcache-3>… – Hide quoted text — Show quoted text -> > "Andy" <a…@andycabs.com> wrote > > > Can anyone please advise me, what are the > > > problems/dangers of setting the pressure too high. > > Too much pressure can (among other things?) trigger/increase > > central apneas. Not a good thing. > > -Quick
Response:
In article <43e9b5c2.0310280458.6db45…@posting.google.com>, a…@andycabs.com says… > Dhorwitz…could you please expand to me what a "central apnea" is and > how it differs from normal/(abnormal?) > Andy
"Normal" or Obstructive apnea is the more common blockage-induced type. This is the one us fat busturds get from too much of us surrounding the air-ways- although there are plenty of skinny busturds with the same problems; we not only outweigh them, but probably outnumber them as well <BFG>. Central refers to a "glitch" in the Central Nervous System where the brain forgets to send a signal to breathe. Not quite as common, it can happen while sleeping or in some cases (like me) whilst awake. Central Events can be triggered by overpressure of a xPAP, drugs, sound, certain frequencies (colors) of light, specific frequency of pulsating light, or for no reason at all. I only know of the connection with sound and light as I can ‘force’ a central event in myself with specific sounds and/or lights. vic in chicagoland
Response:
Dhorwitz…could you please expand to me what a "central apnea" is and how it differs from normal/(abnormal?) Andy – Hide quoted text — Show quoted text -"Quick" <dhorw…@NOSPAMcisco.com> wrote in message <news:1067294538.575465@sj-nntpcache-3>… > "Andy" <a…@andycabs.com> wrote > > Can anyone please advise me, what are the > > problems/dangers of setting the pressure too high. > Too much pressure can (among other things?) trigger/increase > central apneas. Not a good thing. > -Quick
Response:
Hey Andy, I resemble that comment… ME "Andy" <a…@andycabs.com> wrote in message
news:43e9b5c2.0310280455.281c767d@posting.google.com… – Hide quoted text — Show quoted text -> I may be wrong but I thought Apnea was due to the airway being blocked > "mechanically" by excess tissue around the windpipe, normally present > in fat buggers like myself. > The Brain comes into the equation only > when breathing stops, and a body jerk is activated to begin > breathing…but I do agree that minimum pressure rather than max > should be used to stabalise the condition. > Andy
Response:
Theoretically, some people think, it has been talked about hereabouts, not necessarily my opinion, I’m no doctor, please don’t stone me for using the word, my fingers tremble to type… barotrauma It’s the idea that high pressures can bring about changes in lung tissue leading to inflammation. (I mention this only in friendly memory of Doug Ruth.) If you look look up just the word barotrauma in Google Groups, you will learn a lot about xPAP, the late Doug Ruth, this newsgroup, and, I suppose, scuba diving.
Response:
Blimus! DSPS…thanks, it never occured about burstng ear drums…scary! Any idea what pressures approach this, when ear infection is likely to begin and at what pressure permanant damage could happen, 10,15 20, 30?? Andy – Hide quoted text — Show quoted text -"dsps77" <priv…@nospam.com> wrote in message <news:wCnnb.4997$RQ1.1446@newsread3.news.pas.earthlink.net>… > Theoretically, some people think, it has been talked about > hereabouts, not necessarily my opinion, I’m no doctor, please > don’t stone me for using the word, my fingers tremble to type… > barotrauma > It’s the idea that high pressures can bring about changes in > lung tissue leading to inflammation. (I mention this only in > friendly memory of Doug Ruth.) If you look look up just the word > barotrauma in Google Groups, you will learn a lot about xPAP, > the late Doug Ruth, this newsgroup, and, I suppose, scuba > diving.
Response:
I may be wrong but I thought Apnea was due to the airway being blocked "mechanically" by excess tissue around the windpipe, normally present in fat buggers like myself. The Brain comes into the equation only when breathing stops, and a body jerk is activated to begin breathing…but I do agree that minimum pressure rather than max should be used to stabalise the condition. Andy – Hide quoted text — Show quoted text -"Gary Rimar" <m…@garyrimar.com> wrote in message <news:0Rlnb.5527$P%1.4555300@newssvr28.news.prodigy.com>… > Too much pressure can result in death. No joke. Central apnea is a result, > which means that your brain decides you don’t need to breathe, so you don’t, > which causes your heart to stop, and removes your need for a CPAP > permanently. > Sarcastic? Maybe. Am I trying to get the point across? Definitely. > It is not good to be on the wrong pressure, but if one must be wrong, it is > better to be under than over, as minimally as possible. > Gary > "Andy" <a…@andycabs.com> wrote in message > news:43e9b5c2.0310271425.43567d60@posting.google.com… > > Excuse my ignorence, I am inexperienced in CPAP thingys, but I have a > > RES MED S7 on a months patient trial, after the first week I came to > > the conclusion it was not providing as much benifit as the first > > machine I had for a weekend. This was supposed to calculate my > > pressure requirement but because of mask leakage gave inconclusive > > results and my clinician set the resmed at 8, commenting that I may > > have to have it increased to 10. Getting in touch with the hospital I > > find she is on a weeks holiday, and there is no one else qualified to > > change the pressure…Can anyone please advise me, what are the > > problems/dangers of setting the pressure too high. I am an overweight > > Asmatic male, age 52 with no other heart or BP problems. It would also > > be useful to know how to reset the pressure to make the most of this > > trial. BTW I am in the South East UK being treated under NHS hospital > > after referal from doctor and one nights sleep study. > > Thank you > > Andy
