apap and chest pain
Question:
- Hide quoted text — Show quoted text -Tom Devlin wrote: > normc <no…@socal.rr.com> wrote: >>My neurologist sleep doc has told me similarly. Everyone doesn’t >>necessarily DIE if they don’t use their xpap for one night. > But you might _wish_ you could. <Rueful grin> > My old Aria died a couple of years ago, leaving me without a spare. I > went through three days in zombie-mode before a new insurance company > and DME got their act(s) together enough to get me a new blower. I > don’t _ever want to do that again! > I now have a spare CPAP. > Tom
As is often the case, it is difficult (at least for me) to cover all the whys and wherefores in an email/post. The worst possible for me would be laying in bed without a pillow. The next worse would be with a pillow. The next worse to that would be using a foam wedge. However, the best is my recliner. I couldn’t walk, sit at the computer, or lay in bed for three months, without severe pain, but I could position myself in the recliner so that I didn’t have any pain, could get up without having to twist, and was able to sleep I didn’t use my CPAP and felt great from a ‘quality sleep’ standpoint. None of the symptoms that I had experienced before using CPAP. I made arrangements to use a recording pulse oximeter to see what was happening to my blood oxy sat levels, but never got around to using it. Instead, I was concerned that my need to get up every two hours to urinate was a telltale indicator of my OSA. Sure enough, I went back to my CPAP and that problem changed to four hours.
Response:
normc <no…@socal.rr.com> wrote: >>>My neurologist sleep doc has told me similarly. Everyone doesn’t >>>necessarily DIE if they don’t use their xpap for one night. >> But you might _wish_ you could. <Rueful grin> >> My old Aria died a couple of years ago, leaving me without a spare. I >> went through three days in zombie-mode before a new insurance company >> and DME got their act(s) together enough to get me a new blower. I >> don’t _ever want to do that again! >As is often the case, it is difficult (at least for me) to cover all the >whys and wherefores in an email/post.
Oh sure, and your doctor was right, I didn’t die. <g> >However, the best is my recliner. I couldn’t walk, sit at the computer, >or lay in bed for three months, without severe pain, but I could >position myself in the recliner so that I didn’t have any pain, could >get up without having to twist, and was able to sleep
I slept in the recliner while waiting for a new CPAP, it wasn’t as good as the blower, but it did seem to help. >Instead, I was concerned that my need to get up every two hours to >urinate was a telltale indicator of my OSA. Sure enough, I went back to >my CPAP and that problem changed to four hours.
I monitor my dreams as much as anything, few dreams seem to mean that my pressure’s ok. Many dreams, especially if I wake up sweating, means that I’m due for a pressure boost. Tom
Response:
normc <no…@socal.rr.com> wrote: >My neurologist sleep doc has told me similarly. Everyone doesn’t >necessarily DIE if they don’t use their xpap for one night.
But you might _wish_ you could. <Rueful grin> My old Aria died a couple of years ago, leaving me without a spare. I went through three days in zombie-mode before a new insurance company and DME got their act(s) together enough to get me a new blower. I don’t _ever want to do that again! I now have a spare CPAP. Tom
Response:
Em wrote: > Hi and thanks for all the responses! i am glad to see this is still a > fantastic group of people. i remember most of y’all, you have helped me with > CPAP years before. in fact, i think Tom was the person who encouraged me to > see a sleep doctor. > i’ll try to answer the questions: > as far as not using it tonight, the doc said it was okay.
My neurologist sleep doc has told me similarly. Everyone doesn’t necessarily DIE if they don’t use their xpap for one night. > i have already had > two PSG’s. this was bit of an experiment to see if i could tolerate apap and > to see where my pressure was at.
Were you titrated following one or both of your PSGs and resulting Dx of OSA? I was having similar problems to yours after my PSG/titration. I told my neurologist sleep doc that I wanted to use (at home) an apap and a recording finger oximeter to see what was going on. The apap to determine if the pressure is OK and the oximeter to determine if you might be experiencing any neurological sleep interruptions (often called central apneas). This would be indicated by pressure OK, but O2 sat low. You don’t mention an oximeter! Did your PSGs specifically indicate whether you experienced any central apneas during your PSGs or, potentially more likely, during your titration(s)? > i had a cflex with a humidifier, and various types of masks. the end result > was, even if i did manage to get to sleep with it (which didn’t happen > often), i removed it in my sleep.
This has happened to many of us. Some have even reported turning off the blower and not even knowing it. > tho i don’t recall ever experiencing > bronchial pain during that time. > on the first PSG, my RDI was 96 and o2 sats dropped to 74. on the second > PSG, my RDI was 11. on both sleep studies, i got the most improvement on the > lowest pressure levels (5-6), the hyopneas increased at higher levels.
Guess this sez you were titrated. This is the first time I have read of this kind of situation. Central apneas can occur at higher pressures. If it was me, I would be investigating your potential for CAs. Look at your PSG/titration reports and determine if anything is said about CAs. It is important that it specifically say there were none. Some reports just don’t say anything. Even if it says none, doesn’t mean that you aren’t experiencing them as part of your problem(s). > however, after a 5 month 90 hrs/week crunch, and i am exhausted. it’s been > weeks since the crunch ended and i am still beat. i weigh about 100 lbs, so > i don’t want to lose weight. > so i went back to the sleep doc and they took a close look at the last > study, and found that, while my RDI was 11 (8 apneas and 27 hypopneas)… > the 8 apneas occured three hours into the study, back to back, and my o2 > sats dropped to 79, so i was put on cpap. so they don’t really know if i > would have ‘recovered’ my o2 sats or if the apneas would have stopped.
As indicated above, this can be determined with apap and recording finger oximeter. > so > they thought they would try me on the aPAP to see if i would be less > fatigued, they also said apap is easier to tolerate. it’s a loaner and > didn’t have a humidifier. i have to admit, the apap is MUCH easier to breath > with than a cpap or even a cflex. > also, i have a problem with air escaping out of my mouth (even with a chin > strap), my lips just don’t close tight enough to prevent the air from > escaping.
Precisely what I discovered before I went to a FFM. You’d be amazed at how many users, AND RTs, don’t seem to understand this. It’s the lips that need to be kept closed, not the jaw. i have tried a FFM with the apap, but it leaks a lot. so i went > back to a nasal interface, and two times i have tried it, i am just blowing > air out of my mouth. i am really uncomfortable taping my mouth shut.
Yes, I also know this from experience. I tried tape before my FFM (with a full beard). Which FFM are you using? Was it fitted by a CRT/RRT or did you buy it on the web? If it was fitted…. and it leaks, then you are probably trying to make it too tight (to eliminate the leaks). In other words, it’s not loose enough to work correctly. Loosen all the straps until the mask just stays on your face when sitting up. Then turn on blower and lay down. If there are any leaks, pull on the straps enough to eliminate them. This gives you an idea of how much you will have to readjust the headgear straps to get rid of the leak(s). If you turn your head, and the mask leaks, do the same thing…. pull on the strap first to see how little/much it needs to be adjusted, and then readjust. Sounds like I had pretty much the same problems as you are having. The only reason(s) I post here is to try to help people NOT HAVE THE SAME PROBLEMS I HAD. – Hide quoted text — Show quoted text -> anyways, thanks for info and advice, if you have more suggestions, would > love to hear it. > cheers and thanks again > "normc" <no…@socal.rr.com> wrote in message > news:G3_Cd.47852$Ew6.12712@twister.socal.rr.com… >>Em wrote: >>>not sure the correlatiion. but i am having a lot of chest pain (seems to > be >>>bronchial, center of the chest kinda pain). but geez, it burns when i > use >>>the apap.(there is no humidity on it, BTW). i was just wondering if > burning >>>chest pain is normal on cpap/apap. i only have another week to get > myselft >>>titrated on it, but i am thinking of not using it tonite *whheezzz* >>>suggestions/recommendations? >>>TIA! >>You’ll find many differing opinions here, depending on individual >>philosophies, national health plans/insurance coverage, and/or available >>funds. >>My philosophy is that if one has enough symptoms of a sleep disorder to >>require some kind of diagnostic test, then that test should be a >>complete polysomnogram (PSG). [It is best to learn about PSGs by >>searching the web with GOOGLE. To start off, take a look at >>http://www.suite101.com/article.cfm/sleep_apnea/57133 ] From your post >>it would appear that you have not had a PSG. Titration is normally >>follows a PSG to determine what the sleep disorder is. If it turns out >>to be OSA, then a titration is done. How was it dermined that you have > OSA? >>If the PSG doesn’t determine what the disorder is and how to treat it, >>at least you know you’ve done the most medical science can do. >>Moreover, when you do anything less than a complete PSG, you run the >>risk of not fully determining what your exiting, and, in your case, >>forthcoming, problems, might be. Many without adequate initial testing >>have gone months trying to figure out what is wrong, feeling like crap >>(that’s crap not cpap <g>). I went months working out the fine points >>even after having a PSG. >>To work out the fine points, I used a recording finger oximeter(to >>determine blood oxygen saturation levels, necessary to assure heart, >>brain, and other organ health) I used an autopap to make some >>determination of, what is often called, central sleep apnea (CSA)(CPAP >>pressure OK, oxygen saturation not OK). >>I’ve noted a tendency, here on ASSD, to oversimplify the overall matter >>of sleep disorder, and, in particular OSA. So do your inquiring, >>reading, and researching carefully. Some posts are long, well written, >>and sound like they are written by a sleep disorder specialist. Don’t >>accept any statements without a reference that you read. There also >>seems to be a tendency to provide links to what appears to provide >>suppot, but really don’t. >>Finally, beware the conspiracy theories. These are the theories that >>PSGs only make money for doctors and sleep labs. PSGs are >>state-of-the-art diagnostic tools for sleep disorders. If you can’t get >>one, then you must do the best you can, but don’t believe that >>everything will be OK without one. It may or it may not. >>PSGs help many, many people. Can you get along without one? Sure, you >>may have immediate results. But, if you are miserable while untreated >>now, you may have to spend months more of misery. >>In the event you are unable to get a PSG now, and you still feel like >>crap, be certain that you dog your healthcare providers until you get one. >>HYH
Response:
I had a problem with feeling like I was hyperventalating when I first went on CPAP. Took me a few minutes to get with the rhythm even using the ramp up. Now I don’t have the problem except once in a blue moon. As for pain. I didn’t have any. Perhaps you should be talking it over with a Respiratory therapist. Lynne – Hide quoted text — Show quoted text -Em wrote: > not sure the correlatiion. but i am having a lot of chest pain (seems to be > bronchial, center of the chest kinda pain). but geez, it burns when i use > the apap.(there is no humidity on it, BTW). i was just wondering if burning > chest pain is normal on cpap/apap. i only have another week to get myselft > titrated on it, but i am thinking of not using it tonite *whheezzz* > suggestions/recommendations? > TIA!
Response:
Hi and thanks for all the responses! i am glad to see this is still a fantastic group of people. i remember most of y’all, you have helped me with CPAP years before. in fact, i think Tom was the person who encouraged me to see a sleep doctor. i’ll try to answer the questions: as far as not using it tonight, the doc said it was okay. i have already had two PSG’s. this was bit of an experiment to see if i could tolerate apap and to see where my pressure was at. i had a cflex with a humidifier, and various types of masks. the end result was, even if i did manage to get to sleep with it (which didn’t happen often), i removed it in my sleep. tho i don’t recall ever experiencing bronchial pain during that time. on the first PSG, my RDI was 96 and o2 sats dropped to 74. on the second PSG, my RDI was 11. on both sleep studies, i got the most improvement on the lowest pressure levels (5-6), the hyopneas increased at higher levels. however, after a 5 month 90 hrs/week crunch, and i am exhausted. it’s been weeks since the crunch ended and i am still beat. i weigh about 100 lbs, so i don’t want to lose weight. so i went back to the sleep doc and they took a close look at the last study, and found that, while my RDI was 11 (8 apneas and 27 hypopneas)… the 8 apneas occured three hours into the study, back to back, and my o2 sats dropped to 79, so i was put on cpap. so they don’t really know if i would have ‘recovered’ my o2 sats or if the apneas would have stopped. so they thought they would try me on the aPAP to see if i would be less fatigued, they also said apap is easier to tolerate. it’s a loaner and didn’t have a humidifier. i have to admit, the apap is MUCH easier to breath with than a cpap or even a cflex. also, i have a problem with air escaping out of my mouth (even with a chin strap), my lips just don’t close tight enough to prevent the air from escaping. i have tried a FFM with the apap, but it leaks a lot. so i went back to a nasal interface, and two times i have tried it, i am just blowing air out of my mouth. i am really uncomfortable taping my mouth shut. anyways, thanks for info and advice, if you have more suggestions, would love to hear it. cheers and thanks again "normc" <no…@socal.rr.com> wrote in message
news:G3_Cd.47852$Ew6.12712@twister.socal.rr.com… – Hide quoted text — Show quoted text -> Em wrote: > > not sure the correlatiion. but i am having a lot of chest pain (seems to be > > bronchial, center of the chest kinda pain). but geez, it burns when i use > > the apap.(there is no humidity on it, BTW). i was just wondering if burning > > chest pain is normal on cpap/apap. i only have another week to get myselft > > titrated on it, but i am thinking of not using it tonite *whheezzz* > > suggestions/recommendations? > > TIA! > You’ll find many differing opinions here, depending on individual > philosophies, national health plans/insurance coverage, and/or available > funds. > My philosophy is that if one has enough symptoms of a sleep disorder to > require some kind of diagnostic test, then that test should be a > complete polysomnogram (PSG). [It is best to learn about PSGs by > searching the web with GOOGLE. To start off, take a look at > http://www.suite101.com/article.cfm/sleep_apnea/57133 ] From your post > it would appear that you have not had a PSG. Titration is normally > follows a PSG to determine what the sleep disorder is. If it turns out > to be OSA, then a titration is done. How was it dermined that you have OSA? > If the PSG doesn’t determine what the disorder is and how to treat it, > at least you know you’ve done the most medical science can do. > Moreover, when you do anything less than a complete PSG, you run the > risk of not fully determining what your exiting, and, in your case, > forthcoming, problems, might be. Many without adequate initial testing > have gone months trying to figure out what is wrong, feeling like crap > (that’s crap not cpap <g>). I went months working out the fine points > even after having a PSG. > To work out the fine points, I used a recording finger oximeter(to > determine blood oxygen saturation levels, necessary to assure heart, > brain, and other organ health) I used an autopap to make some > determination of, what is often called, central sleep apnea (CSA)(CPAP > pressure OK, oxygen saturation not OK). > I’ve noted a tendency, here on ASSD, to oversimplify the overall matter > of sleep disorder, and, in particular OSA. So do your inquiring, > reading, and researching carefully. Some posts are long, well written, > and sound like they are written by a sleep disorder specialist. Don’t > accept any statements without a reference that you read. There also > seems to be a tendency to provide links to what appears to provide > suppot, but really don’t. > Finally, beware the conspiracy theories. These are the theories that > PSGs only make money for doctors and sleep labs. PSGs are > state-of-the-art diagnostic tools for sleep disorders. If you can’t get > one, then you must do the best you can, but don’t believe that > everything will be OK without one. It may or it may not. > PSGs help many, many people. Can you get along without one? Sure, you > may have immediate results. But, if you are miserable while untreated > now, you may have to spend months more of misery. > In the event you are unable to get a PSG now, and you still feel like > crap, be certain that you dog your healthcare providers until you get one. > HYH
Response:
On Fri, 7 Jan 2005 17:43:15 -0000, "Frankie" <femfran…@blueyonder.co.uk> wrote: >Ditto …. >Experianced chest pain in first weeks of CPAP usage too. >Still don’t know why folks do not get supplied with a HH as a matter of >course by now. This little addition to my CPAP was the turning point of me >getting compliant and makes usage far more bearable. The dry air burns like >hell without it! >Frankie
If you buy it yourself, there is no problem whatsoever. Any supplier will be pleased to accomodate you. :-) If it’s from a healthcare provider, then the small matter of
