Adverse Affects Possible From Wrong Prescribed Pressure?

[2Tim215]

Hello, This might take a bit, coffee ready? Good! Okay, When I first had my sleep study December 2010 it was a two part study, 69.3 AHI results from Severe OSA. My questions are these. Can the wrong prescribed pressure with no Ramp or EPR turned on cause further damage? My straight pressure was only 7cm but that was full time throughout the night. I advised the person who came and set me up when asked how the mask felt that it was hard to breathe out. Obviously as most of you I was warned about not having therapy could be dangerous and when I was told mine was severe I was determined to make it work. Couldn't the person who came to my house to set me up have turned on the EPR and Ramp to see if I felt more comfortable? I know I can't change the past but now that I have been on the AutoSet vs. the Escape I breathe much better AT NIGHT! BUT, during the day I am easily short on breath, my chest feels tight and heavy, basically a very uncomfortable feeling, before the Sleep Study my Cardiologist said my heart was good although I did have High Blood Pressure that needed medication which after adjustments works. Its hard to say if its my lungs that are bothering me or my heart. I ruled out gas although at times that was an issue on the Escape. Although I feel better at night with my new Autoset I am still fatigued during the day. Based on the above information has anyone else went through this after starting out on a brick? Do these conditions get better with continued use on the AutoSet? My settings are 6cm-12cm, I notice in ReScan I am reaching 11.9cm, SleepyHead 11.91, 95% 10.84cm, average 7.27. I was on the brick for almost two years and wondering if it did more damage than help! I'm waiting to hear back from my primary care, possibly starting on supplemental 02. With the above information what would be the best Doctor to do a follow up with? My primary care is great but not an expert in this field. I'm just a bit panicky not being able to breathe right during the day and find myself getting irritable quite often.

[Dawei]

Tim, my guess is that having trouble breathing during daytime sounds like a question for your doctor. That is, it doesn't sound like apnea (my understanding is that apnea isn't possible when you're awake).
I was on a brick for a full five years with a pressure of 7 (from the initial sleep study). During that time, I was not having any daytime breathing problems. That's remained the case since I switched first to an Elite and then to an Autoset. Ramp and EPR are comfort features, so I don't see how not having them on during your time on the brick would be harmful.

[zonk]

what would be the best Doctor to do a follow up with?

http://www.apneaboard.com/forums/Thread-...ng-the-day

[2Tim215]

Tim, my guess is that having trouble breathing during daytime sounds like a question for your doctor. That is, it doesn't sound like apnea (my understanding is that apnea isn't possible when you're awake).
I was on a brick for a full five years with a pressure of 7 (from the initial sleep study). During that time, I was not having any daytime breathing problems. That's remained the case since I switched first to an Elite and then to an Autoset. Ramp and EPR are comfort features, so I don't see how not having them on during your time on the brick would be harmful.

I guess my thought was more to the EPR rather than the Ramp. I realize it is a comfort feature but fighting to exhale for almost two years vs. the AutoSet I couldn't help to wonder if that is why I'm still feeling this way during the day. I don't believe I am having any apnea's during the day and no congestion or cough. Just searching for answers so I am more equipped before going to my primary care who may end up sending me to another type of doctor. They just called back, they will get me in on the 11th. I did send them copies of my low 02's, they seemed surprised it was still happening on the new machine.

[PaulaO2]

Unless you have a chronic lung issue, CPAP is not going to be an issue. A ventilator in ICU has a much higher pressure. A CPAP can't even blow up a balloon. You may feel like you are having difficulty breathing against the pressure but, again, unless you have a lung issue, it really is just a mind thing.

I've read that some patients have issues with chest pain etc but no one has ever discovered why other than they also had lung/heart issues. One theory is that with the help of the CPAP, we're now actually breathing like normal people do and we're not used to it, hence the temporary discomfort.

Shortness of breath right after getting the Autoset is most likely sheer coincidence. This is something to discuss with your doctor. And quickly.

[2Tim215]

Hi Paula, Just to clarify, I have been fatigued for months now, long before the AutoSet. Having shortness of breath etc. I have seen my Doctor about this a few times now. We tried medications, one to give me energy, Modafinil 200mg, and when that didn't work he went with the Zolpidem ER 12.5mg (Ambien), thinking it would help me sleep better and wake up refreshed (hardly ever take it unless can't sleep as it didn't work either). It was about that time I started suspecting the Escape wondering if it could be decreasing my 02 and might be the culprit and started searching the internet when I found these Forums as I wasn't informed about CPAP therapy at all except from what the "nice" DME told me about two years ago. One of the first things I was advised was to buy the Pulse Oximeter which I did back in October, recorded every night since looking for answers while working on obtaining the AutoSet after learning most questions couldn't be answered without proper data and the benefit of an AutoPap. That was when I realized I didn't have one even though it had the SD card. Anyway, still scratching my head trying to figure out what is going on. Not sure why the shortness of breath and feeling weird in my chest. Hopefully I'll learn more on the 11th as I continue searching for answers before my appointment! Thank you everyone for replies, interesting post Zonk!

[archangle]

Tightness in the chest can always be heart trouble. We can't diagnose you.

Increased pressure can give you muscle soreness in your chest. It usually goes away fairly quickly. How long have you been on the new machine?

It's unlikely that "bad CPAP" did you any harm greater than untreated apnea would have. However, untreated apnea can be pretty bad.

Some CPAPers report feeling bad after starting CPAP. Some use the term "sleep debt," but it's probably a bit more complicated than that. Even if CPAP is right, your body sort of has to readjust to not being strangled over and over during the night. Maybe you have "sleep debt" from inadequately treated apnea.

What's your AHI?

[2Tim215]

Tightness in the chest can always be heart trouble. We can't diagnose you.
I understand that, just checking to see if any others here had related issues.

Increased pressure can give you muscle soreness in your chest. It usually goes away fairly quickly. How long have you been on the new machine?
20 days, started 11/14.

It's unlikely that "bad CPAP" did you any harm greater than untreated apnea would have. However, untreated apnea can be pretty bad.

Some CPAPers report feeling bad after starting CPAP. Some use the term "sleep debt," but it's probably a bit more complicated than that. Even if CPAP is right, your body sort of has to readjust to not being strangled over and over during the night. Maybe you have "sleep debt" from inadequately treated apnea. Okay, I'll look into "Sleep Dept" further.

What's your AHI? Currently looks very good, last night 2.48, last 7 average 1.71:grin:

[PaulaO2]

Anything less than 5 is the goal. And you're reaching that!

Have you had any lung capacity tests done or the like?

Too low a pressure can result in badly treated sleep apnea so that's not good.

Too high a pressure *might* cause central apnea events but that's never been proven except anecdotal. Even then, after a short time, the events go away as the body and brain adjust.

[2Tim215]

Anything less than 5 is the goal. And you're reaching that!

Have you had any lung capacity tests done or the like?
No, I don't believe so.

Too low a pressure can result in badly treated sleep apnea so that's not good.Could be part of it?

Too high a pressure *might* cause central apnea events but that's never been proven except anecdotal. Even then, after a short time, the events go away as the body and brain adjust.
That one might be concerning for future adjustments! I had a Lung collapse June 2, 1991, probably safe now though!!!