Asthma & CPAP

[MARrshh]

Sitting here in the wee hours after being awakened by a somewhat startling experience involving my CPAP usage.
 
( 1 )  Background:  77 yrs. old (ouch!), several sleep studies over the years, always with the "Mild to Moderate" apnea finding. Have used CPAP machne on-and-off for years -- wildly non-compliant a good deal of the time, but trying hard to stay with it now.   (btw, Cloth mask liners with my full face mask making all the difference in the world!) 
 
As an aside, I have tons of psychological problems with sleep -- so deep and long-lasting that no shrink wants to tackle it.  Oh well . . .  the old "do the best you can" bromide will have to suffice.
 
( 2 )  And More:  Diagnosed with Asthma a few years ago, although the doc said I've probably had it since childhood.  Symptoms again considered  "moderate" -- lifelong shortness of breath, occasional minor wheezing, and -- since I started on the Flovent spray med, some coughing.  Have never had to resort to the "rescue" inhaler (albuterol) in a life-threatening situation, although it helps with coughing episodes and helps me sleep better.


( 3 )  And finally to the point:  I was awakened a few minutes ago by some weird breathing pattern that seemed to be getting out of hand.  I was using the CPAP  but as I was awakening, I realized my breath was coming in very short puffs with hard, quick exhalations.  It was strong enough to wake me up, and I sleep very soundly when I do finally get to sleep. My machine is new and seemed to be working properly.
 
Anybody want to speculate -- was I just having an asthma attack?  Can something like this be dangerous?  Are bi-level machines any better for asthmatics?  All replies, ideas or even expressions of disdain are welcome !


 

[OpalRose]

I'll attempt to address some of your concerns.

(1)  "wildly non-compliant a good deal of the time, but trying hard to stay with it now"

I hope you will do all you can to stay with Cpap therapy.  Untreated sleep apnea will most likely and has over the years caused your asthma to worsen.  You can Google Sleep Apnea and Asthma.  Many good articles!  

(2)   My advice comes from experience.  I'm not a Doctor.  

I also suffer with Asthma and allergies.  I use an inhaler (albuterol), when needed.  
It helps me to use it an hour before bed, especially if having a bad day with coughing and wheezing.  Along with Cpap use, it will keep your airway open.  It's best to talk to your doctor on usage.

3  We would be able to give more targeted advice if we could see an OSCAR chart. We have some very knowledgeable people here that can look at your flow rate graph and spot breathing abnormalities.  

Follow this tutorial to Organize a daily chart, take a Screenshot and post it here:

http://www.apneaboard.com/wiki/index.php...ganization

Also, scroll down to the bottom of page. See "Possibly Related Threads".

[MARrshh]

A belated 'Thanks' for your reply. I have the OSCAR software installed and am in the process of learning how to use it -- no easy feat for an aged dinosaur like me ( "Tyrannus Marrshh" ), but I'll get there.

Let me reiterate for the benefit of anybody interested: the aftermarket-purchased cloth liners for my full face mask have made such a difference -- I simply couldn't use the mask consistently before I found those liners, but now the leakage and fit problems are about 98% resolved ! And no, I have no financial interest in the company that makes or sells them :c) .

[car54]

"Are bi-level machines any better for asthmatics?" It depends upon the severity of your asthma. I have trouble exhaling. With my bilevel I am able to adjust my EPR to a greater range and that helps.

[Apnea23]

Check your daytime and nocturnal oxygen saturation using an o2ring. It has to be a continuous monitoring device to catch any short desaturations.

CPAP, when people have underlying lung conditions, can be a red herring.

The mouth breathing, aggressive snoring and weird breathing can be your system trying to aggressively maintain o2 supply. This can /cause/ airway obstruction.

A lot of people could throw away their CPAP machines if sleep doctors and specialists actually analysed o2 saturation along with the other parameters.

CPAP indeed can make such case worse in some respects, causing more issues during REM. Though CPAP will help outside of REM sleep as it will help you intake more air (and o2).

You probably woke up from hyperventilation in REM sleep. This would be an arousal response to rescue you from the chaos. This is one of the things I mean about CPAP potentially causing more issues, especially during REM.

Ultimately you probably just need o2 supplemention.

I recommend getting an o2ring and taking a look. No one else will do it for you. I had to figure it all out on my own, and now no longer use CPAP.

Underlying lung issues since birth, finally all makes sense at 40 after 2 years on CPAP.

Can I ask.. do you get indigestion/heartburn/adrenaline surges throughout the day, mainly 30-45 minutes after eating (the bigger the meal the worse it is)? Do you feel your body ramp up and stay ramped up for well over an hour afterwards.

Low grade anxiety/adrenaline you may have considered normal.

Cognition decline - worse after food and moving? A feeling comes over you and you feel it in your head?

Hot and sweaty when everyone else isn't, especially in warm weather. ..if it's hotter than usual, breathless upon any mild activity such as walking.

After eating and moving about is when you would suffer most with intermittant hypoxia - you will feel it most then, but it will persist all day with peaks and troughs, including sleep also.

If that doesn't ring true, feel free to ignore.

If you have lung issues, your o2 and intermittant hypoxia needs ruling out before CPAP or sleep disorder diagnosis.

When we feel breathless during the day, it is because our o2 requirements are not being met by our lungs. This is hypoxia. This can and will also happen in sleep to a lesser but significant degree, especially during REM. Disturbing sleep, fragmenting sleep stages as your system turns on emergency measures to rescue falling o2.

I actually dread the thought of how many people with lung issues are on CPAP and are being misdiagnosed and thus mistreated. And the suffering continues.