Asthma and CPAP Qs from newbie

[SleepyEdmonton]

i am trying so hard to use this CPAP machine. The person I deal with at the supplier is only available Wednesday to Friday so it’s gonna be a very very long weekend! Would appreciate any advice from members here. 

I have asthma and sleep apnea (apparently I stop breathing 32x per hour which is considered severe). I awoke this morning to discover I was breathing through my mouth, which I don’t think I have ever done before. And all morning I have been in bed coughing severely and clearing phlegm. I’m exhausted and my chest hurts. 

Question 1: Does anyone know if using the CPAP while awake and sitting up will deliver more oxygen into my lungs and reduce the coughing? 

Question 2: Why, on my third night using the machine, am I breathing through my mouth? It seems to be working properly. Turned on, water in the chamber, nasal mask in place, etc.

Thanks for any suggestions/advice.

[ApneaQuestions]

It's possible that your machine is not configured well for you. To determine that, we'd need to see data so that any recommendations can be based on data and facts.

So the usual response applies here...

1) Upload a redacted copy of your complete sleep studies if you have any (all pages not just the summary)
2) Download OSCAR so that you can read your data
3) Configure the OSCAR UI to emphasize the important graphs and turn off things like the pie chart and calendar
4) Get the important graphs into the recommended positions
5) Upload your chart for a recent night
6) Get a copy of your clinician's manual for your machine

See my sig for handy links to do all the above.

You are in the right place to get the machine optimized if changes are needed.

[SarcasticDave94]

Hi SleepyEdmonton,
Welcome to Apnea Board.

I'd like you to get OSCAR, a free report tool members of AB have developed. It's use will help you see your own therapy data, and you can post it here for us to see and give informed suggestions.

I get asthma like symptoms from my version of COPD FWIW, so I am sort of understanding your situation, at least I hope so anyway. Do you think it may help to use your scripted inhaler if applicable, maybe before a mask on at bedtime? I've done my rescue inhaler a few times in this scenario, mine is called Ventolin BTW. Again if applicable, were there breathing exercises you were to practice during episodes? Again, this may help loosen up the lungs to combat symptoms.

On to the questions:
1. A CPAP does pressurize you slightly, not nearly as much as a ventilator of course. Try doing some mask and machine on times while reading, TV time, etc. to get used to it, and to see if it adds comfort. I did this a few years ago on starting PAP therapy and it does help in the getting used to a mask and machine.

2. Without OSCAR data it's a semi-educated guess right now, but it's possible the machine settings aren't giving you enough air. What is your PAP set to? And which exact machine make and model have you been issued? BTW you can order the clinical manual for your device, assuming it's on the list in the CPAP Setup Manual tab above. I'd look at it and get your copy.

Hope the above helps some. Best wishes for success.

[sheepless]

a few thoughts. there might be something else going on but a positive spin might be that your cpap is helping you sleep longer and deeper than you've been used to. deeper means slacker muscles which might lead to a slackened jaw, leaks and dry mouth.

the standard fixes for dry mouth, mouth and lip leaks, are a soft cervical collar, chin strap, mouth tape & the tongue suck technique. some people have to use a full face mask to maintain a relatively sealed circuit but may continue to suffer dry mouth. some who have this problem have found some relief using a kind of moisturizing lozenge. (I don't know anything about this. xylimelt or something that looks/sounds close to that is one variety.)

maybe 70% of the time I awake with a stuffy, runny nose, post nasal drip, coughing and sneezing. sometimes it comes and goes all day, sometimes it works itself out in an hour or two. I've tried all kinds of humidity and tube temp settings and can discern no pattern of help or detriment. it often depends on the time of year. still, it's worth experimenting with these settings. some folks prefer more humidity and temp, others do better with less.

[SleepyEdmonton]

Thanks for the responses and sorry for the delay in responding myself. But I’m sick. And I think it’s the CPAP machine that made me sick.

When I first started to use the machine - after the clinic had set it up per the doctor’s instructions, and after I cleaned the new mask and hose, and the water tank and the filter, as instructed - I noted a musty smell. The smell disappeared after a short while, but now I am wondering if I took something into my lungs which has caused the congestion, and coughing, and phlegm I am continually expelling for two days now. Ironically, I cough less now when I use the machine while awake, which I attribute to the humidity it is delivering to my lungs.

If I am in the same condition or god forbid worse tomorrow (Monday) I am off to the doctor.

With regard to uploading and downloading as suggested, I will have to ask the clinic for the information on Wednesday.

[Gideon]

on uploads and downloads.
You should have a copy (full copy, not just summaries) of all your sleep studies and prescription for your records. in case you move or change doctors if for no other reasons.
downloads, OSCAR is a read only tool, it will not write anything to your SD card or CPAP. The manuals tell you how to look at everything on your machine, and change the settings if you choose to do so.
Because you are getting "musty" smells, empty and wipe the dry the humidification chamber every morning, and maybe a vinegar rinse the first day (leave it open to air out after)
Fill the chamber as part of your go to bed routine.

And when it comes to having breathing issues and CPAP Dave is the ticket. He knows how to convey info to doctors to get the desired outcome.

[SarcasticDave94]

Personally, I'd do this about your therapy, keep a therapy diary, either mental if you can remember all facts, figures, etc. Better is to physically write your personal observations and complaints. Something like "I am having issue X or asthma attacks increased, or fill in whatever, versus before CPAP therapy." It could also be problems like it's harder to breathe out, mask on, after 1 hour use, etc.

OK simple suggestion, note all issues and complaints, take these to doc, ask what to do to fix, meaning definite fixes not wasting your time and effort with "it could help", you'll need "will help" stuff. Remember, that you have to convey these issues and demand time, recognition and solutions. Bring these up until either they help or you fire them.

A your choice alternate is for us to help your issues here as best as we're able on Apnea Board via OSCAR data.