Chest Pains. Set pressure?

[Dolla Bill]

I had severe chest pains waking up in the morning several days in a row and getting worse to the point where I went to Emergency Hospital. Nine hours later I had a clean bill of health. CT, Xray, EKG a few more. 

I talked with a woman in my sleep doc office and she asked where was my pressure. It was at 15 and 4. She suggested I set it to 9 and 4. I did this. This AM I still had chest pains, but somewhat less, But it seemed I had a hard time breathing through my mask. Seemed like the pressure was too low. But I had some nasal congestion.

Have appointment with my sleep doc on Monday. His office called me today and he said that I go without the CPAP for three days and he would reset my machine. THe nurse was talking fast and I was unable to tell her I had reset my machine. Going without the CPAP seems like a bad Idea. I have been on my machine 15 years.

See OSCAR after lowering the pressure.

Also dry mouth after taping my mouth shut

Just noticed that I had set the pressure last night 9 to 9. Just reset it to 4 and nine.

[Millstone50]

I think we need to get those leaks under control

[staceyburke]

The leaks you are having are mouth leaks. Some people will use a full face mask and others tape their mouth. However you do it your Cpap will NOT show the correct or type of Apnea you have.

[Dolla Bill]

I set pressure 4 to 9. Still severe chest pain this morning

I did tape my mouth shut. No help,

I have a full face mask. Will try it again.

I guess I go to sleep tonight without the cpap machine

[OpalRose]

I guess I go to sleep tonight without the cpap machine

Why???  Not using your Cpap is not going to solve your issues.

Consider that the excessive mouth breathing not only causes dry mouth, but you are probably swallowing a lot of air causing Aerophagia.  This can cause chest discomfort.

You can work on controlling your mouth breathing.  Try sleeping on your side with your head slightly elevated.  You'll need to find what keeps you from mouth breathing....
If tape isn't working, try a soft cervical collar that helps prop your jaw up.  It may keep your mouth from opening.  Alternatively, some find that while on their side, tucking a corner of their pillow under their chin keeps the jaw from dropping down and mouth from opening.  

Think, do you breathe through your nose during the daytime?  If yes, you should be able to do it at night.  If no, then you should visit with an ENT to check if there are any nasal blockages.  

If these things don't prove effective, go back to your full face mask.  But the leaks need fixed, which in turn will tame the Aerophagia.

Aerophagia is often helped by using lower max pressure, or trying Cpap mode at a lower pressure.


The algorithm can reach the maximum pressure for various reasons. You can see that with the leaks. You can try Cpap mode with a pressure 8 (Cpap mode), and use EPR 2.  Observe for a couple days, then if no chest pain (Aerophagia),
raise the pressure slowly... try 8.4.  Observe for a day or two and repeat until you find a pressure that gives decent therapy, but also relieves Aerophagia.

Also, for comfort alone, if you stay with the Auto mode, a minimum pressure of 4 may be too low and cause you to feel air starved. Try raising it to 6 or 7cm to get full use of EPR.

[Dolla Bill]

Why???  Not using your Cpap is not going to solve your issues.

Consider that the excessive mouth breathing not only causes dry mouth, but you are probably swallowing a lot of air causing Aerophagia.  This can mimic chest pain.

You can work on controlling your mouth breathing.  Try sleeping on your side with your head slightly elevated.  You'll need to find what keeps you from mouth breathing....
If tape isn't working, try a soft cervical collar that helps prop your jaw up.  It may keep your mouth from opening.  Alternatively, some find that while on their side, tucking a corner of their pillow under their chin keeps the jaw from dropping down and mouth from opening.  

Think, do you breathe through your nose during the daytime?  If yes, you should be able to do it at night.  If no, then you should visit with an ENT to check if there are any nasal blockages.  

If these things don't prove effective, go back to your full face mask.  But the leaks need fixed, which in turn will tame the Aerophagia.

Aerophagia is often helped by using lower pressures.  Note: Using a pressure of 4 is too low and will cause you to feel air starved.  Drop the pressure to 8 (Cpap mode), and use EPR 2.  Observe for a couple days, then if no chest pain (Aerophagia),
raise the pressure slowly... try 8.4.  Observe for a day or two and repeat until you find a pressure that gives decent therapy, but also relieves Aerophagia.

I am using 4 as a low number and a high number is 9. I will set EPR 2. Should I have a lower number at a higher pressure, More than 4 on the low end?

I thought that Aerophagia was related to bloat and belch. But could mimic chest pain. The chest pain was so severe that I was admitted into emergency hospital. I thought I was going to die from heart attack! In my life I have ever gone to emergency except one time when I had blood clots in my right lung. I mentioned this to doc in hospital and they did a CT scan and I was clear of clots.

I usually sleep on my right with a cube pillow. Not sure how to correct mask leaks. I use nasal pillows and seem tight enough when I go to sleep. I guess I dislodge during the night. In tried chin strap, Biotene and mouth -- tape still dry mouth. If my mouth is taped shut how can it dry out?

This morning severe chest pains and dry mouth. not as dry as usual. No tape mouth

You have very good knowledge and appreciate your help!

[OpalRose]

If you're not experiencing belching or burping, then your "chest pain" may not be Aerophagia. But Aerophagia does cause pain.

Since you had all the correct tests (CT, Xray, EKG, etc.) and received a clean bill of health, that should give you some piece of mind. But if that pain continues, don't hesitate to check back with your doctor.

By using a low pressure of 4, you may be trying too hard to breath, gulping air and maybe over-using your chest muscles.

Two things: Keep working on the leaks. Also, find a pressure range that allows for more comfort.

I think you should narrow your pressure range.
Try a minimum pressure of 6. Set max pressure at 8. Use EPR 2.

Keep trying mouth tape, maybe a different brand. Also, besides what you're already doing for dry mouth, try raising the humidity.

[Dolla Bill]

I set the machine at "Factory Default." Minimum pressure of 6. Set max pressure at 9. Use EPR 2. Mouth tape. Nasal pillows. 

11:00am Monday appointment with sleep doctor. He seems well qualified. Has more degrees in sleep disorders than a thermometer!

[Expat31]

Try the following:-

   - Make sure the tape is wide enough to cover the corners of your mouth, especially if you have any facial lines that can act as "gullies" for the air and to track down and escape. Saliva can also weaken the tape.
   - Double up, or triple the layers the tape used.

The above may seem a bit drastic, but it is true that leaks needed to be stopped, one way or another

[dataq1]

By using a low pressure of 4, you may be trying too hard to breath, maybe over-using your chest muscles.  

I don't wish to sidetrack this thread, but I'd like to understand the comment "trying too hard to breath" at 4cm pressure.

At 4cm there is plenty of volume, so unless  there is an obstruction the lungs have plenty of volume available, so there would be no need to over-use chest muscles.

Can some one explain why it would be too hard to breath (assuming no obstructions) ?