Repertory problems including Pneumonia. HELP.

[allen4444]

Hi everyone!

I was on Bi-pap from about 1999 to 2010. 9/11cm full face mask.

I won’t go into all the details but I stopped my Treatment for 3 years and developed a lot of problems…Heart and a-fib, among others.

Now I’m back.... this time on Cpap. (9cm nasal mask)

I’ve only been using my C-pap (brand new Respironics PR System One REMstar Pro with C-Flex+ rental unit) for 3 days, (nasal mask 9cm with built in humidifier) but am noticing some congestion in the lungs and cold like symptoms. Dry throat throughout the day, and now a sore throat and sneezing and runny nose in the morning. This was not a problem till I started on the unit.
I’m noticing sleep has improved but my lungs are now giving me some problems with congestion.

I am worried because from 1999 to 2010 I was on a Bi-pap with full face mask and developed a lot of repertory problems including [Pneumonia (several times!!!) One where I had to stay in the hospital for 6 weeks. These repertory problems where very severe. Part of the problem I know is I did not keep my equipment clean enough.

I know I have to keep the equipment clean but this unit is brand new and lung problems have already started. Noticed problems with in the first day or two of treatment.

Is my humidifier to high?
Setting it between (3 and 4)

I know maybe I am overreacting... but this does not seem normal.

I have all filters installed on the unit.

What is going on with my lungs…and please don’t say it’s a coincidence. I need to figure out how to stay on my unit without developing severe repertory problems.

That was one of the main reasons I stopped using Bi-pap for 3 years.

My heart problems A-fib and sleep problems require C-pap but I also can’t have repertory infections. HELP!

Allen from PA

[Sleepster]

I know I have to keep the equipment clean but this unit is brand new and lung problems have already started. Noticed problems with in the first day or two of treatment.

Your lungs are getting a work out at night. Something they're not used to. Give yourself some time to adapt, but if you are still concerned after a few more nights discuss the issue with your doctor.

[RonWessels]

Let me start by saying that 9/11 cmH2O are very unusual settings for a BiPAP machine. Perhaps in 1999 there was no EPR/CFlex option, so the split inhale/exhale pressure could only be achieved using a BiPAP device.

With a possible humidification setting of 3-4, you are obviously not using the heated tube humidification, but rather either the System One humidification (adjusts for existing room temperature/humidity) or classic humidification (straight temperature control of the water tank).

When most people start CPAP treatment (and with a hiatus of 2 years, you could be considered to be starting again), they do get some lung discomfort at first. Opinions differ as to what the cause is, but common reasons cited are the extra exertion that your diaphragm has to provide to exhale against the pressure causes muscle ache, and that the CPAP pressure causes you to inhale more deeply and stretch the lungs somewhat opening up regions that were formerly closed up. Either way, this effect diminishes with time.

Another possibility is that nasal drainage changes somewhat while under CPAP therapy. Most people find that their sinuses tend to open up and remain open while under airway pressure (with appropriate humidification). It may be that, rather than swallowing the sinus drainage, you are inhaling it into your lungs. In this case, a decongestant before bedtime might be appropriate.

You should check the state of the filters on the CPAP unit. For a Respironics CPAP unit, there should be an outer coarse grey filter and behind that a fine white filter. Together, they should filter out any allergens from your airway, but if they are excessively soiled (it being a rental unit), perhaps the opposite is happening.

What sort of water are you using in your CPAP unit? To eliminate any possibility that your tap water is at fault, you should try using distilled water. It should be for sale in the bottled water section of your local grocery store. Make sure you thoroughly clean and dry your equipment if you are using tap water and want to switch.

Other than that, I'm at a loss as to what is causing your distress. If all else fails, you could try modifying your humidification setting. Humidification with a nasal mask is less important than, say, with nasal pillows. Try turning the humidification off and just have passive humidification with the airflow simply passing over the (unheated) water in the humidifier tub.

Good luck!

[trish6hundred]

Hi allen4444,
WELCOME! to the forum.!
I echo what has been said so far.
You might turn your humidity back a notch to see if that helps you.
Best of luck with your CPAP therapy, don't give up.

[DreamDiver]

Welcome allen4444

Consider turning off C-Flex. I found that when I did this on the M-Series Pro, my diaphragm stopped aching. I hope you are seeing a pulmonologist about your pneumonia. There may be other circumstances that fellow cpappers like us are less likely to have experience with or knowledge about.

[martinsr00]

I was on Bi-pap from about 1999 to 2010. 9/11cm full face mask.

... I am worried because from 1999 to 2010 I was on a Bi-pap with full face mask and developed a lot of repertory problems including [Pneumonia (several times!!!) One where I had to stay in the hospital for 6 weeks. These repertory problems where very severe. Part of the problem I know is I did not keep my equipment clean enough.

Is your problem pathogen related or simply a change in the demands placed on your lungs by the cpap machine? Who knows. But colds, pneumonia, etc. likely have a pathogen component.

The best way to guard against picking up pathogens in your hoses, masks, etc., is to clean and disinfect them. Cleaning perfectly inside the bumpy hoses and mask crevices may be hard.

You can, of course, do this chemically with frequent (say daily or every couple of days) washing.

I use a mask/hose ozonator instead. Dump the mask in the ozonator while still attached to the hose every morning, it disinfects the mask, pumps the ozonated air from the contained mask, through the hose, and into the humidifier tank where it bubbles through the water. The mask and hose remain dry.

After I got mine, a minor cough and congestion that had been brewing for awhile went away. Anecdotal evidence? Yes.

Ozonators are pricey. Say about $250. Is the price worth the avoided risk? That's for you to decide.

Every night, when I put the mask on, it smells fresh and sanitized -- when I didn't use this device, after a few days, it didn't.

Every week or two, it's still a good idea to wash hoses and masks to clean out residues that could harbor pathogens.

What you've just read is quite controversial on this forum. There's the "I've never had a problem, soap and water is cheap, and if it's good enough for me, it's obviously good enough for everybody else" camp. There's the "ozone will damage your machine/masks/etc" camp. Also the "Don't waste your money, it's snake oil." camp. My camp follow the dual maxims: "Pay your money and take your choice." and "Manage your own risk."

I suspect that agressive soap and water, and perhaps chemical disinfectant cleaning will do the job as well or maybe better. If you have time and patience, this would seem to be an ideal solution.

Here's my morning routine: On awakening, rip the mask off and dump it in the ozonator box (headgear and all) and close it. Next, replace the water in the humidifier tank. About 1 minute's work. When the ozonator timer goes off around noon, the ozonator makes ozone for 10 minutes where it dissipates over the next several hours. The mask remains in the box until bedtime until taken out and put on.

Very little daily time spent.

[allen4444]

First I wanted to thank everyone for there suggestions and insights. Very helpful!

I’m interested in the Ozonator for sterilization. What brand would you recommend and if anyone has comments negative and or positive about Ozone, it would be appreciated.

Today was much better as far as lung congestion.
So the theory that its lung expansion is at the top of my list of possibilities.

A few of my answers and comments to some of the questions people asked me in there wonderful reply’s:

Turning the humidifier to 3 seemed to help so thanks for that advice!

C-flex is off and was never turned on…but if I ever use it I will be aware of possible problems. I was told by the repertory therapist my sleep doctor does not like C-flex. No explanation why. I might ask my Doc when I see her in a few weeks.

No pneumonia yet so I may have jumped the gun on that but better safe then sorry.

3 years off c-pap definitely makes me a newbie again…although It’s a bit easier for me to adjust since I have done this before several times. I think the lung congestion may have been like you said caused by the expansion and workout from the mashen rather then any kind of infection? Today as I said before was much much better!

9/11 cm on my old Bi-pap was a strange setting but that’s what I was titrated at back in 1999. I think one reason for this is I had asthma and lung damage and could no tolerate pressures above about 9. But I needed 11. Had my lungs been normal I probably would have been put on C-pap 11cm.

Filters are clean and only about 3 days old!

Yes I only use distilled water. Never tap.

And finally in case anyone is wondering…I have dyslexia and am a terrible speller…. so if you find typo’s….. know I’m trying to get it right but I have a problem with spelling, punctuation and grammar…even with spell check.

Again thanks so much! I really like this board. It has a lot of very professional and kind people on it.

Allen from PA