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[Symptoms] Tingling hand palms and feet soles
#1
Tingling hand palms and feet soles
A while ago I tried an ASV without much succes (too dynamic for me), now on BiPAP (for UARS). Back then using ASV I got a tingling sensation nearly instantly in my hand palms and my foot soles. This was with high PS (> 5). I never thought about it anymore as I was diagnosed around that time with (pre) diabetes type 2 so I assumed the tingling was neuropathy.

Now several months later I know for a fact I have my blood glucose welll under control for months already (I have continous glucose monitoring and calibrate now and then, also the GP). The tingling was also a lot less/gone. In the mean time I was on BiPAP with PS around 4 or so (still not set on a fixed setting).

Recently the tingling became very bad again, also during the day, while my blood glucose levels are actually still going very well. Glucose was tested again by the GP, as was blood flow and vitamin B12/D3. All good. Then I realized I upped the PS of my BiPAP to 5 (over fixed 6.x - 7) as it would give me no discomfort and even better flow rates, and thought about this ASV experience. I tried these pressures in the past on CPAP as weel using EPR 3 but never had the tingling sensation, only with PS around 5.

Does anybody recognize this tingling sensation at high PS? I also notice my hands and feet look different; more red and my hands are way less smooth (almost rinkly if that is a word, with very tight skin). 

It sounds to me as if I am possibly overventilating, thereby reducing CO2 in my blood resulting in vasoconstriction hence the tingling sensations. I wonder if this was self-inflicted with the high PS but could not find anything like this on the forum, so it does not sound typical at all. 

Tonight I will go for P = 7.6 with PS = 3.4 (IPAP 11 seems to be my minimum, PS 3 gives bad flow limitations, I really need a tad more) and see if that changes anything for a few days.
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#2
RE: Tingling hand palms and feet soles
Fair post.  The pressure support on this ventilator has gone up to around 10 during my sleep.  I don't have diabetes though.  No tingling sensations in my fingers, toes, hands, feet, etc. though.  

That said, I am not an expert on diabetes.  Those more qualified than me about diabetes may want to speak to this.

Mainly just wanted to post and say high PS has zero effect on "tingling" in my fingers or toes (a non-diabetic).
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#3
RE: Tingling hand palms and feet soles
One aspect sounds like edema. A web definition: "Edema is the medical term for swelling caused by fluid buildup in the body's tissues and organs."

Tingling and fluid retention doesn't sound ASV related. I had ASV with edema from a heart issue, and in my case they're definitely not related.

Even if this isn't edema, I'd say that another medical issue is causing this.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Tingling hand palms and feet soles
Interesting question. Your hypothesis makes sense to me in that having too high a PS for your body to properly manage CO2 could result in hyperventilation or hypocarbia. I know that if I have PS too high I get headaches, no tingling to speak of or I just have not noticed it.

Now I have to do some reading on it.
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#5
RE: Tingling hand palms and feet soles
It's possible the higher PS is a catalyst for making a medical issue more present and accounted for I suppose.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Tingling hand palms and feet soles
Thanks for the replies so far and indicating a link towards PS is not very likely. I have a GP appointment tomorrow related to my diabetes blood work and I will discuss the symptoms and see what she thinks. We could throw in CO2 blood work to at least verify this is the cause.

Reading on "hypcapnia" (low CO2 in blood) I do recognize a lot....elevated heart rate, caused by bad breathing. I do currently have heart rate issues as well, the tingling, and my breathing is verified bad. I just started "proper breathing" with physiotherapy (she verified my breathing is high and shallow) and just read Buteyko breathing is a way to increase CO2 in your blood. This would be the most logical underlying issue explaining this.

Then the question would become can overventilation cause your breathing to become bad, as in that my lungs get lazy?

PeaceLoveandPizza, enjoy your new reading material ;-).
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#7
RE: Tingling hand palms and feet soles
Hi all,

I thought it would be a good idea to share some OSCAR data to see if anybody notices anything that is a bit off related to my respiratory. 

Notes: 49 yo male, BMI just below 25 (87 kg, 1.87 m), self-diagnosed UARS (always AHI < 1, mostly CA or H).

Some respiratory statistics from the whole 3 years (no large deviations):
- Tidal volume: 0.48 (median)
- Respiratory rate: 15.6 (median) --> is this not a bit high?
- Resulting minute vent: 7.38 L/min (median)

Shown is a pretty typical night (I went to bed 23:00 but I just had a bio-break). Leakage is higher than normal, still working on getting this better.

Full night:
   

Detail of a stable part:
   
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#8
RE: Tingling hand palms and feet soles
That sounds like a neurology issue. Yep, needs an MD visit.
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#9
RE: Tingling hand palms and feet soles
You might want to arrange a neurologist consult through your GP to rule out peripheral neuropathy.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#10
RE: Tingling hand palms and feet soles
I will contact my GP in a few weeks max anyway to exclude this.
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