Shallow breathing under the CPAP pressure

[Lee2263]

I woke this morning to the machine making more noise than it should. I was, I knew, breathing very, very shallow, kinda like off in a corner of the mask is the best description I can give. Anyway, some of the problem for the machine noise was a bit of an air leak, which was probably due to the fact I had upped the humidifier to nearly 3. A bit of moisture slippage is my guess.

Anyway, what exactly is the point of a CPAP pushing air in, into where? just the throat, oral cavity or the lungs? I'm confused. Not hard to imagine since I've probably killed off a few million brain cells this last 14 months. Take into consideration also I get clusters of OAs on my report, not regularly throughout the hour. Also I've woken up at a lower pressure, (5 cm) hyperventilating or panting, and looking at the new pressure of 8 cm, the clusters and numbers are the same or in some nights, worse. Very few Hyponea go with these clusters of OA I might add, and who knows if you are snoring or just moaning and groaning in your sleep anyway.

Lee

Lee

[GumbyCT]

Clearing my events makes my machine moan, ha! Tough job but someone has to do it.

[Snoredog]

you need to increase your bottom pressure from 5 cm to at least 6.0 or 6.5. That minimum pressure needs to be where you don't starve for air and is high enough to flush out exhaled CO2.

how does CPAP pressure work?

Think of your airway like a fire hose on the asphalt, when no pressure is in the hose the hose lays flat or collapses, when the fireman turns on the pump to pressurize the fire hose you see the hose become nice and round as pressure builds up.

CPAP does the same thing only with air, it pressurizes your airway and esophagus just like that fire hose. If you are using a nasal mask, you should feel that happening by opening your mouth, the pressure built up will release and you should feel your airway collapse all the way down to the LES at the stomach.

You need to watch this video:
http://www.resmed.com/en-us/patients/ab ... 40x380.swf

[Lee2263]

Thanks Snoredog for the movie. I watched that over the weekend. Makes sense to me. However, from what my Dr has dx'd, I am blowing off too much CO2, and this is why I have tetany, from the hyperventilating. Too fast breathing, and too shallow. I am beyond the paperbag too. This is a very complex issue and you have to look at it from several directions. Taking into consideration also, I had a 2 minute bout of involuntary hyperventalation while laying in bed where my diaphragm went into spasm 5 days after the accident. And in the last 8 months my ribs on the left side feel stiff, like wood. Plus it still hurts to lay on that side at times. And heaven forbid I lay my left forarm across them.

After the accident if I took a deep breath using the chest muscles, I would have extreme muscle spasms into the upper chest, between the shoulder blades and deep within the neck. My pain episodes would start in the muscles of the soft palate, the muscles behind the eyes, facial muscles and would quickly emcompass the muscles of the tongue, throat, trachea and upper chest. By this time I am in excruciating, crushing pain, where my shoulders ache, arms and hands near useless and barely able to get a pill bottle open. This extended into the back and the legs, heavy and painful. This would take me to bed to writhe in pain for a while until I passed out. Course at this point I was probably hypoventilating, and the BP was dipping for sure.

Standing up straight and taking a deep breath fully brought spasms of pain. Which of course would make me breath harder and expell more CO2 than I should. Nice. Doc says it is like I am at high altitude 24/7. Only the pills keep me at near sea level you might say.

I have a very sensitive Sympathetic Nervous System which reacts to even minor elevations of adrenaline which is what keeps my system on high drive. I do not suffer the need for sleep unless I am in the grip of a pain episode. (Doc is thinking Narcolepsy) Not sure why, maybe system is trying to reboot itself. But when all I had was a painkiller to deal with it, I woke with severe tetany, slowed thinking and response time and all my joints hurt. This is a neuromuscular disorder first order, Sympathetic System involved, producing the OSA, but I am also wondering if there might be some Central Apnea involved as well. I am reading an excellent on this. Because there are moments that the breathing becomes an 'Oh yeah, take a breath, your heart is starting to pound'.

The other question I had I guess, from your reports, do your OA episodes come regularly throughout the night?

Lee

[Needsdecaf]

There is definitely no discernable pattern to the events shown on my readout.

Good luck, sounds like you need it!

[Lee22633]

There is definitely no discernable pattern to the events shown on my readout.

Good luck, sounds like you need it!

I need to take a closer look at my reports and see where I have the worst episodes. Thank you

Lee

[ozij]

Thanks Snoredog for the movie. I watched that over the weekend. Makes sense to me. However, from what my Dr has dx'd, I am blowing off too much CO2, and this is why I have tetany, from the hyperventilating. Too fast breathing, and too shallow. I am beyond the paperbag too. This is a very complex issue and you have to look at it from several directions.

Lee,
There is no doubt at all that you have a very complicated problem, and you apprently suspect your neuromuscular problem causes obstructive apneas, as is fybrotic tissue in your chest pressing on your airway (!)and then, when the pressure is high enough to keep you from obstructions, you think you're getting central apneas - very complex.

When properly treated, those of us with garden variety osbtructive sleep apneas have an event or 2 per hour - rarely clusters.

Those of us with garden variety positional sleep apnea may have more events when on their back - and thus need different pressure for different positions. But at the right pressure, nobody should have "clusters".

However, you do not have garden variety obstructive sleep apnea - something your doc. is, thankfully, already aware of. Some people who blow off too much CO2 need special masks, and they certainly need special machines - Lubman for instance needs to a special machine (a Resmed Adapt SV), a special non-vented mask, and oxygen.

You are doing well to read about complex sleep apnea - and it does seem like you have a very special, exceptional condition and need the help of the best specialst you can find.

Within the last 14 months I was rear-ended and my left hand stayed on the steering wheel and I straight-armed the impact into the wheel. I think it damaged muscles and nerves in the left shoulder and upper back, under, below and beside the scapula. I beleive the intercostal nerves come off the T1 down to T7 I think, and this is where I am also very numb still.
<snip>
About 20 months ago, I started having epeisodes of muscle cramping in the ribcage, so bad I could hardly breath and it seemed each time I exhaled the muscles tightened up even more.

I see the doctor today. He is the pain guy. Although he runs the sleep lab and should know what I'm talking about

Hi Nodsy! I am a new forum member and am currently being treated by a pain mgt doctor for sleep apnea, which was I beleive, brought on by a car accident I had in Feb 07. Damage to my neck and breathing

I'm not at all sure that a pain managment specialist, who also runs a sleep lab is the best specialist for your complex condition and keeping you on Remstar Pro for two months is weird. The doc's decision to up your pressure from 5 to 8 based only on your report of hypervnetilation, before he even saw the results is weirder still.

Your use of medical and anatomical terms is quite impressive. As for Mayo not wanting to look at you, that is weirdest of all.

All in all, yours is a very very singular case....


O.

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