Sore back with CPAP?

[Kiralynx]

Kiralyx - have you noticed that with the SCD diet your pain has reduced at all? For me the joint arthritis-like pain is very clearly linked to my carbs and sugar intake (my mom has the same response, and she has had arthiritis her whole life).

Well, keeping in mind that the SCD is the SPECIFIC Carbohydrate Diet, not a limited carb diet (ie, limits the type, not the amount), actually, yes. If I eat more advanced foods which can border on non-SCD, the pain index can go up. It can also go up if I eat too many of even the permitted carbs.

But -- the thing which totally throws me is that, in point of fact, my pain IS related to my apnea. Since CPAP, I've seen a significant reduction in pain (which I was hoping for). I formerly woke at least twice in the night with hip pain, had to take my nutriceuticals, and wait for them to kick in before I could go to sleep. Looking at my first week to ten days of data, I was seeing apneas, periodic breathing, and clusters of hypopneas, all right around the points in the night that I used to wake up.

Pain will, I have determined, be worse if AHI is higher. AHI going higher can often be related to a leak rate outside of mask parameters. I'm seeing reductions in clusters of hypopneas, and the apneas have almost dropped out. In particular, the apneas almost completely dropped out after we lowered my EPAP from 10 to 6. (MaxIPAP 14, MinIpap 10, and originally EPAP was 10, also.)

AHI for me is often 4 or less, but a stressful evening (like being told by my boss that I won't be getting any hours during Christmas 'cause I'm too inflexible and won't make myself available from 8a to midnight 7 days a week) can kick it up to 8... and I did wake up aching the following morning.

So at present, a combination of reduced disaccharides and no polysaccharides, plus lowered AHI yields significant pain relief. Among other things, I've reduced my doses of anti-inflammatories from 6 per day to 2 doses per day.

OTOH, I still haven't figured out why the pain issues kicked up at 7.5 months into the diet and after a weight loss of 60-75 pounds. Since the pain issues and the apnea are clearly linked, I'm guessing that was the point at which my apnea became severe enough to be causing significant desats. However, like many, I now suspect that I have had apneic events dating back to 1982 when I weighed 135 pounds at 5'6", because I was having intermittent hip pain even then, usually related to long days on my feet.

[nate fry]

You can sleep in all positions with cpap. I have 13,000 hours on mine and I sleep on my sides , stomach , never did on my back. You have to practice and you can do it. I throw the hose over my head and when I sleep on my stomach I put my arm under my forehead. You will be suprised what yu can do after a while, good luck.

[echo]

That's good to hear Kiralynx. I often thought there was a carbohydrate-arthritis pain link. Of course one person does not a theory make, but it helps support it.

But -- the thing which totally throws me is that, in point of fact, my pain IS related to my apnea. Since CPAP, I've seen a significant reduction in pain (which I was hoping for). I formerly woke at least twice in the night with hip pain, had to take my nutriceuticals, and wait for them to kick in before I could go to sleep. Looking at my first week to ten days of data, I was seeing apneas, periodic breathing, and clusters of hypopneas, all right around the points in the night that I used to wake up.

I'm not sure if people with Fibromyalgia and OSA also have reduced pain as result of successful therapy, but there is definintely a pain-AHI link. So I think what you're experiencing could be classified as "normal". Also, I suspect that if we're sleep-deprived, the body (or mind) is more sensitive to any stimulus, and any internal inflammation could be interpreted as more painful than if we weren't sleep deprived.

AHI for me is often 4 or less, but a stressful evening (like being told by my boss that I won't be getting any hours during Christmas 'cause I'm too inflexible and won't make myself available from 8a to midnight 7 days a week) can kick it up to 8... and I did wake up aching the following morning.

That sucks, I'm sorry. I know when I'm more stressful I also tend to have more restless sleep, which of course just makes me more sleep deprived and more prone to stress the next day.

So at present, a combination of reduced disaccharides and no polysaccharides, plus lowered AHI yields significant pain relief. Among other things, I've reduced my doses of anti-inflammatories from 6 per day to 2 doses per day.

Excellent

OTOH, I still haven't figured out why the pain issues kicked up at 7.5 months into the diet and after a weight loss of 60-75 pounds. Since the pain issues and the apnea are clearly linked, I'm guessing that was the point at which my apnea became severe enough to be causing significant desats. However, like many, I now suspect that I have had apneic events dating back to 1982 when I weighed 135 pounds at 5'6", because I was having intermittent hip pain even then, usually related to long days on my feet.

Well.. this goes back to my post about the other things that are linked to bowel imbalances - the parasites, candida, etc etc. One theory is that while we're sick, we may be in pain but we are in a sort of homeostatis. Once you start losing weight, getting healthy, all the crap that's dying off in our systems starts releasing toxins, or somehow distrupts that homeostatis, and you suffer more from it. The die off is supposedly a temporary dip, sort of a rebound effect. Maybe there is a more scientific explanation though (BTW I still have to apologize to you about the rant on your previous post - I've been delaying answering you. Now that we're on the topic... I just wanted to say that I didn't disagree with any thing you said, it's just that due to my own experiences with food, etc, I finally came to the conclusion that there must be something deeper that was causing all my food intolerances, sensitivities etc. I could not figure out why I would react to foods that other people could enjoy - so I started digging deeper and deeper and ended up with the various stories of candida, parasites, liver imbalance, etc. So that's the point I wanted to make - I think that if the body is not able to reach a balance after so many years on a specific regime, then there might be other deeper issues that the diet alone is not able to solve. Just my 2 cents. I'm sorry if you were offended. And sorry to everyone else reading this, it's way OT on this thread!).

Now another thought - you might be right about the "coincidence". Just from my own experience, and from what I've read here and there, a person might be able to manage untreated OSA for a long while, until they hit a threshold, which is trigger by - oh I don't know - but for example a very stressful time in their life, or significant life changes, or anything else that tips the balance from 'tired and sick but hanging on' to 'i'm about to die'.... That's just *my* theory, for what it's worth. I'm a bit obsessive about trying to explain every single cause and effect in my own body, because after a long time of being sick or feel poor, it starts to turn into a puzzle, or a Sherlock Holmes' mystery that must be solved. And I suspect I'm not alone, since many threads like this one exist.

/getting off my soapbox now and apologizing for the thread hijacking...

[Kiralynx]

That's good to hear Kiralynx. I often thought there was a carbohydrate-arthritis pain link. Of course one person does not a theory make, but it helps support it.

No, but one person here, one there, and a third over yonder begin to establish a pattern.

Well.. this goes back to my post about the other things that are linked to bowel imbalances - the parasites, candida, etc etc. One theory is that while we're sick, we may be in pain but we are in a sort of homeostatis. Once you start losing weight, getting healthy, all the crap that's dying off in our systems starts releasing toxins, or somehow distrupts that homeostatis, and you suffer more from it. The die off is supposedly a temporary dip, sort of a rebound effect. Maybe there is a more scientific explanation though

Actually, they're all interlinked. For instance, when you start killing off the bad bacteria, there's room for yeasts to grow, and candida is an opportunist from the get-go. Parasites can set you up for imbalanced gut flora and vice versa -- a healthy gut might be able to give the parasites a kick in the yin-yang, but a damaged one is vulnerable.

(BTW I still have to apologize to you about the rant on your previous post - I've been delaying answering you. Now that we're on the topic... I just wanted to say that I didn't disagree with any thing you said, it's just that due to my own experiences with food, etc, I finally came to the conclusion that there must be something deeper that was causing all my food intolerances, sensitivities etc. I could not figure out why I would react to foods that other people could enjoy - so I started digging deeper and deeper and ended up with the various stories of candida, parasites, liver imbalance, etc. So that's the point I wanted to make - I think that if the body is not able to reach a balance after so many years on a specific regime, then there might be other deeper issues that the diet alone is not able to solve. Just my 2 cents. I'm sorry if you were offended. And sorry to everyone else reading this, it's way OT on this thread!).

Hey, I spent 25 years hunting for the magic cure which would deal with my gut issues. I tried d@mned near every diet and treatment under the sun. SCD is the best I've found. It has given me my life back, and as I mentioned in the other thread, my eating is not exactly limited -- I served my friends SCD tacos al carbon for lunch today, and they were STUFFED when they were through! At the same time, diet, like a CPAP mask, is a very individual thing, and what works for one may not work for another. Kim M and I spend lots of time chuckling about the fact that we're both SCD, but what we each eat couldn't be more different.

Now another thought - you might be right about the "coincidence". Just from my own experience, and from what I've read here and there, a person might be able to manage untreated OSA for a long while, until they hit a threshold, which is trigger by - oh I don't know - but for example a very stressful time in their life, or significant life changes, or anything else that tips the balance from 'tired and sick but hanging on' to 'i'm about to die'.... That's just *my* theory, for what it's worth. I'm a bit obsessive about trying to explain every single cause and effect in my own body, because after a long time of being sick or feel poor, it starts to turn into a puzzle, or a Sherlock Holmes' mystery that must be solved. And I suspect I'm not alone, since many threads like this one exist.

Oh, absolutely. As for digging into answers, why the heck do you think I have a 12,000 book library? I'm always researching....

/getting off my soapbox now and apologizing for the thread hijacking...

[offering a snowy paw] Wouldn't want you to slip on the soap....

[Raj]

I don't have time to read every post in this thread right now so I apologize if I'm repeating someone else's information. Back problems while sleeping can have a variety of causes, but there are some fundamentals that can easily be affected by xPAP therapy. In order for the body to fully relax while sleeping, the spine, neck, and head have to be in good alignment. Otherwise spinal muscles (mainly the deep multifidus muscles that attach the vertebra) keep working to avoid damaging the spinal cord. Wearing an apparatus on our heads, especially one that we must keep in a certain position to avoid leaks, can easily affect how we lay our heads on our pillows; and managing our air-tubes can also alter our sleeping positions.

Certainly a mattress that sags or is overly hard can cause back problems to anyone who sleeps in one position all night or for a significant amount of time, but if your bed seemed comfortable before xPAP, I'd experiment with pillows, pillow height, and pillow position as a first step to solving the problem. You can also try routing the hose overhead if you haven't done this with a movable hangar or a hangar with a flexible extension (I use several scrunchies chained together).

Breathing with the lower ribs provides the best blood oxygenation by pulling air into the lower lungs, so switching over to chest breathing isn't an ideal solution. Still, the pressures of xPAP plus a concern with getting enough air can encourage a kind of over-breathing where the ribs are repeatedly expanded more than necessary and that can also cause back problems by irritating the intercostal muscles. Try to train yourself to breathe deeply but softly and not force anything.

For most back problems, exercise (sorry to say) is vital, but that should include exercises that address the multifidus process (such as the bird-dog, which I'm sure you can Google) and the transversus abdominus (which involves pulling in the lower abdominal muscles -- crunches and sit-ups don't activate the right muscles).

I hope some of this helps.

[DreamStalker]

Well I did read every post (not there is anything wrong with not reading them all) and yes, many go through a "PHASE" of back/rib pains shortly after starting their PAP treatment. And for just about everyone, the pain goes away just as mysteriously as it began. My hypothesis is that the body adapts to: a) expanded chest cavity from pressureized respiratory system and b) from having to breathe against an increased pressure. Just like when you start a new exercise work out, your body hurts at first but then begins to adapt to the new physical stresses. Mine was lower ribs in front and spianl area between shoulder blades that went away after about 3 or 4 weeks after it started.

So y'all just need to chill and stick to the therapy ... give it time.

BTW - what is the deal with no canned veggies on the SCD list? ... but is ok with same veggies frozen or fresh?
... and how do you make tacos without tortillas?

[echo]

/getting off my soapbox now and apologizing for the thread hijacking...

[offering a snowy paw] Wouldn't want you to slip on the soap....

Thank you

[silver123]

Just a note that sometimes GERD can cause referred pain to the sides or the back. If by any chance you suspect GERD, be cautious taking OTC antiinflammatories. They can really irritate the stomach and make the situation worse. If in doubt, check with your doc. Try following some of the general GERD guidelines that have been mentioned numerous times and see if they help.

silver

[Kiralynx]

BTW - what is the deal with no canned veggies on the SCD list? ... but is ok with same veggies frozen or fresh? ... and how do you make tacos without tortillas?

Dreamstalker,

There's this jolly loophole in the regulations regarding canned vegetables, and lots of other processed foods which allows something, if it's less than 2% of the total weight by volume, or if it's something which aids in the manufacture, to be called a "processing aid," and not an ingredient. Thus, it doesn't have to be listed on the label. Canned veggies are fine -- if you can them yourself so you are sure there's no added sugar, or high fructose corn syrup or other crap in them.

When giving SCD advice, I usually tell people, "This is what works, and the reason it works, is because I didn't do it this way, and the results were..." In seven years on the diet, I've probably made every mistake it's possible to make. (I'm striving valiantly not to do the same thing with my CPAP therapy! )

As for tacos, I have tortillas. I make them out of pecan souffle bread -- a recipe I invented. You wouldn't think it, but the darn stuff tastes like whole wheat bread. So I make circles out of it, add my stuffings, roll it up, and chow down. I use slightly heavier squares for everything from sandwiches to hot dog buns. There are other nut flour based breads which are delish (like the cheddar-parmesan rolls I served with dinner yesterday), but they're a bit high calorie for someone trying to lose weight. So I save them for special occasions.

No corn tortillas... or at least, I haven't come up with a suitable recipe yet... hmm, wonder if cashew or almond flour would work? I have also used cheese lace and dehydrated it to make crispy taco shells.

[congahands]

Okay, my back problems have been resolved. To restate briefly what I was experiencing. When I slept on my back I woke up with a stabbing pain right over my spine. When I was on either side, I ended up with a stabbing pain on my shoulder blade.

First off, my chiropractor re-located 4 ribs(2 on each side) that were dislocated. Secondly, I started sleeping with two large pillows under my legs when I sleep on my back.

I'm pain free now.

YAY!!!!!

[GaryGarland]

Ive been on cpap for 2 weeks and my back has been killing me in the morning for most of that time. I usually sleep with 2 pillows, last night I only used 1 and it helped some. I figure its because I have been used to turning half way through the night and now I am trying to stay in the same position so my mask doesnt move and leak. I have been told it gets easier to mave around after awhile.

Exactly ditto. Today i called for an orthopedic appointment - my back is killing me. It's been mediocre for years, but with the CPAP i try not to move, or when i do to the side i'm very deliberate (and sideways usually causes leaks) - i've taken painkillers that help but the pain comes back between 1 and 4 a.m. and it is a disaster - i try to get up to stretch my back a bit (hey, an almost un-required trip to the bathroom to kill 2 birds) but now my back is killing me (plus broke a toe, can't walk well, yikes!!!!)
i did start going to the gym (now on hiatus b/c of toe) but i was spending quite a bit of time on my stomach and back to strengthen those core muscles. my pain seems to be mid and lower back versus shoulder blades.
i had back pain during sleep before, but not nearly as intense as now - i think it's because i'm trying not to move, and also, i'm a bit less exhausted so sleeping more shallowly.
looking forward to hearing cures from others - may try the naproxyn and magnesium combo...

[TonyCazaly]

Some initial pain is natural as you adjust to the different breathing and sleeping pattern. If it continues, are you exercising? Also, are you drinking a lot in the evenings? If don't do my daily exercise or I have a heavy night on the booze I wake up with a sore back about 4-5am. I'm not sure how exercise helps but I'm guessing that drinking a lot would mean that the CPAP (mine's an auto) is pumping more and more air into me to try and keep my very relaxed airway open. I also tend to wake up full of air and need to expel.

Keep experimenting with solutions

[CindyJean]

I am at week 2 with my cpap and I just woke up early with terrible upper back muscle cramps. Why?

[CindyJean]

Heating pad + Advil + sitting up a while has helped.

[OptimisticChap]

I pity all of you who have posted in regards to back and rib cage pain!
I have been there and experienced the very same things. I have been getting muscle massage therapy on a monthly basis for several years due to spondylolishesis back problem. I told my therapist about my CPAP back and chest pain experiences. He pointed out that its probably coming from lung diaphragm expanding further than usual. And there are muscles attached from the diaphragm to the spine area which in my case were tightening up severely. My R.R.T. dropped the CPAP pressure slightly and the pains subsided from there on. A month later I had my pressure increased half a CM and instantly my pains came back. It was very depressing! I searched these forums for information in regards to adjusting my own pressure. Since I found the valuable information I have adjusted my pressure in very small increments every 4 days. Now I'm at my prescribed pressure of 8.0 and it was a comfortable journey achieving it.
My heart goes out to all of you who are experiencing the chest and back pain issues!