Sleep apnea , allergies and asthma

Hi,
My wife noticed that I take deep breaths during the day as if I'm catching up on low oxygen (like audible breathing) 2 years back. After clearing heart (echo, ekg , heart monitor) and chest X-ray, a pulmonologist diagnosed me with sleep apnea (AHI - 29 with 4 centrals). He also did PFT which he said technician didn't do it properly but diagnosed me with allergic asthma as well. But I don't have any usual allergy symptoms like runny nose, itchy/red eyes , wheezing but we noticed that oxygen levels dropped to ~90 while I had audible breathing once. Not sure if it's oximeter issue. I would like to know if the inflammation of lungs can be due to sleep apnea itself and not really asthma ? I have been using CPAP regularly for a month now with AHI under 3(with 0.9 as best). We see that some days I don't have that shortness of breath/audible breathing but it is present on other days/ for some portion of the day. I am on symbicort 1 puff twice a day. Anybody with similar symptoms or got some improvement with CPAP? I wore bodimetric o2 vibe oxygen monitor throughout the night last week and the lowest o2 was 94 with average 97. Thanks

Hello Kishore and welcome to the forum,

I've never heard that untreated sleep apnea causes lung inflammation all by itself. What I have read is that there is appears to be a relationship between asthma and untreated sleep apnea. In other words, asthmatics are more likely to have sleep apnea too. In my case, I have allergic asthma and I have severe obstructive sleep apnea.

Based upon what I've read in this forum, many will attest that their asthma gets better with the use of their machine. The machine has air filters and that helps. I personally had a flare when I first started treatment, most likely because I was breathing deeper. But I was definitely in the minority. BTW, the problem quickly resolved itself.

Please read the Sticky: Newbies PLEASE READ BEFORE POSTING if you haven't already done so. viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html We'd like to know more about you.

Best wishes,
MrsRinPDX

Hi Kishore,

You ask a number of questions. I can't and won't respond to your particular case. But I can tell you some things in general.

1. Allergies in general aren't the same as asthma. Asthma takes pace in the endothelial cell layer lining the bronchioles. Those are the little tubes leading off'n the bigger tubes in your lungs. The walls of these little tubes have muscles in them.

True asthma involves three things, sometimes happening all at once:

a. the endothelial layer 'leaks' fluid;
b. the endothelial layer swells up;
c. the muscles in in the bronchiole walls tighten.

Now, it can sometimes happen that the one same 'trigger' can provoke red eyes, runny nose, and asthma. But that doesn't mean these things always go together, and go together for all people.

To repeat, you can have asthma 'on its own'.

2. I haven't read any accounts of sleep apnea treatment directly causing asthma. And if anything, warmed and filtered air is beneficial to the bronchioles.

3. A condition which is often mistaken for true asthma is chronic hyper-ventilation. That is, breathing too much and too often, and thus blowing off carbon dioxide, and changing the acid-alkaline balance of the blood.

The specialist in chest medicine that I interviewed when I worked as a medical journalist said that hyper-ventilarion is very common - with an incidence, he said, of 1 in 10.

And the HV syndrome has a long list of effects. Not that people have all of the effects at the same time - but audible breathing, frequent sighing, and the feeling of 'air hunger' – "It's as if I'm not getting enough air" – are just three of them.

I'm surprised your pulmonologist did not (it would seem) mention hyper-ventilation to you, and did not (it would seem) observe if your current breathing pattern is HV-like. But the guy I interviewed said he despaired at so many of his colleagues over-looking the obvious.

Treatment for hyper-ventilation is doing certain breathing exercises - as a way to developing better on-going breathing habits. It is often useful when starting to develop such habits to be supervised by a breathing physiologist.

PS. If your O2 sats didn't go below 94, you're fine on that score.

I was diagnosed with asthma almost 30 years ago and had my first sleep study done around 20 years ago. My asthma appears to flair up less often since I started treating my sleep apnea. When I do have flair ups, they have been milder than what I had prior to using my machine while sleeping. Since starting to use the machine, I have not had to go on steroids because of my asthma flairing up.