Tietze syndrome flare up from CPAP

I just started CPAP therapy for mild sleep apnea. I got diagnosed with Tietze Syndrome in January (it is like costochondritis but the cartilage is inflamed/swollen under the ribs).
Using the CPAP machine on the lowest setting (5) causes me to have excruciatingly painful flare ups. My ribs are in so much pain that I have only been able to wear the mask for 5 hours so far because I wake up from the pain (so bad I was sobbing).
Even on the lowest pressure it feels very difficult to breathe out and I feel like my lungs stay over-inflated. I also swallow massive amounts of air at 5cm/min and it makes my gut hurt. I used it for an hour when I was awake just to make sure it was the machine and it was ; it caused me intense pain after in my ribs.

Are there any possible home-hack solutions to this or is PAP just not going to work for me?

Welcome! Could you tell us your pressure settings—minimum and maximum? And do you know what the range of actual pressures at night is? It’s counterintuitive, but you may actually be more comfortable with a higher minimum. However, let’s first get that additional information.

A 2 minute search gives me this:
"Although many times it can be extremely painful, to the point of being debilitating, Tietze's syndrome is considered to be a benign condition that generally resolves in 12 weeks."
So, there is hope.
Ask your doctor about something for the pain.

Miss Emerita wrote: ↑

Sat Aug 15, 2020 4:09 pm

Welcome! Could you tell us your pressure settings—minimum and maximum? And do you know what the range of actual pressures at night is? It’s counterintuitive, but you may actually be more comfortable with a higher minimum. However, let’s first get that additional information.

Minimum pressure setting is 5 and the maximum is 10. I haven't been able to use it long enough to know what the recorded pressure range is.

chunkyfrog wrote: ↑

Sat Aug 15, 2020 5:09 pm

A 2 minute search gives me this:
"Although many times it can be extremely painful, to the point of being debilitating, Tietze's syndrome is considered to be a benign condition that generally resolves in 12 weeks."
So, there is hope.
Ask your doctor about something for the pain.

It took about two months to resolve the last time I had a flare in January. I current take keterolac and aceitomenophen for the pain. Cyclobenzebrine works better but they won't give me any.

My doctor told me to discontinue CPAP until my pain went away and I am going to try a nasal mask instead of a full face. Pretty anxious about trying to use it again because the day after I last tried I was in too much pain the whole day to do anything but lay in bed and manage my pain.

I am suspicious your doctor might be full of cr@p.
Sufficient sleep, with adequate oxygen often helps with pain, even fibromyalgia.
Check with another doctor. He might be crippled by his prejudices.
We females are too familiar with medics who only know how to treat males,
As are the elderly well aware of docs who only know how to treat young people.

I can understand why you're reluctant to try CPAP again. It certainly makes sense to let this flare subside before trying again.

I asked about pressure because very low pressure (like 5) can actually make people feel air-starved, which could lead to an unusual amount of exertion on inhale; high pressures could lead to an unusual amount of exertion on exhale.

So when you return to CPAP, I would recommend careful attention to the pressure settings. A minimum = maximum of 7 with flex of 3 would probably be the least effortful settings, though they might not be therapeutic for your apnea. But at least you could see whether your cartilage can tolerate that.

In addition, if you download the Oscar software and import the data from your machine, we'll be able to see what pressures would be more therapeutic for your apnea. If you needed to increase your pressure, you could do that gradually and possibly avoid triggering a flare.

All of this is pretty speculative. You might want to run these ideas by your doctor.