Can you get lung damage from too much cpap pressure?

G'day,

My S9 is set to pressure 20 and some days I wake up with sore lungs - like someone has put an air compressor hose down my mouth and blasted full pressure. I woke up with sore lungs again today - felt like they had been stretched, it took 8 hours for them to start feeling a bit better. My question is - can you get lung damage from pressure 20? Also, my wife dropped my machine a while ago and it appears to have no visible damage and functions normally. Could it be malfunctioning and giving too much pressure? Is it worth going to the dealer to put it on a pressure test gauge to help? Thanks in advance

Are you sure that it is your "lungs" that are sore and not your chest muscles (perhaps from breathing more deeply and stretching muscles that haven't been stretched for a while)?

My understanding is that the biggest problem of a pressure higher than you need is that it may trigger central sleep apneas that a lower pressure won't. The trick in titration as I understand it is to raise the pressure high enough to keep your throat open but not so high as to trigger the centrals. For some people the "sweet spot" can be small.

My chest pain did feel like my lungs, but it actually was my chest muscles, getting a 'workout'.
I had not breathed that deeply for years.
In a few days, I was breathing better in the daytime, too. A little fitness boost--
(Remember Susan Powter?)
CPAP pressure is unlikely to harm anyone's lung tissue unless they have a rare but serious pre-existing lung disease.
If a doctor prescribed your machine, he has eliminated that possibility.
Edit: in view of your OCD history, and the length of time on the machine, I might also suspect muscle spasms in your chest due to anxiety. Your doc may be able to help you with that.

You are likely working out muscles to breathe out against the pressue. Do you have EPR turned on? That should help.

If you are on CPAP and really need 20 cm of pressure then you need to be evaluated for bipap. But I suspect what's really happening is that some bozo set your pressures wide open (4-20) and leaks are driving the pressures up too high. Your doctor or you should take a look at the data and see what's going on.

--Then again, you may need EPR or a BIPAP.
Like janknitz said.

Thanks heaps for the info and advice! I was wondering - what is an EPR? Hmm so high pressure means I may have need for a biPap after all?

My doc has disabled the automode and just placed the machine on a set pressure all night of 20. So even if my machine is on set pressure, will mask leaks still cause the pressure to rise?? If that is the case maybe that is why my lungs hurt because my mask has been occasionally leaking out the side though I thought it was pretty minor.

Also I don't know if it is my chest muscles that hurt, it is a different kind of pain and it feels like my lungs.

Thank you Chunkyfrog, JanKnitz and Drowsy Dancer for the info

So to see if it made a difference I changed the setting on my s9 autoset using the doctors menu last night. It was set on constant pressure - 20. I changed it to automode with a low pressure of 4 and a high of 16 to give me a break. I woke up and my lungs don't feel stretched like before (but I better go to the doc today for a lung checkup anyway). Unfortunately it changed my AHI from 0.3 per night to 8 which is bad. Obviously my doc has set it on 20 at constant because that is what provides the lowest AHI. I DID notice there was an EPR setting in the menu and it said off. I have found out that EPR means exhale pressure relief (or something like that) - and there is low med or high setting.

I cannot see a sleep doc for at least a week (although I may be able to swing a full pulno lung test again in the pulno lab at the local hospital) should I change my settings from auto to set at 20 again, but this time activate EPR on high mode?? Will this make my lungs feel a little better on pressure 20? & can mask leaking raise your pressure even at set pressure??

Thanks in advance

If it were me, and my doc didn't mind, I would try setting my minimum at 18 and my maximum at 20 and my EPR at 3 and see what that did for my AHI. If I continued to have trouble adjusting to CPAP, I would complain very loudly and with great detail to my doc in order for him to be able to say that I had "failed" CPAP so that I then qualified for a bilevel (also called BiPAP or VPAP) machine.

Anyone having adjustment troubles on CPAP pressure over 15 cm should qualify for bilevel once the doc has enough info to make the case to insurance that the patient cannot tolerate CPAP at the pressure(s) needed.

I cannot see a sleep doc for at least a week (although I may be able to swing a full pulno lung test again in the pulno lab at the local hospital) should I change my settings from auto to set at 20 again, but this time activate EPR on high mode?? Will this make my lungs feel a little better on pressure 20? & can mask leaking raise your pressure even at set pressure??

Yes, set it for straight 20 with the EPR turned up to the maximum setting (I don't have a ResMed, but on mine it's a setting of 0 to 3, so I'd set it at 3).

If that's still too uncomfortable, then I'd try jnk's suggestion of 18 to 20 with EPR at 3, at least until you see the doctor again.

No, Mask leaking will not change the pressure if you're set on CPAP rather than APAP. I was guessing that you might be on an APAP setting.

20 is an awfully high pressure, and it does sound like you're getting some leaks. The therapy doesn't work well, and the data is not as reliable, if your leaks are too high, so you need to watch that. If your machine is on ramp, try using the mask fit feature to make sure you are adjusting your mask at maximum pressure.

Matty332, if you have an AHI of 0.3 with a pressure of 20, I would leave the pressure at that. The EPR could well resolve your other problems without raising your AHI. Changes in pressure, unless prescribed by a sleep doc, should be very small, and kept at the new pressure for at least a week. Anything large is likely to mess up several sleep parameters to an extent that it will be hard to sort out. Your doc prescribed the 20 cm for a reason, and it sounds like it is the comfort settings that need to be adjusted. A lot of people feel like they are suffocating with a pressure of 4 cm (I was one). With a range of 4 to 16 it is possible that the machine can't ramp up quickly enough to be able to treat the events that need the higher pressure - especially if you really need the 20 cm. So, as Janknitz said, put it back to CPAP mode at 20, and adjust the EPR.

Matty332 wrote:I don't know if it is my chest muscles that hurt, it is a different kind of pain and it feels like my lungs.

It is likely a muscle soreness like you feel when beginning a new exercise. Face it - when was the last time you breathed that deeply?

jnk wrote: I would try setting my minimum at 18 and my maximum at 20

After breathing at 18 or 20 using a Bipap will feel like nothing at all

jnk wrote: Anyone having adjustment troubles on CPAP pressure over 15 cm should qualify for bilevel once the doc has enough info to make the case to insurance that the patient cannot tolerate CPAP at the pressure(s) needed.

Gday Matty, I experienced the same chest discomfort as you when I first started cpap. At first I was very concerned because I have asbestosis and any change in chest discomfort is a worry. However as time went on the pain has gone, so I can only conclude in my case that it was muscle pain. The main advantage for me is that my breathing has improved overall and I can now do things that used to leave me gasping. I believe that having sleep apnea treatment has extended my my life expectancy. I must repeat that this is my own experience, it may be completely different for you. My initial pressures were 4-20 cm which I found through experimenting were set too high, I am presently on 11-14 cm and although my AHI have gone up a little I am strangely getting better sleep quality

cpap pressure is in the area of .2 psi. it is actually very low pressure. wanna prove it to yourself? i did. stick a balloon over your cpap air outlet. it has the pressure to bring the balloon up to it's original form, but will not even try to inflate it even with the cpap set at 20. try it. ventilaters put out much more pressure and do not damage lungs. i think they are in the 80 range.

Thanks again everyone!

Last night I put my CPAP settings back on constant pressure 20 but turned on EPR to 3. I woke up this morning and my lungs feel a lot better. I still feel a little tight at times but it is sooo much better than before. Thanks again! Oh yeah, the only downside is that my AHI index is about 3 now instead of 0.something but I can live with that if there is no lung pain. AHI is acceptable right?

Matty332 wrote:AHI index is about 3 now instead of 0.something but I can live with that if there is no lung pain. AHI is acceptable right?

Yes, AHI of 3 is acceptable.
Question...how much of that AHI is central index?