Persistent sleeping position pain

[FlyingMoose]

EDIT: I have changed the topic title based on the direction of this thread.

Chest pain when using CPAP seems to be a fairly common problem. But whenever anyone asks about it on the forum, the reply is always to go to the emergency room right away.

I have been through all that, multiple times, including more EKGs and blood enzyme tests than I can count, 3 echocardiograms, even a catheterization with contrast, which showed 0% blockages, and am under the care of a cardiologist, who agrees that it is being caused by CPAP, and that is it better to continue to use CPAP despite the pain because it is still better than OSA. I have spent tens of thousands of dollars on tests for something that I pretty much knew from the start is caused by CPAP, and I am glad that I now know for sure. But what am I supposed to do now about a problem that, despite all the tests, still receives the same answer on the forum of "go to the emergency room"?

It is frustrating that everyone on the forum refuses to address this problem, because CPAP-caused chest muscle pain is not something that a cardiologist can address, and we all know that sleep doctors are pretty much worthless. If people here refuse to help anyone with chest pain, it won't go away. It's sort of a catch-22, you can't get rid of it because no one will help, and no one will help because you can't get rid of it.

What is someone supposed to do about a common problem that is so taboo here?

[LSAT]

Often during the first weeks of CPAP use a person will have pain in the lungs and chest muscles from the air pressure. If you have been having problems longer than that I doubt if the CPAP is to blame.

[FlyingMoose]

If I stop using CPAP (as I did for a week when I had nasal surgery) it completely goes away. Also, it doesn't occur when I sleep on my side instead of my stomach, but then I get aerophagia.

[Cardsfan]

You could start by retitle your thread to remove the words "Chest Pain". We all have it drilled into our head that means go to the ER.
Something like "muscle soreness" perhaps

[Pugsy]

The prudent suggestion for someone who is complaining of chest pain or extreme difficulty is....see a doctor because none of us have working crystal balls.
For myself it comes down to how a person is describing their symptoms. Are they using the words "pain" "extreme" "can't breathe" or are they saying words that might not be so alarming like "there's a little tenderness when I inhale and exhale in my chest".

Yes, cpap use at first can cause some chest muscle soreness due to the new exercise exhaling against pressure that will go away with a little time just like when we go to the gym and do some new exercises that work muscles in a way they haven't been worked before will go away.

BUT since our crystal balls can't see to the person who is doing the complaining it wouldn't be impossible for the pain to be related to the heart and it's always better to be safe than sorry.

In the recent thread that I think you are referring to the word "extreme" stood out to me and while my idea of "extreme" very well could be different from someone else's idea of "extreme"...that word sends up red flags to me. Also in that thread the chest wall muscle soreness thing was mentioned as a possible cause of the problem and I thought it was very likely what was going on given that user's prior comments about difficulty exhaling BUT we don't know all the facts so we have to go with the prudent choice.

Some things/complaints we just shouldn't be messing around and pooh poohing off since we can't possible know for sure what is going on.

[Krelvin]

The prudent suggestion for someone who is complaining of chest pain or extreme difficulty is....see a doctor because none of us have working crystal balls.

+1

[chunkyfrog]

If the pain does not change with exertion (like climbing steps), it is more likely not heart related.
Location is also a key, but not definitive. My chest pain after starting cpap was spread around, not centralized.
It also went away after a few days, but my adaptation to cpap was quick.
If you have anxiety, discomfort may last longer.
Other disorders may be responsible, but even some doctors lack the training to think outside the "cardiac box".

[FlyingMoose]

One thing of note: If I "breathe into my belly" (using my diaphragm) like they tell people doing exercise to do, the pain immediately goes away. After a while, I forget and start breathing normally with my chest again, it comes back. But the pain does change with exertion; it completely goes away, probably because I am breathing more deeply. This is one of the main reasons I think it's caused by CPAP. Like a sore muscle that hurts when you use it.

The thing about going to the ER is the amazing level of incompetence I've experienced at all levels, from the intake staff (making me wait hours even though I was complaining of 7/10 chest pain, and saying it's probably just heartburn), to the workers drawing blood (supposed to do a test every 4 hours but the first one was after 12 hours), the nurses (failing to put a heart monitor on for 2 hours and being surprised I didn't already have it on), the doctors (giving me a medication that made me much sicker despite it having a very high interaction risk based on my genetic profile, and most of them had never even heard of genetic drug reaction testing), the computers (not even having a place on the chart for a drug reaction profile). I've had 2 different doctors come into my room a few minutes apart and tell me opposite things. A relative was killed by a medication that was specifically listed as an allergy on her chart, and me and my relatives have very bad adverse reactions to medications based on our genetics. Even if they say they know what it means, they don't check the meds or take it seriously. They prescribe very dangerous medications like candy. I was in the hospital again for an adverse reaction to the smallest dose of a beta blocker, and it took me 10 months to recover, and I'm still having physical and psychological problems from it (high blood pressure, panic attacks, hyperventilation, which I never had before). I think one is just as likely to be harmed as helped by the medical profession in general.

So don't act like the ER is some magical place that fixes all problems, for me it hurt my health much more than it helped, and I think wouldn't have helped that much if I had a severe heart attack that couldn't wait a few hours. And this is at a huge, brand new regional medical center, not some po-dunk little local hospital.

[chunkyfrog]

. . . genetic drug reaction t. . . A relative was killed by a medication that was specifically listed as an allergy on her chart, and me and my relatives have very bad adverse reactions to medications based on our genetics. . . I was in the hospital again for an adverse reaction to the smallest dose of a beta blocker, and it took me 10 months to recover, and I'm still having physical and psychological problems from it (high blood pressure, panic attacks, hyperventilation, which I never had before).

When I read this, a light bulb literally flickered over my head. But I'm a frog, not a doctor.
You should still keep bugging your doctors, every now and then. Maybe one will finally get a clue.
Bug! OMG, I'm late for lunch! Gotta run.

[HoseCrusher]

Perhaps while people are waiting to get their equipment and start their xPAP therapy, they should do some exercises to prepare.

They could blow up a dozen balloons a day. After a week you could have a festive party and start therapy with improved chest muscles...

[Krelvin]

They could blow up a dozen balloons a day. After a week you could have a festive party and start therapy with improved chest muscles...

Most likely would have little affect since the breathing you do with the CPAP is typically while sleeping and you are not blowing up balloons doing that. The CPAP assists you in breathing, it doesn't really add to filling up your lungs as it itself cannot even blow up a balloon. Different breathing, different muscles, just plain different. It could also be caused by not moving as often as before, so it might not have anything to do with breathing at all.

[SewTired]

Is your sleep doctor a pulmonologist? I know mine is. Sleep doctors aren't completely useless you know. Call your office and ask them how to tell the difference between ordinary chest muscle pain from beginning cpap usage and more serious issues that should involve you coming in or being referred.

You feel kind of dumb but I've run into the same problem with acid reflux, how to tell whether you're actually having a heart attack or acid reflux attack.

[PoolQ]

I hear you. That being said, we do not diagnose here. Sleep apnea can, and does lead to strokes and heart attacks. I personally had a heat attack first and then was diagnosed with SA 7 months later, I sure wish I had caught the SA sooner.
When I read the posts you are referring to I read them as "see your Doctor about it, this is important stuff" and I don't read it as "Dang jump in the car right now and go to the ER".

IF SA shares symptoms with heart attacks, it seems reasonable at least to me for a Doctor to decide which it is. I certainly don't want to be telling someone which it is on a public forum. I don't want to say if they should go to the ER or call an ambulance or just make an appointment in two weeks. I also don't want to tell them to not pay attention to chest pain.

[FlyingMoose]

Is your sleep doctor a pulmonologist? I know mine is. Sleep doctors aren't completely useless you know. Call your office and ask them how to tell the difference between ordinary chest muscle pain from beginning cpap usage and more serious issues that should involve you coming in or being referred.

You feel kind of dumb but I've run into the same problem with acid reflux, how to tell whether you're actually having a heart attack or acid reflux attack.

She is a pulmonologist. I have talked to her about the chest pain, and all that I can get her to say is that she doesn't know what's causing it (she didn't even ask for any additional information or tests or anything), and says that CPAP never causes chest pain or back pain (which I had a bit of, but has gone away). Her response was to prescribed a pressure which was too low for me to breathe with (I ended up going to an ENT doctor and needing a septoplasty and can now breathe much better). I also asked her about the hyperventilation which was clearly being caused by beta-blocker rebound, and she insisted that that was impossible, and that it was caused by asthma (some test, which I think was performed incorrectly, said I have mild asthma). She said that the machine should automatically adjust for my constricted nasal passages, but according to the clinical manual it adjusts to changes in breaths, not to a consistent constriction. She also insisted on using Apria as a DME even though there are better ones available that my insurance takes, I get the feeling there is some kind of behind-the-scenes deal going on. She was providing me no more benefit or help, so I stopped going to her.

Talking to these doctors is like talking to a brick wall, they never believe me, even about stuff that is causing harm. I suppose I could keep trying different doctors but it gets very expensive when a first appointment is $300-400 to see the doctor for 10-15 minutes. I am totally fed up with the medical industry at this point. For the prices they charge, they should provide much, much better service. I am always very nice, probably a bit of a pushover, but one of these days I'm going to blow up at a doctor and yell until they throw me out of the office.

This forum is much more helpful than any doctor I've been to, and I'm frustrated that one of the problems I'm having is taboo.

[FlyingMoose]

... it seems reasonable at least to me for a Doctor to decide which it is.

Even if a doctor has already decided that, the people on the forum still insist on refusing to answer questions about chest pain. It's as if the members collectively believe it's impossible for CPAP to cause chest pain even though that's clearly not true. At what point can we actually discuss pain which IS caused by CPAP?