Please help with advice on hyperventilating /short of breath

[sammy1954]

I am using a resmed and have a pressure of 16 ,have gained a bit of weight since that pressure -20 lbs -but i wake up very short of breath ,have mild copd and take meds as well
I tried lowering pressure to 14
then using auto pap 14-18
now trying to 18 tonight.
can u help ,,,i have a decent full face mask ,mouth breather ----

this has been going on for a few years but very bad lately

the last sleep doc said its my weight the pickwickian syndrome

but is this somehting i have to live with ?

i recently had bad leaks but fixed that now ---
any ideas of what to do?

I know lose weight---etc but i need some help now

could anyone suggest something i tru=ied chin strap new mask etc ...

am I doing somehting wrong?

please any ideas are helpful

i have noticed my mouth more dry and my water used quickly

ty in advance 4 your replies
sam

[Jay Aitchsee]

Sammy, it sounds as if some of your problems could be related to mouth breathing. You say you have a decent FFM, but your profile indicates a nasal mask. ?
Without the results from a software program, anybody would be hard pressed to offer more than a WAG as to your problems.
Below are some links to how to obtain the software (SleepyHead) and how to post the results. Why not give it a shot?
BTW, I think Pickwickian Syndrome relates to hypoventilation (shallow, insufficient breathing) rather than hyperventilation (rapid, deep breathing).

https://sleep.tnet.com/resources/sleepyhead
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

[OkyDoky]

The good news is that you have a machine that has full data. Use the links that Jay gave you to learn about how to see that on your computer. Once you learn how to share that with us we may be able to find some clues to symptoms.

[raisedfist]

Is your doctor talking about obesity hypoventilation syndrome (OHS)?

You may need to be on bi-level therapy instead of CPAP. CPAP can work for OHS in many cases but not all. This is something to discuss with your doctor.

Bi-level therapy helps you ventilate and blow off CO2. Due to obesity your chest wall movement can be compromised making it difficult to get air in and/or out, especially during (REM) sleep. So, with OHS and mild COPD, you may experience both a restrictive and obstructive defect in your breathing (a pulmonary function test can tease out the exact issues with airflow).

Bi-level therapy could also be more comfortable because with ResMed you have a lot of control regarding therapy settings. You can adjust the rise time, Ti min and max, and the cycle time.

CO2 levels sometimes become elevated with COPD since obstructive diseases can cause air trapping/inefficient gas exchange.

Your doctor should probably be doing blood tests to determine if your CO2 is elevated. If so, I would imagine you would be switched over to bi-level therapy.

[Pugsy]

Are you using EPR on your machine (exhale pressure relief) and if so...at what setting?
Sometimes adding EPR can make the regular cpap machines work sort of like a little mini bilevel because using EPR creates and bilevel situation.

[sammy1954]

Thank you for replying .I am using a full face mask I changed it.
And I odnt have a sleep doctor but have had the test two years ago for blood gases all indicated a c pap.
Bi pap is covered by hte governemnt here so I dont think they were too keen on changing it.

I am quite certian I could use a bi pap
I turned machine up to 17 and less short hyperventilating but still there.
Drs here dont really pay much attention .

Im serious its not good .
They just give you the machine and off u go
I am using epr at 3

how do I stop mouth breathing would that help I have thought about taping my mouth shut?
my mouth is so dry in the morning.I will try to use the computer to figure some things out.
why did you ask a bout epr?

[Pugsy]

why did you ask a bout epr?

Because using EPR makes the machine work like a bilevel could work and it was worth a shot in terms of maybe helping you breathe easier but since you are already using EPR at 3 we can't make it do more.
A regular bilevel machine will go to 25 and instead of the 3 difference you are getting now with EPR you could get maybe 4 or 5 or 6 difference which might help the ventilation a bit.
I am just guessing though because we really don't know what is going on with you for sure.
It was just an idea to try with your existing equipment.

Drs here dont really pay much attention .

Where is "here"?


You've got a full data machine...have you used the software to see if anything just stands out on the software report?

[raisedfist]

Thank you for replying .I am using a full face mask I changed it.
And I odnt have a sleep doctor but have had the test two years ago for blood gases all indicated a c pap.
Bi pap is covered by hte governemnt here so I dont think they were too keen on changing it.

I am quite certian I could use a bi pap
I turned machine up to 17 and less short hyperventilating but still there.
Drs here dont really pay much attention .

Im serious its not good .
They just give you the machine and off u go
I am using epr at 3

how do I stop mouth breathing would that help I have thought about taping my mouth shut?
my mouth is so dry in the morning.I will try to use the computer to figure some things out.
why did you ask a bout epr?

Can you post some data from SleepyHead? It would be great to see your AHI breakdown and some different graphs, so we can see what's going on. As well as your leaks.

Leaks can cause the water usage from the humidifier to increase. When I use my FFM and have low leaks, water can last 2-3 days for me. If I use nasal pillows and mouth breathe during the night, water runs out in one night for me.

Also, CPAP itself can cause CO2 retention in some cases. http://www.sleepnet.com/apnea104/messages/168.html

CPAP is usually effective in CO2 retention that is caused by sleep apnea. Bi-level is what is effective in CO2 retention that is caused by other issues such as airway disease, obesity, etc. CPAP just keeps the airway open, which is important, but often times only half the picture for certain sleep breathing disorders.

Were you feeling the same of shortness of breath before CPAP?

[palerider]

You can adjust the rise time, Ti min and max, and the cycle time..

and by that, he means "how sensitive the machine is to your starting and stopping your inhalation, and how long it will stay at the higher pressure to help you inhale.

[palerider]

Where is "here"?

"Location: earth" isn't much help... we don't get many extraterrestrial visitors... I doubt if anybody on the ISS needs cpap,no gravity... but ya never know.

[Pugsy]

we don't get many extraterrestrial visitors

Well I don't know about that...seems like those little buggers visit my house quite often and mess with me and my machine.

It might be helpful to know where "here" is in this situation though...like are we talking third world country or something else.

[palerider]

we don't get many extraterrestrial visitors

Well I don't know about that...seems like those little buggers visit my house quite often and mess with me and my machine.

It might be helpful to know where "here" is in this situation though...like are we talking third world country or something else.

I mean "here on the forum!" :taps foot:

you and your aliens are a whole different matter

[sammy1954]

I listed my location Canada which is far behind in healthcare ....I have tried everyhting here

I saw a pulmonary dr last summer said my copd not bad and tummy was causing most breathing problems...

I am to see a hospital dr march 8 going ot ask for bipap --here only govt can giv eyou bi pap

ridiculous
I have raised he pressure to 16-19

and it was better somewhat but he leaks were causing many breathing issues

I cannot stay at 16-19 as it is too hard ot breathe back
So I am going back to 14 -19 see what happens

i prefer a fixed pressure and I relaly want to stay at 14 so I can breathe easier but i doubt that will work.
as for sleepyhead i dont know how to use it i tried ----i have a mac and no way to download\

i just want to breathe easier ---16 used to be good and work bit now i dont know

so i am going to try 14 to 18 or 19 that is a big spread but i just cant take it anymore .

sleep drs here are not helpful ,i have adressed this issue for the length of time i have used c pap --4 years --no response --one dr said maybe lower pressure ?
i honestly give up ....

im going to go low even tho i dislike auto pap --takes too long to address the apnea ---i have a program w the machine i ffollow and just took card in to respirologist all she said was mouth leaks
very frustrating ,i have always thought needed bi pap --we shall see ty for your help any ideas appreciated

[Julie]

Excuse me, but Canada is NOT 'far behind in health care'! You may be in a region where there aren't a lot of major teaching centres, or just unlucky with your doctors, but Canada has always been ahead, if anything, in medicine generally. Things may move more slowly depending on lots of factors but it doesn't mean we don't have a very progressive system. And that comes from someone who worked in teaching hosps all my life.

Love your avatar - reminds me of my (now ex) Samoyeds who 'faked' white wolves in pix all the time in pix . I do wish you'd be a bit more forthcoming about where you live though - this is a big place after all!

[Pugsy]

There is data available on the machine itself. What is it showing?
If you need the much higher pressure and simply can't handle exhaling even with EPR helping out then a bilevel is the next step but I know that Canada makes it hard to get one and have the government pay their portion.
Are you in a position where you could buy one yourself? Would you or could you do that.