Worried: Lung irritation after PAP

Dear folks who made your valuable suggestions to me: Allow me to share the last night's results and ask for your thoughts?
At a bi-level set at 10/6 the AHI results are noticeably better (than at 10/4 a night before), although still bad (in the 20's vs. 40's). The irritating (lung?) sensation became more of a mild tingling now, so is it a proof of the CO2 theory or the fact that I increased the humidifier from the factory recommended 2 to 4? The night humid, so perhaps it is simply getting a warmer air in?
The excessive CO2 blow-off theory is very intriguing because I have countless centrals which last on average 20 seconds (30 sec max). Could it also be that I am holding my breath not needy air? During those 20-30 seconds of gaps marked as centrals, SleepyHead shows some periodic pulse-rate-like mini bumps every few seconds. They are perfectly shaped and periodic, so I suspect that it is a machine's pulse and not my breathing which flatlines for 20-30 seconds. What do you see on your charts? Does yours completely go flat during the central episodes or you see some small periodic bumps in between? Also, why is PAP therapy not helping? I already found the max range (10) when was on auto, and now I am bi-leveling to it all night, so why am I getting countless centrals? Going to higher pressures (up to 18 in auto mode) did not help a bit. Something is going on and I can figure out on my next step except going down in pressure from 10 on an uneducated guess that perhaps I am over-oxygenating?

If sign up, log in you can put up Sleepyhead graphs ( free software available here) and people will be able to help you much better.

TeddyBear777 wrote:SleepyHead shows some periodic pulse-rate-like mini bumps every few seconds. They are perfectly shaped and periodic, so I suspect that it is a machine's pulse and not my breathing which flatlines for 20-30 seconds. What do you see on your charts? Does yours completely go flat during the central episodes or you see some small periodic bumps in between?

first off, why don't you join the forum, and post some pics instead of trying to describe things and hoping that people interpret your descriptions correctly?

the machine doesn't have a "pulse", but you do, and that sometimes shows up in the flow trace.

TeddyBear777 wrote:Also, why is PAP therapy not helping? I already found the max range (10) when was on auto, and now I am bi-leveling to it all night, so why am I getting countless centrals? Going to higher pressures (up to 18 in auto mode) did not help a bit. Something is going on and I can figure out on my next step except going down in pressure from 10 on an uneducated guess that perhaps I am over-oxygenating?

you started off with wild settings instead of building up to something needed, there's really no such thing as over oxygenating yourself on room air. but you can make yourself hypocapnic, which it certainly seems you've done by overventilating yourself.

palerider wrote:the machine doesn't have a "pulse", but you do, and that sometimes shows up in the flow trace.

because I like to say ballistocardiographic: search.php?st=0&sk=t&sd=d&keywords=%2Bb ... diographic++

palerider wrote:you started off with wild settings instead of building up to something needed, there's really no such thing as over oxygenating yourself on room air. but you can make yourself hypocapnic, which it certainly seems you've done by overventilating yourself.

+1

TeddyBear777 wrote:During those 20-30 seconds of gaps marked as centrals

You are probably holding your breath as a result of the above or mouth breathing: viewtopic.php?f=1&t=112758&p=1085906#p1085906

TeddyBear777 wrote:Also, why is PAP therapy not helping?

Have you given it any kind of chance or used any reasonable methodical approach? http://www.aasmnet.org/Resources/Clinic ... 040210.pdf

I need to see the report.

Jay Aitchsee wrote:

palerider wrote:the machine doesn't have a "pulse", but you do, and that sometimes shows up in the flow trace.

because I like to say ballistocardiographic: search.php?st=0&sk=t&sd=d&keywords=%2Bb ... diographic++

I figured you would

Folks, thank you for your inputs! I don't know how to load my data onto this forum to show you what I have so I used the language to describe it.
I don't think that I am hyperventilating, but perhaps holding my breath for some reason? I noticed that with the air blowing in, I don't want to take breaths as often as I normally would or take shallow breaths so perhaps this is what it is. Anyway, my chart is stranger than any other chart I saw, and I wish I could show it to you. Meanwhile, my BiPap settings are fairly reasonable at 10/6.

TeddyBear777 wrote:Folks, thank you for your inputs! I don't know how to load my data onto this forum to show you what I have so I used the language to describe it.
I don't think that I am hyperventilating, but perhaps holding my breath for some reason? I noticed that with the air blowing in, I don't want to take breaths as often as I normally would or take shallow breaths so perhaps this is what it is. Anyway, my chart is stranger than any other chart I saw, and I wish I could show it to you. Meanwhile, my BiPap settings are fairly reasonable at 10/6.

register for an account.
read this: https://sleep.tnet.com/resources/sleepyhead/shorganize

if you really wish you could show it to us, then do it, and quit 'wishing'.

10/6 may be too much for you, but you can go on with 'I don't think" or you can get with the program.

TeddyBear777

I hope you don't mind me saying so, but it's hard to proceed when you ask for help and then don't quite follow the suggestions - or else don't put them into effect in a systematic manner.

In one day, Wednesday, you got two good suggestions from Pugsy (ie, change humidification, change one of the pressures) - and went off and applied them both at the same time.

And then you ask 'which produced the benefit?'

I, for one, can't tell you. The systematic way to procede is to try one thing at a time. See what it does. Then move on to another thing. (And try that one thing for two or three nights in a row, because any one night on its own can be unreliable, an 'odd-ball'.)

You say now that, "I don't think I am hyperventilating - but perhaps I am holding my breath for some reason." The doctor I interviewed about hyperventilation - and he was the world authority on the subject - said that breath-holding and gasping - sometimes alternating with shallow breathing - and a feeling of 'air hunger' are all part of the pattern. And it may be that you're only noticing some bits of it.

I don't think you can accurately say you are hyperventilating, or not. And I know for sure you can't trust someone like me to say whether you're hyperventilating, or not - because I can't see you. And nor can anyone else here.

And short of you setting up a video camera or a smart phone, and filming yourself thru the night, and posting that somehow, we have no reliable way of knowing what you're doing with your breathing ...

.. other than from data.

That's why people are asking for a Sleepyhead report. It shows breath by breath and pressure by pressure what is happening.

So finding out how to upload some data is what you need to do next. If you don't mind me saying so.

Hi Rick, I followed Pugsy's suggestion and increased a humidifier setting and it helped with the "irritation"... I am changing pressures mindfully, but at this very early discovery stage, I am not fine-tuning the settings yet but trying to find an overall range starting with no idea where it should be. After just 3 nights I already have a clue, which is not bad... You are right, I cannot be certain if I am hyperventilating or not, but the definition of the word includes anxiety, and I don't feel that I am anxious, but in my sleep - how knows. One of my challenges now is not even pap therapy related. It is struggling to sleep as I was a life-time stomach sleeper and now re-learning to sleep on my sides and back... Thanks for the input!

Dear Pugsy,
I also have a question about the system configuration - BiPap/humidifier - hose - mask/me. I just read that the machine needs to be below the mattress, and mine is a bit above it on a night stand.
The hose comes out from the machine and goes up a bit over the bed's headrail and down to my head/mask. Does this create a problem, if so - which one?
As I increased humidification from 2 to 4 per your advice, I feel better in my chest - thank you! But I also have a lot more condensation now in my mask and dripping out of the hose.
I don't have a heated hose yet and will have to buy one ($75 out of the pocket with a bigger power supply). That should help with the condensation I gather. Meanwhile, I wash my mask, and then connect it back to the system and just blow-dry it all. Am I making sense?

Any part of the hose or humidifier that's above your head will cause rainout or condensation in the mask... the water runs there instead of back to the machine, so reconfigure your set-up.

Thanks Julie. I understand but my only other present choice is putting the machine on the floor, and I suspect that it is not good for the machine's motor to be pumping up 2-3 feet? Is moisture in the mask a problem for my breathing or is it just a nuisance that I can dry up when done each morning?

TeddyBear777 wrote:Thanks Julie. I understand but my only other present choice is putting the machine on the floor, and I suspect that it is not good for the machine's motor to be pumping up 2-3 feet?

it's just air. it doesn't care.

Until you get the heated hose setup maybe you could fashion some sort of hose cozy and that might be enough to keep the rain out away.