Severe Asthma Exhaserbation, CPAP & Awakenings

I have been CPAP for 6 months now. Was 100% compliant 2 days into my treatment. My AHI was 1-2 for the first few months and is now always .2-.9. I sleep with it approx 8 hours a night from the hours of approx 12;30-8;30am each night. However, from the entirety of the time I have been on CPAP I will wake up at a mimum 3 times per night, wide awake and most of the time needing to go to the toilet. I really want to know what the cause of this is as I just want to sleep from start to finish for once. Please be aware of a neighboring issue, I have asthma. And before starting CPAP i was not on any preventative medication and rarely used my asthma puffer as I rarely had any symptoms. However, immediately upon starting CPAP my asthma became worse and is getting increasingly worse. To the point where I am having to take oral steroids, 2 different inhaled steroids and beta agonists. I have tried every humidifer setting. even removed it. I have cleaned the machine many many times.

I have attached the sleepyhead images of the times I have awakened, including attached some general info on my sleep architecture, extremely all over place and very concering as I cannot get a consistent nights rest. My main concern is centered around the asthma side of things. I have not heard much in the line of cpap exhasterbating asthma this much. However one night I did not used the cpap machine but instead tried using the AVEO tongue retainer, this was horrible and wokeup feeling like i got hit by a truck. However, the next day I felt as if my asthma had settled ever so slightly...So I'm just extremely confused by the whole situation. Furthermore, interestingly enough I am 22 yr old male. Very into fitness and am otherwise healthy. I have allergies to dust mold and pollen. Have had my tonsils and previous nasal polyps removed. I used a FF mask on the RESMED s9. f20 mask. If anyone could provide any insight to this dilemma it would be MUCH appreciated as I do not know which option to take. The only thing I could think of is if Mould spores have somehow grown on the tubing
I have ordered another hose.
Resorting to saving up for the tongue channelling surgery becuase It is the only thing i can think of at this stage, and have had an ENT tell me my tongue covers much of my airway.

If anyone has any knowledge or ideas i can try please let me know. My pressure is on 6, and my epr is on 1. I have previously played around with this. used to have it on 2,, changed it to 1 and thought i noticed some asthma relief. So changed it to off. then I thought symptoms slowly returned so changed it back to 1 but am still the same so this may not reflect any change in symptoms. my AHI in the study was 26, 70 something during REM sleep...
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^^^^ architecture
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^^^ sleepyhead awakenings

I'm sorry I don't have much to offer. My Asthma is much better with CPAP. I have cough variant asthma, and when I have an exacerbation about the only time I'm comfortable and not coughing is when I'm using my CPAP--I'd use it all day if it was practical.

When you're a hammer, everything looks like a nail. That's why I'm wary of ENT's that want to do a surgery to "cure" your sleep apnea. Never heard of "tongue channeling", but I would be extremely diligent about researching the lifelong side effects such a surgery is likely to have and what--in objective terms--your ENT considers a favorable outcome of such surgery (it may not be what YOU think a favorable outcome might be).

Seems to me the person who should be addressing the asthma side is a pulmonologist, not the ENT. But pulmonologists are more likely to throw more asthma meds at your symptoms instead of looking for underlying causes. Since you're into fitness and diet, have you tried any tweaks to your diet that might tamp down the autoimmune response you are having to something (maybe the materials inline in the CPAP) and reduce inflammation? You might look into an autoimmune protocol (an elimination diet) or consider adding some anti-inflammatory foods or supplements (I'm thinking Omega 3's from pastured animals or dairy, wild caught fish, or fish oil supplements) and reducing inflammatory agents in your diet (e.g. processed oils, sugar, grains). It may be that something with CPAP just pushed you over the edge with respect to inflammation, and tweaks to your diet might calm things down again. The nice thing with this approach is that if it works you'll know it, and if it doesn't work you're not out a bunch of money or a piece of your anatomy. Sometimes people get great results from a dietary approach (and sometimes not). I will tell you it's made a world of difference for me! I went from having 6 to10 severe asthma exacerbations a year to one mild exacerbation every few years.

I rarely have obstructions using cpap. Even down at pressure 5 ill rarely get one the whole night. Ive been seeing a pulmonologist for over 3 months now with little progress with medications underlying causes etc. I have also been using many supplements omega 3's, anti oxidants etc. Im going to also try reduced breathing buteyko method. I originally saw an ent to check my polyp regrowth which was minimal. Upon the camera going down my throat he showed me how much tongue was blocking my airways as i relaxed so therefore he suggested i may be a good candidate and told me to look into it. As he did not do the procedures himself i didnt see this as a coniving act to benefit himself but as a someshat useful option if there are no others. I will also try the elimination diet as this seems to have good results. I also have a nasal pillow i am going to try out. It seems as soon as i put on the ffm by airways start to constrict its very odd. I have an ige level of 480 which is also very high, excuse my unstructured sentemce patterns also i am currently at work and find this part of my life crucial to getting to the bottom of such an issue.

Like JanKnitz, I have found my asthma bothers me less since starting treatment for my apnea. I have both exercise induced asthma and allergy induced asthma. I need my rescue inhaler only once or twice a month, and only need the nebulizer when I have bronchitis attacks. I have taken montelukast sodium and allergy medication daily for several years.

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Jwicks1995 wrote:I rarely have obstructions using cpap. Even down at pressure 5 ill rarely get one the whole night. Ive been seeing a pulmonologist for over 3 months now with little progress with medications underlying causes etc. I have also been using many supplements omega 3's, anti oxidants etc. Im going to also try reduced breathing buteyko method. I originally saw an ent to check my polyp regrowth which was minimal. Upon the camera going down my throat he showed me how much tongue was blocking my airways as i relaxed so therefore he suggested i may be a good candidate and told me to look into it. As he did not do the procedures himself i didnt see this as a coniving act to benefit himself but as a someshat useful option if there are no others. I will also try the elimination diet as this seems to have good results. I also have a nasal pillow i am going to try out. It seems as soon as i put on the ffm by airways start to constrict its very odd. I have an ige level of 480 which is also very high, excuse my unstructured sentemce patterns also i am currently at work and find this part of my life crucial to getting to the bottom of such an issue.

Hi Jwicks1995,

I would definitely try Janknitz's diet suggestion first to see if that improves things. As she rightfully said, you have nothing to lose.

Your statement about the FFM constricting your airway makes sense to me. On a related note, I came down with the dreaded cold and contrary to popular advice to use a FFM in this situation, I found it made things worse. So you might have success wearing your nasal pillow mask although of course, I can't say for sure.

Best of luck.

When I use a FF mask it pushes my already receded jaw back. So I use it for colds but otherwise stick to nasal masks.

Where is your air intake located? You may be drawing in air that has an allergen, such as dust mites, that is worsening your asthma.

in general, a bpap works better with asthma events and a damaged lung. as to a machine causing an event? I don't know.