Coughing Fit with CPAP?

I am curious if anyone knows whether having a coughing fit while wearing the CPAP would impact you AHI numbers?

Coloneldad wrote:I am curious if anyone knows whether having a coughing fit while wearing the CPAP would impact you AHI numbers?

Not necessarily. But, it might depend on the circumstances and length of coughing duration.

But, if you're having lots of "dry coughing", one of the most common medications that could cause it is Lisionpril. It's often prescribed for high blood pressure and to protect the kidneys for folks with Diabetes.
If you're taking it, you might ask your doctor to put you on an ARB medication (Lisionpril is an ACE medication) to see if the problem goes away.
When I started therapy, it caused me nights of coughing fits which went away when I stopped taking it. My doctor then put me on an ARB class medication.


Den

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If you are experiencing a coughing fit. I would remove the mask, turn off the machine, and sit up for a few minutes. Then put it on again and go to sleep.

I used my machine when I had my last bout of bronchitis. When I have it, I do a lot of coughing, especially when I lay down. I didn't see any major differences in .my AHI when I was coughing and when I wasn't.

D.H. wrote:If you are epereicing a coughing fit. I would remove the mask, turn off the machine, and sit up for a few minutes. Then put it on again and go to sleep.

That is what I used to. And I would then fall asleep without cpap. When I have a cough that is bad enough to have coughing fits, they will just keep coming, so I could barely go 5 minutes without a coughing fit. These could be due to a cold, or allergies, etc. Once I get coughing, it can take weeks to clear, and I will have frequent coughing fits, especially when trying to sleep.

I figured out that I needed to raise my minimum pressure so that I could have my coughing fit with the mask ON, and get past it. The higher pressure kept me from feeling starved for air (kinda like new people trying to start out at 4; I would gasp for air during a coughing fit). My normal settings are 11-17. During a cough, I change it to 13-17, and that works great. My ahi still doesn't go above 2, so the cough doesn't make me worse (at least not with cpap on auto doing its job). I wouldn't be surprised if sleep apnea gets worse if untreated with a bad cough.

I have not looked at data to see what a coughing fit looks like on the graphs. It has been awhile, so I have switch computers. I might be able to look at the data on the old computer and find a night where I changed the starting pressure.

I suppose it might be possible for the machine to misinterpret the breathing that is going on in and around a coughing spell.
I think it would be more likely to be irregular breathing getting a flag than the cough itself though.
Remember the AHI is composed of "events" that need to last at least 10 seconds in duration to earn a flag.
And while we may feel like we cough for 10 seconds sometimes....it's more likely a series of coughs during that 10 seconds intertwined with some breathing which is probably really irregular.
The cough itself is unlikely to earn an apnea flag of some sort because it is so brief. Now the irregular breathing that might be associated with the cough could be a different story.
That irregular breathing could have some SWJ flagged events and affect the overall AHI that way if there is a lot of them.
It would be fairly easy to spot on the detailed graphs though...a cluster of something right at a known awake time which means SWJ (Sleep/Wake/Junk)....and if there are very many of them just manually remove them from the overall AHI an recalculate the AHI manually.

Now if there are multiple sessions involved and the SWJ stuff is isolated to a particular session then a person can turn off that session in SleepyHead and thus remove those SWJ events from the AHI.

The cough itself though...I don't think it lasts long enough to earn any sort of flag. The breathing going on during a coughing fit....now that might earn some sort of flag but it's SWJ flags and thus not part of the therapy itself.

Any reason why the max is 17 rather than 20? Did that come from the doctor?

Pugsy wrote:The cough itself though...I don't think it lasts long enough to earn any sort of flag. The breathing going on during a coughing fit....now that might earn some sort of flag but it's SWJ flags and thus not part of the therapy itself.

you're right, it's just going to be a big spike on the flow chart, the only way it'd get a flag would be if there was a long holding of breath before, or after the cough.

Pugsy wrote:I suppose it might be possible for the machine to misinterpret the breathing that is going on in and around a coughing spell.
I think it would be more likely to be irregular breathing getting a flag than the cough itself though.
Remember the AHI is composed of "events" that need to last at least 10 seconds in duration to earn a flag.
And while we may feel like we cough for 10 seconds sometimes....it's more likely a series of coughs during that 10 seconds intertwined with some breathing which is probably really irregular.
The cough itself is unlikely to earn an apnea flag of some sort because it is so brief. Now the irregular breathing that might be associated with the cough could be a different story.
That irregular breathing could have some SWJ flagged events and affect the overall AHI that way if there is a lot of them.
It would be fairly easy to spot on the detailed graphs though...a cluster of something right at a known awake time which means SWJ (Sleep/Wake/Junk)....and if there are very many of them just manually remove them from the overall AHI an recalculate the AHI manually.

Now if there are multiple sessions involved and the SWJ stuff is isolated to a particular session then a person can turn off that session in SleepyHead and thus remove those SWJ events from the AHI.

The cough itself though...I don't think it lasts long enough to earn any sort of flag. The breathing going on during a coughing fit....now that might earn some sort of flag but it's SWJ flags and thus not part of the therapy itself.

Thanks, I suspect this is a little of what may be happening with me. I have sinus issues which results in sinus drainage down the throat and into my lungs at times. Thus resulting in some coughing fits when it gets bad.

D.H. wrote:Any reason why the max is 17 rather than 20? Did that come from the doctor?

The original prescription was 11-17,which has worked well. I assume the doctor figured there was no reason to give the machine a chance to chase pressure past a needed point. I am fortunate that my sleep doctor has sleep apnea, so he actually understands USING a machine.

As far as my own data, I have seen spikes to 16.9, but I have only noticed one time where it actually reached 17. And id those are truly spikes where it goes right back down. In a single night, I may have a few spikes to 15 and a one or two to 16 or 16.9. I tend to roll back onto my side when the pressure goes up, so it doesn't stay up very long. Maybe a couple minutes.