Increased pressure - chest pain?

[AndrewB]

I've been using my Resmed S9 since about April. Originally they had me on a pressure of 8cm which still gave me scary-high (50+) AHI numbers. After a second study they had me set the machine to 11cm which dropped my AHI to reliably be below 20.

Since I can never follow instructions, after a month or so on 11cm I took it upon myself to self-diagnose and bumped the pressure up to 12cm. This has dropped my AHI down to reliably below 10 BUT - if I'm on the hose for more than 8 hours I get a strong pain in the centre of my chest right at whatever the bone is called in the middle.

A couple of facts to add on to this. I have hypertension and occasional chest pain from that but my recent angiogram indicated that I wasn't likely to kick off soon. I was also in a car accident at the end of July were I was bruised by my seatbelt (thank heavens for good engineering) which coincides with me increasing the pressure.

My own theory is that my ribs are still healing from the car accident. As an experiment, last weekend when I knew that I'd get over 8 hours in bed, I decreased the pressure back to 11cm. Some pain, but not as much but I certainly didn't feel as well rested as I did with 12cm. I bumped it back up to 12 to get a good night's sleep and am now caught in a conundrum between pain of an unknown source and good sleep.

My question is:
- should I follow instructions, drop my pressure to 11 and move on?
- should I drop the pressure to 11 for a few weeks to give my ribs a chance to heal (if that's the problem)
- is it really unlikely that the extra 1cm is causing pain in my ribs and I've got something else wrong?

Thanks

[Muse-Inc]

Try setting the EPR to max (3) with the higher pressure. When I had bruising from slamming into the seatbelt (mine shredded ), my chest was sore for months. Deep beaths were really unpleasant...can't imagine what a challenge CPAP therapy would have been. You have my sympthaty. Those numbers are scary high..shame you haven't got an APAP to keep pressure as low as is needed to keep your breathing stable and prevent events.

[Julie]

Just wondering if you could get away with even a slightly lower pressure if you discovered you opened your mouth when asleep (easy to happen while air is being pushed in through your nose) and possibly needed a full face mask which would allow you to breathe that way but not lose the Cpap air. If you do breathe that way, moving your pressure up just makes the problem worse, but doesn't give you effective therapy.

[brazospearl]

Andrew, honey, bless you heart! Generally, chest pain needs to be tended to by a doctor. Since you've been pretty well under a doctor's care, for one reason or another, recently, I'm inclined to think your pain is related to your car accident. While I have no direct experience in that area, I've known several people who were involved in high-speed chases, and they ALL say it took months for the pain to subside. This seems particularly true for the breathing-related pain from the seatbelt. That said, I do have personal experience coping with chronic pain, and I know I handle pain better when I've had better sleep. I'd keep the pressure at 12. I also hope that fewer apnea events would speed your healing process, but I could have that logic all wrong. Again, talk to your doctor if you're concerned about chest pain.