Sudden onset of chest discomfort,and in throat.Could this be from BiPAP treatment?

[Dreamweaver1980]

Hello and I am a new user here. Thanks in advance for any advice or help. So I have been on Philips Respironics BiPAP w/humidifier,for around 3 weeks to a month now. ResMed F20 full face mask. My pressure is set at 9 over 5 per sleep docs orders. With using the Dreammapper app,my AHI has been doing fairly well staying at between 2.9-4.0.(original sleep study had shown 14.9 before treatment). My compliance is at 93% so I'm happy... somewhat...
So in the last couple of days, I have been experiencing some middle chest discomfort in my upper stomach where the esophagus with go to my throat. It kind of lingers and even though I have been diagnosed with GERD in the last 6 years, I have never experienced this until now even while on medicine. Could this be due to aerophagia possibly? Has/does anyone ever experience this? Another demon I fight is my bad sleep hygiene. I can't seem to get my butt in bed before 12 midnight. I know..I'm a work in progress lol. Thanks!

[Julie]

Have you been virus tested? Don't fool around here - get to an MD or testing place.

[DreamDiver]

Hello and I am a new user here. Thanks in advance for any advice or help. So I have been on Philips Respironics BiPAP w/humidifier,for around 3 weeks to a month now. ResMed F20 full face mask. My pressure is set at 9 over 5 per sleep docs orders. With using the Dreammapper app,my AHI has been doing fairly well staying at between 2.9-4.0.(original sleep study had shown 14.9 before treatment). My compliance is at 93% so I'm happy... somewhat...
So in the last couple of days, I have been experiencing some middle chest discomfort in my upper stomach where the esophagus with go to my throat. It kind of lingers and even though I have been diagnosed with GERD in the last 6 years, I have never experienced this until now even while on medicine. Could this be due to aerophagia possibly? Has/does anyone ever experience this? Another demon I fight is my bad sleep hygiene. I can't seem to get my butt in bed before 12 midnight. I know..I'm a work in progress lol. Thanks!

Dreamweaver1980, Welcome!

A number of reasons could be the cause of your chest/throat discomfort. It's probably best for you to talk to a doc about it, because none of us are really qualified to give you anything other than opinion. That said, a number of things come to mind.

• If this is something new, it could be that you have contracted pneumonia, or perhaps Covid-19. If so, these are things best answered by you and your doctor. If your SPO2 is low, even during the day, it's time to visit your doc. As Julie suggests, let's not dawdle.
• How long have you had the Respironics BiPAP? If you could add the specific machine to your profile, others may be able to come along with their own experiences or suggestions. For now, perhaps you could also name your specific machine in the thread.
• Having used both Respironics and Resmed machines, they use drastically different algorthims. For me, Respironics' algorithm tends to make me feel like I'm running a race, like I have to keep trying to breathe faster -- all night long. That never gets achieved, but by the end of a night, my whole diaphragm and chest feel sore. This does not happen for me with Resmed machines. The Resmed algorithm is more subtle. If you're experiencing what seems like muscle aches without typical pneumonia, wheezing, coughing, sneezing, etc., this is a possible reason for your chest discomfort. Some have found that after a few days or weeks, the discomfort passes and they're basically used to the machine's breathing algorithm. Others never get used to it and find themselves happier on a Resmed machine.
• Like you, I have GERD. It's possible that something has changed in that department, in which case it's probably time to get an appointment to talk to your GERD doc. It might be difficult right now because of the current problems with Covid-19, but you could at least set up an appointment for next month, if this is the likely culprit.
• I too get aerophagia. If you're suffering from that, it usually feels like you've got a stomach ache in the morning, or really bad gas, primarily from the air you've been swallowing all night. Do you feel like you have to burp all the time while you're half asleep? This might be a thing, but it would be hard to say until you can view more of your data.
• A lot of us are familiar with a program called OSCAR which allows you to review your sleep data in great detail, and also to post it on this forum so we can all look closer at your data. If you're comfortable with that, you can find the program here. From there, with some insight from other forum members you may get a handle on your settings.
• Large leaks can also be a problem. You may see some indication on your machine's readout in the morning about large leaks. OSCAR software allows you to delve deeper into large leak data. If you're getting large leaks, it means you're not getting therapy. That could be a source of discomfort and may be worth checking out even if it's not the source of discomfort in this instance.
• Sleep hygiene is certainly important. If you don't sleep until midnight, that's not necessarily bad, so long as you can sleep through until seven-thirty or eight am. It's even okay if you get up for twenty minutes to read and then go back to sleep. The important thing is consistency, night after night -- that it's the routine every night, getting at least an average of 7.5 hours sleep (for most people). There are other sleep hygiene considerations, that are available in the wiki. We're all a work in progress. The key is continuing that progress.
• Others will probably have additional ideas about what the chest discomfort may be. Hang in there. You'll get yourself sorted.

[Dreamweaver1980]

Thanks Dreamdiver ..as for covid19,I have been fine and nowhere for 2 weeks. I have had no fever and feel great other than this new chest discomfort.Its not a heart or GERD feeling pain like I've had before. Well..as for the heart I've never had issues. My machine is the Respironics BiPAP with humidifier. It's been better today,but possibly due to me taking the mask off around after 3 hrs of use. Tried to sleep without it the rest of the night but I payed for it this morning.Headaches, feeling woozi etc. I guess I'll keep giving it the go. They say it's better to use it than not.

[DreamDiver]

Thanks Dreamdiver ..as for covid19,I have been fine and nowhere for 2 weeks. I have had no fever and feel great other than this new chest discomfort.Its not a heart or GERD feeling pain like I've had before. Well..as for the heart I've never had issues. My machine is the Respironics BiPAP with humidifier. It's been better today,but possibly due to me taking the mask off around after 3 hrs of use. Tried to sleep without it the rest of the night but I payed for it this morning.Headaches, feeling woozi etc. I guess I'll keep giving it the go. They say it's better to use it than not.

I certainly encourage you to carry on with the the mask and machine. They're basically a lifesaver. I see now that you've put that you have APAP rather than BiPAP in your profile. They are two different machines, even though they may both end with "Auto". People with a lot more experience than I will be able to help you more if we know for sure whether your machine is:

This one: Philips Respironics DreamStation Auto CPAP Machine with Heated Humidifier <--APAP

or

This one: Philips Respironics DreamStation BiPAP® Auto Machine <-- BiPAP

It sounds a lot like what I experienced when I was using the Respironics machine. Glad you've elected to carry on. If insurance is important to you, remember that they usually require you to have yourself masked up and using the machine for at least four hours per night [edit per ChicagoGranny: for at least 70% of nights]. That doesn't necessarily mean you have to be asleep. Some who find it frustrating at first often find it easier if they just sit in bed with the machine on. With the Airfit 20 mask, you can sit up, read or do puzzles all you want. If you fall asleep again, so much the better. If it is the algorithm, I hope you'll find that it mitigates after a while. If it becomes too much, absolutely go back to your doc. If necessary, you could ask for the alternate machine from Resmed.

I hope at some point you'll consider trying the OSCAR software with the SD card in your DreamStation. Glad you're social distancing. Stay safe!

Chris

[ChicagoGranny]

Most insurance companies follow the Medicare rules for compliance.

How does Medicare define CPAP compliance or adherence? Medicare defines adherence as using the device more than 4 hours per night for 70% of nights (that's 21 nights) during a consecutive 30 day period any time in the first three months of initial usage.

[DreamDiver]

Thanks for the better answer ChicagoGranny!

Most insurance companies follow the Medicare rules for compliance.

How does Medicare define CPAP compliance or adherence? Medicare defines adherence as using the device more than 4 hours per night for 70% of nights (that's 21 nights) during a consecutive 30 day period any time in the first three months of initial usage.

[Dreamweaver1980]

Actually Dreamdiver,I think I may have put the wrong machine.Mine is the BiPAP. It looks the exact same as the one I chose in the pic. It's called the same thing too..hmm..idk what to do,I couldn't find mine in the options

[Pugsy]

Mine is the BiPAP. It looks the exact same as the one I chose in the pic. It's called the same thing too..hmm..idk what to do,I couldn't find mine in the options

Look on the bottom of the blower unit for the model number. Should start with DSX or maybe DCP and followed by 3 digits and some letters.
Tell us the 3 digits...
200, 400, 500, 600, 900 or maybe higher
Then we can tell you exactly which machine and it might not be a choice in the menu but once we know exactly what it is you can just add it to the comments section.

[Dreamweaver1980]

Ok cool thanks! It says DSX with 700

[Pugsy]

Your machine is the DreamStation BiPap Auto.
It's not currently listed in the equipment profile menu choices. Neither is mine. Must be a software glitch.
Just type "DreamStation BiPap Auto" in the comments section and we know what it is.

[Dreamweaver1980]

Here is how last nights sleep looked. I'm still under the 5.0 mark that my sleep specialist said is fine. Normally my AHI is staying under that,yet occasionally it will go as far as to 7(not often). However,even with it staying at under the 5, I still feel fatigued during the day alot(yet not as bad as it was when OSA wasn't treated). I'm wondering why I only had 1 OSA last night but had 10 Hypopnoeas? Kinda weird,I thought they went hand in hand mostly..like not the same numbers every night in amount,but close. Am I wording it right,by what I'm trying to ask?

[Pugsy]

Obstructive apneas.....a reduction of airflow 80 to 100% that lasts at least 10 seconds
Hyponeas....a reduction of air flow from 40 to 79 100% that lasts at least 10 seconds.....they are still bad.
Do you think there is much difference in the damage done to the body between a 75% air flow reduction of the hyponea and the 82% reduction in airflow of the OA? There's not.
Hyponea is just an OA that doesn't quite make criteria for OA flag.

[Dreamweaver1980]

Ok so an update is in order. I greatly appreciate all of your help and previous comments.
So the chest issues have subsided. The last couple of mornings though,I am waking up with a headache on the top of my head. My mask isn't leaking,nor is it too tight. Could it be I'm not going to sleep until 12-1 a.m.,and waking at around 6-7 a.m.? I know my sleep hygiene is off..but also am having weird dreams that involve me having shortness of breath in the dream,like I'm walking on a long road or running from someone lol..it's weird. As a reminder I'm on BiPAP,and doc just ordered my pressure down a notch to 8 over 4 from 9 over 5.
(8 is pressure of air in,4 is exhale). Any help is appreciated.