Chest Discomfort at Assigned Pressure

[Air Force Retired]

I have been on CPAP now for almost two months, with a prescribed pressure of 10. For the past few weeks I have awakened in the early morning hours with discomfort in my chest, usually on both sides. Some nights it gets to a point that I can not get a good nights sleep because of the discomfort. After I get up all the discomfort goes away within an hour or so. I am considering dropping the pressure down to 8.5 or 9.0 and see if that stops the discomfort but will still give me a decent AHI. I would appreciate any comments or suggestions you might have. I am a side sleeper and flip-flop from side to side every night. Sleeping on my back does not work for me.

[jlk]

Are you using a-flex? If not, try that before lowering pressure. I have had that feeling without using epr on my S-9. Your lungs are getting air pushed at them when your trying to exhale would be my guess. john

[GumbyCT]

Does it feel like muscle soreness?

Has something changed recently?

[cflame1]

jlk... all he's got is a PRO which has CFLEX and CFLEX +... but not AFLEX

[Air Force Retired]

Does it feel like muscle soreness?

Has something changed recently?

It is a constant pain and hurts more when I move. As I stated, it does not appear until the early hours of the morning and goes away within an hour of getting out of bed, so I am sure it has something to do with my treatment. I might add that before I got this machine I was using my wife's old machine which was set at a pressure of 4, without humidifier. I used it for three weeks before this machine and did not have any chest discomfort at all. It did stop my snoring but most probably did not take care of the apnea. It had no data capability, so I have no way of checking this out.

[jbn3boys]

jlk... all he's got is a PRO which has CFLEX and CFLEX +... but not AFLEX

cflex, cflex+, aflex, and biflex are all versions of EPR, just for different machines, with slightly different wave forms. All offer some type of exhalation relief. It looks like the OP has his set at 3, which should give the most relief.

You could also try to use the Resistance Control. It's kind of a guessing game, since Respironcs does not give any help when using a mask made by another company. But it might be worth experimenting with it. I believe with nasal pillows (if that's what you are using), the smaller the size, the higher the resistance should be set.

Do you have the ability to check your ahi daily? If so, then I would see no problem with decreasing your pressure and keeping an eye on your ahi.

Good luck!
jbn

[Air Force Retired]

jlk... all he's got is a PRO which has CFLEX and CFLEX +... but not AFLEX

cflex, cflex+, aflex, and biflex are all versions of EPR, just for different machines, with slightly different wave forms. All offer some type of exhalation relief. It looks like the OP has his set at 3, which should give the most relief.

You could also try to use the Resistance Control. It's kind of a guessing game, since Respironcs does not give any help when using a mask made by another company. But it might be worth experimenting with it. I believe with nasal pillows (if that's what you are using), the smaller the size, the higher the resistance should be set.

Do you have the ability to check your ahi daily? If so, then I would see no problem with decreasing your pressure and keeping an eye on your ahi.

Good luck!
jbn

I am currently using the SWift LT with the medium pillows. I have a Comfort Gel I use when my nose is to sore from a cold etc. to use the pillows. I have the ability to look at all my data and with the Swift LT my AHI has averaged 2.0 to 3.5, with a few ups and downs. I think that first I will try the resistance setting and if that does not give me any relief I will drop the pressure to the highest setting I can that will keep my AHI under 5.0 but stop the discomfort. Thanks for your inputs.

[B_4]

You should inform your doctor.

[RDawkinsPhDMPH]

This is common. It's usually chest wall discomfort. But chest discomfort can be serious so talk to your doctor.


Sorry folks... this is one of the things I discussed in the ebook.

[Janknitz]

Two months is a long time for chest wall discomfort when you are using the maximum flex setting. You should contact your doctor about this.

Do you have GERD by any chance?? I get the symptoms you are describing when I get esophageal spasms, often associated with GERD. Some people's GERD symptoms are much improved with CPAP, while others are worsened. So it may be that, but you should see what your doctor has to say.

[Air Force Retired]

This is common. It's usually chest wall discomfort. But chest discomfort can be serious so talk to your doctor.


Sorry folks... this is one of the things I discussed in the ebook.

Actually, yes, the discomfort does seem to be on the chest wall, sometimes only one side and sometimes both. This morning it was on both sides. To answer another question, yes, I also have GERD BUT, since I went on Prilosec a few months ago I have had maybe only two flair ups. I think in my case, the CPAP has helped with this problem. I had a complete physical just about a week before getting my machine that included chest x-rays, blood tests, drinking liquid chalk (for GERD check) and everything came back normal. I will know if the problem is the apnea treatment in a couple of days. I have checked my previous data and running at 8.5 vice 10 pressure still kept my AHI below 5.0 although my VS was high on a couple of occasions, so tonight I am going to start running at 8.5 pressure for a few nights and see how it goes, both with the discomfort and the AHI. I will report back later. Thanks to everyone and Merry Christmas to all.

[Air Force Retired]

This is common. It's usually chest wall discomfort. But chest discomfort can be serious so talk to your doctor.


Sorry folks... this is one of the things I discussed in the ebook.

Actually, yes, the discomfort does seem to be on the chest wall, sometimes only one side and sometimes both. This morning it was on both sides. To answer another question, yes, I also have GERD BUT, since I went on Prilosec a few months ago I have had maybe only two flair ups. I think in my case, the CPAP has helped with this problem. I had a complete physical just about a week before getting my machine that included chest x-rays, blood tests, drinking liquid chalk (for GERD check) and everything came back normal. I will know if the problem is the apnea treatment in a couple of days. I have checked my previous data and running at 8.5 vice 10 pressure still kept my AHI below 5.0 although my VS was high on a couple of occasions, so tonight I am going to start running at 8.5 pressure for a few nights and see how it goes, both with the discomfort and the AHI. I will report back later. Thanks to everyone and Merry Christmas to all.

After running at a 8.5 pressure my AHI went above 5.0 using both my swift LT and the easylife. I then upped the pressure to 11 and found that the only difference than running at 10 was greater chest discomfort in the morning. Santa brought me an oximeter for Christmas, so I dropped my pressure back to 10 and went several nights with my swift LT and several with my easylife. At the same time I checked my oxy levels at various times during the nights and my oxy levels were steady between 95 and 98. My AHI's ran from 1.9 to 2.9. With this information I think I can safely say I am well within the mark of where I need to be and don't really need to keep checking daily data except maybe once a week. I might add that I also found that if I start to feel the chest discomfort in the night and turn to my back for about 5 minutes the discomfort goes away and I can move to either side again. I have also noted that the discomfort has decreased quite a bit at a pressure of 10 (my assigned pressure) in the last week.

[robysue]

Repeating others advice to inform the doctor's office about this problem. Yes, it could be that the titrated pressure is too high. But reducing the pressure may relieve the discomfort while not providing enough pressure to adequately treat the apnea. If you're still having problem with the pressure after 2 months, maybe its time to see if the doctor's office would be willing to authorize an autotitration for week or so to see where your 90% or 95% pressure level settles on an APAP machine is. That might also give you temporary access to a full data machine while you use a loaner APAP.

[avi123]

[quote="Air Force Retired]
Actually, yes, the discomfort does seem to be on the chest wall, sometimes only one side and sometimes both. This morning it was on both sides. To answer another question, yes, I also have GERD BUT, since I went on Prilosec a few months ago I have had maybe only two flair ups. I think in my case, the CPAP has helped with this problem. I had a complete physical just about a week before getting my machine that included chest x-rays, blood tests, drinking liquid chalk (for GERD check) and everything came back normal. I will know if the problem is the apnea treatment in a couple of days. I have checked my previous data and running at 8.5 vice 10 pressure still kept my AHI below 5.0 although my VS was high on a couple of occasions, so tonight I am going to start running at 8.5 pressure for a few nights and see how it goes, both with the discomfort and the AHI. I will report back later. Thanks to everyone and Merry Christmas to all.[/quote]

After running at a 8.5 pressure my AHI went above 5.0 using both my swift LT and the easylife. I then upped the pressure to 11 and found that the only difference than running at 10 was greater chest discomfort in the morning. Santa brought me an oximeter for Christmas, so I dropped my pressure back to 10 and went several nights with my swift LT and several with my easylife. At the same time I checked my oxy levels at various times during the nights and my oxy levels were steady between 95 and 98. My AHI's ran from 1.9 to 2.9. With this information I think I can safely say I am well within the mark of where I need to be and don't really need to keep checking daily data except maybe once a week. I might add that I also found that if I start to feel the chest discomfort in the night and turn to my back for about 5 minutes the discomfort goes away and I can move to either side again. I have also noted that the discomfort has decreased quite a bit at a pressure of 10 (my assigned pressure) in the last week.[/quote]


I would reduce the pressure to 7 to 8 cm H2O and see if anything is out of normal. I also have GERD and on Prilosec ( 2 daily) and my pressure is 6 cm H2O. Also, RAMP= 0 and EPR = 2 cm H2O. I am 213 lbs.. 6' 2", stopped smoking 30 years ago. I think that I should raise my pressure to 8 to stop slight diziness during the day. Will discuss bwith the doc next week.

[Muse-Inc]

I became intolerant of straight CPAP pressure and got an APAP which I use at a higher pressure range than the CPAP was set to; I also have exhale relief. No more chest pains.