Could this speech symptom be related to PAP therapy?

[old dude]

I have developed a strange artifact in my speaking that seems to have started concurrent with beginning therapy. I would describe it as "breathlessness" in speaking except that it is in no way related to exercise or physical exertion. I still exercise 5X/week with no unusual breathing problems.

This problem manifests itself as running out of breath before completing a sentence that I would have previously easily been able to complete on one breath without thinking about it. Now I often find that I have to regroup and take another breath to complete a sentence. My voice also seems weaker, and often sounds a bit hoarse to me. Some of this seems a little like bronchitis, except without the wheezing and coughing. The severity of the symptoms can come and go throughout the day.

My sleep doc said he had no idea what it could be, but that it wasn't related to PAP therapy. My internist nodded seemingly knowingly but said it was nothing to worry about.

Still, it seems a bit strange to me. Does anyone have any thoughts? It's hard to believe that it isn't somehow related to therapy.

Thanks.

[Julie]

Why either of those two doctors did not send you to a pulmonologist for testing I can't imagine, but that's what I think you should ask for (the referral). It could be a cardiac problem and I wouldn't fool around waiting and wondering what it 'could' be.

[khauser]

I'm with Julie ... if I was running out of breath in a situation that I used to be fine in, I would want my doctor checking for other possible cardiovascular issues.

It may be nothing, but I've never seen anyone else report that here, so I wouldn't assume it was PAP related.

[nanwilson]

Yup... same symptoms, turns out my asthma is back and I'm now on 3 different inhalers . I still get breathless when I talk too much but much less.

[Lazer1234]

Yep, have the same symptoms. As others think here I have had a heart attack 1 year ago. I've been on four controls for it and all values ​​have been fine then.

[old dude]

I appreciate the responses so far everyone.

I am under the care of a cardiologist for atrial flutter, which is what led to my OSA diagnosis and treatment to start with. He ran me through an exhaustive battery of the usual cardio/pulmonary tests just before he ordered the sleep study confirming that I indeed had OSA. I suppose that with the severity of my situation ( AHI=131) there could be some residual damage just now manifesting, but he never mentioned that possibility.

Knowing my background and being sort of the "overseer" for co-ordinating treatment from all of my specialists, I'm a little surprised that my normally very conservative internist blew it off as quickly as he did. Perhaps I should request a referral to a pulmonologist, but I may wait a bit to see if the problem abates somewhat first. This has really been the "year of the doctor" for me already.

Actually, the more I think about it, I' think I'll ask my PCP to reconsider the issue if it continues. I see him again in a week or two.

[StuUnderPressure]

Might be nothing, but that is a symptom of blocked arteries.

You said you were under the continued care of a Cardiologist.

Might be worth an appointment with him for that specific symptom.

[old dude]

Might be nothing, but that is a symptom of blocked arteries.

You said you were under the continued care of a Cardiologist.

Might be worth an appointment with him for that specific symptom.

Really? You mean just the breathlessness as it applies to speaking, not also as it relates to general exertion?

I didn't know that.

My nuclear stress test came back clean but I'm sure they aren't 100% spot on.

[StuUnderPressure]

Might be nothing, but that is a symptom of blocked arteries.

You said you were under the continued care of a Cardiologist.

Might be worth an appointment with him for that specific symptom.

Really? You mean just the breathlessness as it applies to speaking, not also as it relates to general exertion?

I didn't know that.

Blocked arteries reduce the amount of oxygen that is being circulated because the oxygen in the blood cannot get to its destination.

My nuclear stress test came back clean but I'm sure they aren't 100% spot on.

If that nuclear stress test was recent & did not reveal anything, then that is NOT your problem.

A nuclear stress test may not be "100% spot on" but WOULD have detected a blocked artery.

"I" would still see my cardiologist, but I am anal about such things.

[Julie]

There are other potential issues besides blocked arteries, such as fluid build up leading to heart failure and/or inflammation, infection around the heart, etc.etc.

[old dude]

There are other potential issues besides blocked arteries, such as fluid build up leading to heart failure and/or inflammation, infection around the heart, etc.etc.

Agreed Julie, but again, are you referring to breathlessness only as it would apply to speaking, or general breathlessness upon exertion? If it were present upon exertion of all kinds then yes I would agree but remember this occurs only while speaking. I'm fine with exercise, stairs, carrying heavy items, etc.

[StuUnderPressure]

It is weird that it occurs only when speaking.

But with the myriad of ills people on this forum have, someone should recognize that symptom.

But just as an abundance of caution, I would not let it go too long undiagnosed.

[Julie]

Hi - I was referring to the general kind, but you might be experiencing the tip of an iceberg that only is showing up in speech now, but could eventually be more obvious in other ways if it were to be anything serious. I don't think talking requires a great deal of 'air', but I also don't really know much about that in general, so just wanted to give a heads up for you to consider.

[JDS74]

Is there any possibility that you have developed a habit of forcefully breathing out as a result of your relatively high EPAP pressure?

I notice that I breathe out twice as fast as I breathe in with similar pressure numbers.
It may be just that you are running out of air while speaking as a result.

Just a thought.

[old dude]

Is there any possibility that you have developed a habit of forcefully breathing out as a result of your relatively high EPAP pressure?

I notice that I breathe out twice as fast as I breathe in with similar pressure numbers.
It may be just that you are running out of air while speaking as a result.

Just a thought.

Ahhh, now there's an idea that I'll think about. Based on how it occurs (it's difficult to describe) I'd say something like this is a good possibility!

I appreciate all responses and I agree, I won't let it go long without a diagnosis.