My sides hurts - Like I was punched in the ribs

[sloizeaux]

My first night on my machine - slept great - no snoring no events ( according to my wife ) alittle bit of liquid in my mask from the humidifier.
The biggest surprise is I feel like I was in a boxing match last night - my ribs and sides hurt. Anybody have some ideas why ?

[needingu]

I just noticed you had not had a response...I can't imagine why your sides hurt unless you slept so hard you did not change positions all night which will make you sore sometimes. I'm sure you will seek advice if it continues over a period of time or gets worse..

[Born Tired]

sloizeaux,

What is your pressure?

During my titration they upped the pressure to 16. For some of you out there 16 is no big deal, but at 16 my ears were about to explode, my neck veins were ready to burst, and I had to stay awake just to be able to exhale against the pressure . I finally snatched the mask off and said they'd have to greatly lower the pressure. The following day my ribs were very sore. Seems like for a while I had soreness after I got my machine and used a pressure of 7, but the soreness went away.

Hope things work out for you.
Esther
--

[DME daddy]

I have run into this with a number of patients. After the first night of sucessful CPAP they had the exact complaint you have. The first few patients I referred back to their physicians, but the docs had no suggestions. The cpap patients were able to work thru it over a period of a few weeks and the pains eventually went away and did not return. Every case had pressures of 9 cm or greater. The problem was most pronounced after a patient new to cpap had slept soundly for at least 6 hours.

I believe we are dealing with the consequences of the chest cavity being inflated to a greater size, and for the most part, being held in that position for an extended period of time. The muscles and connecting tissues are fine with the new position for quite some time then they become sore from the long term if minor stretch.

This is just my humble thought. In any case, some of the patients I worked with had to take a night off cpap once in a while but all did fine in the end.

I do strongly suggest that you report your symptoms to your physician.

[sloizeaux]

My pressure is 11.

The soreness went away after a couple of hours by 11:00 am.

DME Daddy thanks for the explaination - my wide id bearly moved all night. Maybe I was afraid to move. We will see how tonight goes - I'll give everyone an update to AM

[dsm]

We have talked about this often here. I believe DME daddy has it summed up.

I experienced this phenomenon 3 times. First was when I went onto cpap (using 15 cms). If I hadn't just completed a very successful stress ECG test a few weeks before going on cpap, I might have believed it was heart trouble.

It lasted only a few nights but was so painful I got up & walked around a bit. The description of being punched in the ribs/chest is a good one. At the time I was sure it was because I was at last doing some good breathing while sleeping.

The second time was when I switched from cpap/auto to bipap. It was very similar to the 1st cpap experience.

The third time was only recently while doing a series of tests using a VPAP III in cpap mode & varied CMS from 10 to 16 over 6 nights while doing PO readings as well (needed the VPAP III as it supplied airflow volume data as well as the night's AI, HI & AHI data.

So it seems to me it is related to changes in ventilation that will trigger this chest pain effect.

DSM

[JeffroDoe]

Keep in mind that when you first start to use xpap, you may very well be forced to begin using muscles in your chest and abdomen and back to an extent you never have before. This is the result of having to now force air out of your lungs against pressure. Like any muscle you use more than usual or strain, the breathing muscles, and those supportive muscles in the surrounding areas, also get tired and sore. That is precisely what this pain is.

It is not uncommon, especially in the ill or elderly, to wake up every morning for the first few nights with mild soreness, or sometimes very bothersome, back, stomach, side, or chest wall pains. This soreness typically resolves itself over a couple weeks, but can or may linger and hit someone on and off for up to 3 or 4 months.

The xpap pt's constant compliancy is the best cure for this soreness (which can usually be somewhat relieved by using some sort of over the counter analgesic). If one stops usage for a couple nights, or starts and stops to try and combat the pain, it will take longer to get past it. The best way to handle it is to toughen up, resolve yourself to success, and accept that it is a small price to pay for the many future benefits of apnea relief you have to look forward to.

[unclebob]

Hi sloizeaux,

After carefully reading your post, I think there is an alternative for you to consider. You did mention you slept great and your wife can attest to you not having snored.

That's probably the whole problem and the answer to your dilemma.

Think about it. There you are sleeping great and no snoring. Meanwhile, right next to you is your wife - wide awake, hoping that you WILL snore so she can tell you the damn overnight reverse vacuum cleaner didn't work. She was awake all night listening to the whoosh, whoosh and heard every one of the little water drips you so nonchalantly dismissed.

Yep! There you have it! Punched you in the ribs, she did. You really have to give her credit - no marks and the pain was gone by 11 AM.

Yes Grasshopper, you were in a boxing match.

Good luck on your treatment.

Bob F

[dsm]

I have been thinking if I should or shouldn't bring up this topic here but decided to go ahead in the belief there is enough expertise here to clarify this aspect of chest pain.

http://www.chestjournal.org/cgi/content ... _suppl/72S

The above link discusses Pulmonary Hypertension. This is when the arteries around the lungs are stressed and cause chest pains. This particular article looks the PH in relation to OSA.

The condition is certainly exacerbated by OSA.

DSM

[needingu]

Yes, having sleep apnea will give you pulmonary hypertension.. My cardiologist found the right side of my heart had enlarged and therefore ordered the OSA test.. since beginning the cpap it had resumed the normal size. I thought this was worth passing on.

[Mile High Sleeper]

I had the same problem. In line with what the DME guys said, google "costal chondritis" for more information. May also be a good idea to see a doctor and get your heart checked out, since heart problems and OSA are related.

[Russ]

For me, it's more in the back...parrallel with my diaphram. Hurts like I slept on cement every morning so far. 1 1/2 weeks in. Sure hope it goes away at some point.