Muscles of exhalation compromised with CPAP

[lovehatemyCPAP]

I think the point made re 'one' post was because we've had lots of trolls lately who post goofy things and then never return. Yours wasn't goofy, but we're all ready - too much maybe - to call people trolls if they don't come back soon to see responses.

Thank you for explaining that! You have been very helpful. I had one post and I see she has been a member since 2010. Impressive! I can see why her ego got in her way now!

[chunkyfrog]

.
troll, yep.

[lovehatemyCPAP]

I am writing this post to see if anyone has any feedback or is having the same experience with general breathing as I am.

I have been using my CPAP for 2 years consistently now. I am a 39 yr old relatively athletic male dentist. I have not fully accepted that I will be using CPAP for the rest of my life so I am always looking for the reasons why I have it (I have a few theories) and any possible ways to fix it naturally. Using the mask does help me feel and sleep better with room for improvement.

I notice that my breathing during the day is not great. I take shorter breaths or forget to breathe all together. It seems that I do not exhale fully and to empty my lungs I have to consciously contract my diaphragm. I theorize that the CPAP could be detrimental to our overall breathing. Due to the constant pressure emitted by the CPAP, inhalation is never an issue. However, as we have to push/exhale against the pressure of the CPAP we are giving a shortened exhalation thus not utilizing are expiratory muscles and weakening them. After this short exhalation we switch over to a larger inhalation which is again easy due to the outward pressure of the CPAP. Thus with weakened muscles of exhalation our overall breathing will be negatively affected during the day as well.

Opinions.. Thoughts?

Just a reminder: Tell me again who has the ego problem?

I came on here for constructive discussion and feedback not to entertain you. Happy Holidays!

[Julie]

We all adjust our pressures when Oscar shows us it's worth a try (using the clinician manual to explain which buttons to push).

[lovehatemyCPAP]

We all adjust our pressures when Oscar shows us it's worth a try (using the clinician manual to explain which buttons to push).

Oh ok. I haven't used Oscar yet. So would you say changing the settings will mostly be based on Oscar vs. what your personal experience is or maybe a combo of the two? I will try out Oscar and get back to you if I have any questions about it. Thank you Julie!

[ChicagoGranny]

While you are sleeping because you are unconscious your force of exhalation is at the mercy of your CPAP pressure.

Look, I'm a tiny female that is more than twice your age. My exhale pressure setting is higher than yours. When I fall asleep, my autonomous nervous system controls breathing. I breathe gently and easily all night. You must be imagining something based on feelings while awake and thinking about your breathing and the CPAP.

During breathing, the diaphragm (a muscle) contracts to draw air into the lungs. For exhalation, the diaphragm relaxes and the lungs' elastic recoil causes air to be expelled from the lungs. There are no muscles exercised during exhalation while asleep. (While awake, muscles may be consciously flexed to drive additional air from the lungs.)

So, if you are getting any muscle contraction on exhale, it's while you are awake and conscious of your breathing. Probably a little bit anxious about it.

I guess I shouldn't be touching these settings myself?

No medical professional is allowed to touch my machine or determine my settings.

[zonker]

We all adjust our pressures when Oscar shows us it's worth a try (using the clinician manual to explain which buttons to push).

Oh ok. I haven't used Oscar yet. So would you say changing the settings will mostly be based on Oscar vs. what your personal experience is or maybe a combo of the two? I will try out Oscar and get back to you if I have any questions about it. Thank you Julie!

we actually encourage people to adjust their own settings. each of us have different "events" that make up our "ahi", which is a way to measure your specific sleep apnea. so, what works for ME won't necessarily work for THEE. although there ARE, broadly speaking, things that will work for almost anybody.

don't worry about understanding oscar. what you'll need to do is figure it out enough so that you can post a chart here, right HERE in this thread. then the experts can make suggestions based on what they see in that chart in order to help you improve.

good luck!

[Goofproof]

To enter the clinician's menu, press and hold the round knob and the home button simultaneously for several seconds. In the clinical menu, you can view and change your minimum and maximum pressures and change your EPR (expiratory pressure relief), if you don't find EPR on your main menu.

EPR drops the pressure by 1, 2, or 3 cm H2O when you exhale. To be sure you don't increase the numbers of obstructive events you have, you should increase your minimum setting by 1, 2, or 3 to compensate.

Of course, see your physician if you're concerned, but please be aware that (a) daytime exhalation is normally passive and does not involved muscular exertion and (b) normal daytime exhalation is incomplete, i.e., leaves an unexhaled residual volume in the lungs. In addition, daytime respiration is less regular that night-time respiration. We hold our breath when we're concentrating on something or exerting ourselves physically, and we sigh from time to time.

Using CPAP does mean a little bit of exertion on exhalation, and occasionally this give people some sore chest muscles at first as their muscles strengthen. I know of no reason to think this shortens the period of exhalation, or to think that CPAP weakens chest muscles.

In reality, using CPAP makes the chest muscle get stronger because they have to work harder to force the air out of the lungs. Thinking CPAP weakens your chest muscles doesn't compute! Jim

[chunkyfrog]

. . .
In reality, using CPAP makes the chest muscle get stronger because they have to work harder to force the air out of the lungs. Thinking CPAP weakens your chest muscles doesn't compute! Jim

This was obvious to me in the first week.
I had sore muscles in my chest, coinciding with exhalation.
The soreness dissipated, along with the perceived effort.
CPAP "splints" the airway open, so the diaphragm can do its job with the same effort as it has always used.
The airflow from a cpap is very weak, not enough to inflate a latex balloon.

[palerider]

I have not fully accepted

*facepalm*
and there's the root of your problem.

Using the mask does help me feel and sleep better with room for improvement.

Duh

and to empty my lungs I have to consciously contract my diaphragm.

Let me 'splain a little elementary level anatomy to you, when you CONTRACT your diaphragm, it makes you *INHALE*, look into it.

I theorize that the CPAP could be detrimental to our overall breathing.

Your "theory" is hogwash, as others have pointed out.

Due to the constant pressure emitted by the CPAP, inhalation is never an issue.

Continuing your steady streak of ignorance, this one's also wrong. The pressure of a cpap is just enough to hold your airway open, your lungs still have to do the work of inhaling, compressing the diaphragm. Exhalation is accomplished by *relaxing* the diaphragm. I guess they don't teach these basics in dental skool.

However, as we have to push/exhale against the pressure of the CPAP we are giving a shortened exhalation thus not utilizing are expiratory muscles and weakening them.

So in your opinion (note, I didn't mock it as being "eggspurt") exercise and work makes muscles weaker???? What kind of world do you live in? couch potatoes able to lift 600lbs?

After this short exhalation we switch over to a larger inhalation which is again easy due to the outward pressure of the CPAP. Thus with weakened muscles of exhalation our overall breathing will be negatively affected during the day as well.

Inhalations and exhalations match each other, unless you've got hole in your chest somewhere for the excess air to go.

Opinions.. Thoughts?

*facepalm"

Pure and utter hogwash. Everything in your "theory" is wrong...

Is this just a troll?

[palerider]

Rule of thumb with most muscles is by giving them a little extra work, they get stronger, not weaker.

If your theory had any merit, then millions of CPAP users would have compromised exhalation muscles. We don't.

Yes that is true about muscles. I am not sure if my theory has merit which is why I posted.

It's complete and utter bollocks.

How do you know that millions of CPAP users don't have compromised muscles of exhalation?

Your RIGHT! The headlines are covered with reports of people who can't breathe after using cpap, aren't they? I'm sure 60 Minutes did an exposé about it just last week!

Again I could be wrong but this is my theory and it makes sense to me.

Lots of things that are built on ignorance 'make sense' to the person that dreamed it up.

If your CPAP air is pushing against your exhalation air while you are unconscious/sleeping and if the force of your CPAP is a greater force than your normal force of exhalation than the CPAP will win that battle.

Again, completely and utterly WRONG. A CPAP can't even inflate a balloon it's so weak.

It takes conscious action to work out muscles. While you are sleeping because you are unconscious your force of exhalation is at the mercy of your CPAP pressure.

You're so full of it. I hope, for your patients sake, that you do better tooth work than you do respiratory theory.

[palerider]

Rule of thumb with most muscles is by giving them a little extra work, they get stronger, not weaker.

If your theory had any merit, then millions of CPAP users would have compromised exhalation muscles. We don't.

+ a million!
The OP's username says it all . . .
Only one post, too.
Physical fitness does not guarantee health.
My uncle died at 40--doing a treadmill stress test.
[I would never use HIS doctor.]

Yes only one post. Remember when you only had one post? What is your point?

My first post was over a month after I'd joined the forum, well over a MONTH of reading, and it wasn't to vomit up some crackpot theory.

[palerider]

Thank you for that! I guess I shouldn't be touching these settings myself?

You shouldn't be touching those settings yourself until you've educated yourself with what the adjustments NEED to be, or someone here with experience advises changes after reviewing the data.

Diddling with the settings without knowledge typically ends up with less optimal results.

[Okie bipap]

Thank you for that! I guess I shouldn't be touching these settings myself? Although I did read another post stating that they got more help with their CPAP from these forums than they did from their own doctor. Do you adjust yours?

Most of us here have taken on the responsibility of our own therapy and make changes to our pressure as we think are necessary. I have changed mine several times over the five years I have been using it. The people at the sleep clinic never really mentioned it once they saw how well I was doing with the new settings.

[Miss Emerita]

I guess I shouldn't be touching these settings myself? Although I did read another post stating that they got more help with their CPAP from these forums than they did from their own doctor. Do you adjust yours?

You CAN adjust your settings yourself, but you SHOULD only when you have data on which to base a change. The best way to get those data is to use OSCAR. If you want help interpreting the data, you can post a screenshot here and ask for advice.