Do our lungs need all this pressure?

Country4ever · Post by **Country4ever** » Thu Jan 31, 2008 2:16 pm

HI all,
Please forgive my constant need to question everything. I many times drive myself crazy!
I was thinking, and I understand the need for this increased pressure to open up our obstructions, but its not our lungs that need all this pressure......just our oral and nasal pharynxes (or is that pharynicies??).
I'm just wondering what all this extra pressure really does to our lungs?
Surely there is some feedback mechanism to our brains about our lungs being too full?? Maybe that's where the central apnea might come into play in some people with high pressure settings??
I realize that there is no other invention at the moment to help people like us, but I do wonder what the effects are to the lungs themselves.

Where's Bill Nye when you need him??

6PtStar · Post by **6PtStar** » Thu Jan 31, 2008 2:28 pm

Lungs probubly don't but without it none of it would get to the lungs. Just think how much stronger your chest muscles are getting. Bar bells for the chest muscles.

Jerry

Goofproof · Post by **Goofproof** » Thu Jan 31, 2008 2:33 pm

If you could runa a tube 3/4 inch Dia. up your nose into your lungs you wouldn't need any extra pressure.

But you would probably need some pain meds to sleep. Jim

XPAP keeps you airway open, it's easier than the hose.

Country4ever · Post by **Country4ever** » Thu Jan 31, 2008 2:50 pm

I love passive exercise!

I could probably get an endotrachial tube inserted each night, but that wouldn't be too much fun.
I could probably lose weight too. Nah.........
I wonder if some day they'll find something so simple and easy to hold our tissues open, that we'll say "why didn't we think of that???" We can always dream.
I guess what got me thinking about my original question is that I've been going up on my pressures, and the rest of my body just doesn't seem happy with it. That made me wonder what kind of info my lungs being stretched is giving the rest of my body.
I'll figure that "sweet spot" out eventually, and hopefully make all my parts happy at the same time!

Goofproof · Post by **Goofproof** » Thu Jan 31, 2008 2:55 pm

Country4ever wrote:I love passive exercise!

I could probably get an endotrachial tube inserted each night, but that wouldn't be too much fun.
I could probably lose weight too. Nah.........
I wonder if some day they'll find something so simple and easy to hold our tissues open, that we'll say "why didn't we think of that???" We can always dream.
I guess what got me thinking about my original question is that I've been going up on my pressures, and the rest of my body just doesn't seem happy with it. That made me wonder what kind of info my lungs being stretched is giving the rest of my body.
I'll figure that "sweet spot" out eventually, and hopefully make all my parts happy at the same time!

Nanites (Small Cell sized Smart Machines) Jim

DreamStalker · Post by **DreamStalker** » Thu Jan 31, 2008 3:11 pm

They make stents to keep heart arteries open ... dunno why they can't make stents to keep the throat open

split_city · Post by **split_city** » Thu Jan 31, 2008 4:14 pm

CPAP helps to prevent apneas by 1) stenting the airway open by positive pressure and 2) increasing lung volume. In regards to point number two, there have been several studies which have shown that increasing lung volume makes the airway less collapsible.

A study by Heinzer et al shows this lung volume effect nicely. They put their patients on CPAP (at therapeutic level) and measured the change in lung volume caused by this CPAP. The authors then turned off CPAP and increased lung volume, by negative extrathoracic pressure, to the same level caused by CPAP (CPAP lung volume). The also increased lung volume by a further 500mL. The AHI was then measured under three conditions 1) no CPAP and no change in lung volume 2) CPAP lung volume 3) 500mL above CPAP lung volume. AHI was 62.3, 37.2, and 31.2 events per hour respectively.

Thorax. 2006 May;61(5):435-9. Epub 2006 Feb 20. Links
Effect of increased lung volume on sleep disordered breathing in patients with sleep apnoea.Heinzer RC, Stanchina ML, Malhotra A, Jordan AS, Patel SR, Lo YL, Wellman A, Schory K, Dover L, White DP.
Sleep Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rheinzer@post.harvard.edu

BACKGROUND: Previous studies have shown that changes in lung volume influence upper airway size and resistance, particularly in patients with obstructive sleep apnoea (OSA), and that continuous positive airway pressure (CPAP) requirements decrease when the lung volume is increased. We sought to determine the effect of a constant lung volume increase on sleep disordered breathing during non-REM sleep. METHODS: Twelve subjects with OSA were studied during non-REM sleep in a rigid head-out shell equipped with a positive/negative pressure attachment for manipulation of extrathoracic pressure. The increase in lung volume due to CPAP (at a therapeutic level) was determined with four magnetometer coils placed on the chest wall and abdomen. CPAP was then stopped and the subjects were studied for 1 hour in three conditions (in random order): (1) no treatment (baseline); (2) at "CPAP lung volume", with the increased lung volume being reproduced by negative extrathoracic pressure alone (lung volume 1, LV1); and (3) 500 ml above the CPAP lung volume(lung volume 2, LV2). RESULTS: The mean (SE) apnoea/hypopnoea index (AHI) for baseline, LV1, and LV2, respectively, was 62.3 (10.2), 37.2 (5.0), and 31.2 (6.7) events per hour (p = 0.009); the 3% oxygen desaturation index was 43.0 (10.1), 16.1 (5.4), and 12.3 (5.3) events per hour (p = 0.002); and the mean oxygen saturation was 95.4 (0.3)%, 96.0 (0.2)%, 96.3 (0.3)%, respectively (p = 0.001). CONCLUSION: An increase in lung volume causes a substantial decrease in sleep disordered breathing in patients with OSA during non-REM sleep.

jupmalis · Post by **jupmalis** » Thu Jan 31, 2008 4:26 pm

[quote="split_city"]CPAP helps to prevent apneas by 1) stenting the airway open by positive pressure and 2) increasing lung volume. In regards to point number two, there have been several studies which have shown that increasing lung volume makes the airway less collapsible.

Thank you for your valuable information, as some on this forum are unaware that CPAP increases lung volume. I found similar scientific results in my web searches.

By the way, before CPAP, surgeons would perform tracheotomies in extreme cases of obstruction.

Country4ever · Post by **Country4ever** » Thu Jan 31, 2008 6:49 pm

I appreciate that all that air in the lungs helps with the apnea. I just wonder what other effects it might have on the body, since its a pretty unnatural state. Plus, I wonder if the feedback the stretched lung tissue might send to the brain, actually causes the brain to think its over-breathing, and slows the rate down, which might cause more blockage, which causes the machine to pressure up. ??

vesselpessel · Post by **vesselpessel** » Thu Jan 31, 2008 7:24 pm

Thank you Country4ever, yet one more thing to worry about!! However, you make a good point and I hope someone comes along to assuage my fears.

KAZ · Post by **KAZ** » Thu Jan 31, 2008 7:39 pm

Interesting point, when I first started cpap therapy I was issued a BiPap Plus set at 20.0. Almost at once I noticed that I had a high level of energy and began walking several miles each day which lead to weight loss(135+lbs). I wanted to know what was going on and gave back my Plus and bought a BiPap Auto. I spend 90% of my sleep time at 14.0. Without the great advice from this forum I'm certain that I would still be blasting away at 20.0 which at 6 more than required can't be good, not to mention more mask leaks. Regards

Country4ever · Post by **Country4ever** » Thu Jan 31, 2008 8:02 pm

Please don't get me wrong. I realize that all of us need to use these machines, or really bad things can happen........not to mention just feeling like poop all the time.
I'm just trying to figure out why I seem to feel so bad on pressures higher than 8. Sorry.......didn't mean to alarm anyone with my ramblings. I spend alot of my time forming alot of useless theories. It keeps me busy and out of trouble.

Baitman · Post by **Baitman** » Thu Jan 31, 2008 8:12 pm

[quote="jupmalis"][quote="split_city"]CPAP helps to prevent apneas by 1) stenting the airway open by positive pressure and 2) increasing lung volume. In regards to point number two, there have been several studies which have shown that increasing lung volume makes the airway less collapsible.

Thank you for your valuable information, as some on this forum are unaware that CPAP increases lung volume. I found similar scientific results in my web searches.

By the way, before CPAP, surgeons would perform tracheotomies in extreme cases of obstruction.

Goofproof · Post by **Goofproof** » Thu Jan 31, 2008 9:10 pm

True, the extra pressure expands the lungs a little, but the rib cage is designed to prevent a blowout. When starting on XPAP some of us experience soreness due to the excessive workout. As with all workouts, the body has to get used to being used, pain is the result. Natures warning that something out of the normal is going on.

Soon the body gets stronger and the pain goes away, and you are stronger for it. Your body getting stronger is a good thing. Jim

JeffH · Post by **JeffH** » Thu Jan 31, 2008 9:29 pm

Country, I hate to tell you this but your pressure of around 8 is on the low end of the scale, so I wouldn't worry too much about it if I were you. I've been sleeping with 12 for the last nine years and I none the worse for wear from it. Lots of folks here have pressures much higher than you or me.

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Do our lungs need all this pressure?

Do our lungs need all this pressure?

Co our lungs?