CPAPtalk.com

LSAT wrote:How can the people on this forum "answer questions about chest pain". We don't know the person or their background.

Well, they have done so for me, in this thread, so that kind of proves you wrong doesn't it.

FlyingMoose wrote:Is there anything else possible to do about pain caused by sleeping position that goes away mostly but not totally over time?

I don't know of what to offer. Sitting here scratching my head because the usual idea "change sleeping position" also has its drawbacks.

Can you describe the chest wall discomfort in terms that I might be more familiar with?
Like have you ever had costochronditis or pleurisy?
Is your chest wall discomfort made worse by inhale or exhale? Or is it simply there and any movement, not associated with breathing, will cause the discomfort?
Is the discomfort localized to a specific area of the chest...front, back, side?
Is the discomfort still present when you go to bed at night or did it fade away during the day? If it did fade away, about how long before it fades away? Is it much worse when you first get up in the AM and then fade to a dull roar after a couple of hours?
Just how long has this been going on...meaning when did you start cpap therapy?
Do you have any other health issues that might impact the respiratory system....like lung issues, COPD, etc?
Do you cough frequently for some reason or other?
Have you tried some sort of NSAID to see if it helped or not?
Do you have a history of arthritis in your spine?

Pugsy wrote:

FlyingMoose wrote:Is there anything else possible to do about pain caused by sleeping position that goes away mostly but not totally over time?

I don't know of what to offer. Sitting here scratching my head because the usual idea "change sleeping position" also has its drawbacks.

1. Can you describe the chest wall discomfort in terms that I might be more familiar with?
2. Like have you ever had costochronditis or pleurisy?
3. Is your chest wall discomfort made worse by inhale or exhale? Or is it simply there and any movement, not associated with breathing, will cause the discomfort?
4. Is the discomfort localized to a specific area of the chest...front, back, side?
5. Is the discomfort still present when you go to bed at night or did it fade away during the day? If it did fade away, about how long before it fades away? Is it much worse when you first get up in the AM and then fade to a dull roar after a couple of hours?
6. Just how long has this been going on...meaning when did you start cpap therapy?
7. Do you have any other health issues that might impact the respiratory system....like lung issues, COPD, etc?
8. Do you cough frequently for some reason or other?
9. Have you tried some sort of NSAID to see if it helped or not?
10. Do you have a history of arthritis in your spine?

1. It is very generalized and diffuse, symmetrical left-to-right, my whole chest but not my belly. If I sleep on my side it tends to occur on the other side only, plus my neck.

2. No, but I did have myocarditis. The pain from that was more localized. It was in different areas at different times, but it was always a smaller area at any given time. My cardiologist is of course aware of this, and says that it would not continue to cause pain after it has resolved (many months before I started CPAP, I was diagnosed by him with OSA during a follow-up). I wasn't having pain when I started CPAP, it occurred starting the first night, and as I said, if I skip a night it goes away.

3. It is made worse by inhaling. If I inhale with my diaphragm instead of my chest, this does not occur. Since the CPAP pressure changes the point of equilibrium of my lungs (the amount of air when muscles are at rest), perhaps it is caused by breathing into my chest all night against the weight of my body. Or just from not moving all night. Also it gets worse if I move in a way that stretches the muscles ("puff out my chest").

4. If I lay on my stomach, it is in the front. If I lay on my left side, it is mostly on the right, and if I lay on my right side, it is mostly on my left. If I lay on my side it also includes my neck on the opposite side.

5. It is generally worse in the morning, and goes away almost, but not completely, during the day.

6. I have been on CPAP about 7 months now.

7. According to the pulmonologist, I have mild asymptomatic asthma. I have never had an asthma attack, and I think the test may have been done incorrectly. She refused to re-run it, and my insurance has reset now so I would have to pay for it.

8. No.

9. I will try that next time it is bad.

10. No. I have had some possible arthritis in one knee, but not recently.

Things I was thinking I could try:

1. Sleeping on my back (if I can get to sleep, and may need to increase the max pressure).

2. I ordered a nasal pillow mask to try. I tried in the past without success but will try again.

3. I could set an alarm and change position every few hours, but this won't be good for my sleep quality.

4. Besides front and side, I have tried the falcon position, in which I had both the pain and the aerophagia. I will also try more of a fetal position on my side with my head tucked down to prevent aerophagia. I tried that last night and it prevented the aerophagia but I got the pain even thought I wasn't sleeping on my stomach.

Are there any other specialized sleeping positions besides the Falcon?

Myocarditis isn't the same thing as costochronditis.
Costochronditis is an inflammation of the chest wall cartilage. Has nothing at all to do with the heart.
https://en.wikipedia.org/wiki/Costochondritis
Google it and read up on it and see if you think it might fit.
I personally have had it myself but never for as long as you are having symptoms...if that is what is going on here. It can be quite annoying.
From what you describe...I think it's a possibility. Possibly aggravated by sleeping position and/or the positions that we have to get into to accommodate the mask and hose.

If it were me I would maybe try a little NSAID therapy (if your stomach will tolerate it) and see what happens.
From what I read about these sorts of inflammation they can be persistent little buggers to get rid of.

I don't know of any special stomach sleeping positions other than the Falcon which has a name and I sort of end up that way when I wake up and find myself on my stomach.
The fact that it only seems to happen with mask on...perhaps a combination of neck position and body position that we have to do to wear the mask is accentuating the problem. You might also investigate different bed pillows.

Sleeping on your back..may or may not make the OSA worse and may or may not require more pressure. It's worth a try though.

I think Julie is on the right path. Cardiologists only look at the heart, sleep/pulmonary docs are only going to look at the airway, etc. Too bad your sleep doctor isn't at least a little bit of an out of box thinker, because maybe BiPAP pressure would alleviate the discomfort.

A good primary care doc should take a look and perhaps narrow down the possible causes (hiatal hernia, esophageal spasm triggered by CPAP air pressure, costochonditis, etc should all be ruled out). But when I say "good" primary care doctor, I mean it. One who will take a little time to really listen to your complaints and think outside the prescription box. Very few primary care docs these days have those skills.

That's why I like functional medicine and integrative medicine docs--they look at the WHOLE person and are trained to think outside the box. So if you can change your PCP, go in that direction.

Don't rule out chiropractic care or acupuncture. You never know.

CG I think that Reames is just promoting his business...spamming.

FlyingMoose wrote:EDIT: I have changed the topic title based on the direction of this thread.

Chest pain when using CPAP seems to be a fairly common problem. But whenever anyone asks about it on the forum, the reply is always to go to the emergency room right away.

I have been through all that, multiple times, including more EKGs and blood enzyme tests than I can count, 3 echocardiograms, even a catheterization with contrast, which showed 0% blockages, and am under the care of a cardiologist, who agrees that it is being caused by CPAP, and that is it better to continue to use CPAP despite the pain because it is still better than OSA. I have spent tens of thousands of dollars on tests for something that I pretty much knew from the start is caused by CPAP, and I am glad that I now know for sure. But what am I supposed to do now about a problem that, despite all the tests, still receives the same answer on the forum of "go to the emergency room"?

It is frustrating that everyone on the forum refuses to address this problem, because CPAP-caused chest muscle pain is not something that a cardiologist can address, and we all know that sleep doctors are pretty much worthless. If people here refuse to help anyone with chest pain, it won't go away. It's sort of a catch-22, you can't get rid of it because no one will help, and no one will help because you can't get rid of it.

What is someone supposed to do about a common problem that is so taboo here?

So you state that the cardiologist said the pain was from CpAP. Why didn't you ask him/her how the CPAP causes the chest pain. You could have found out from the DOCTOR how to treat the chest pain .You had the perfect opportunity to get an answer yet you blast the forum for not giving you an answer.

+1
At the very least, if you press the issue with a DOCTOR,
they have a NETWORK of colleagues to call when they are stumped.
Most folks on the internet can only relate from our own experience.