Dyspnea and CPAP use?

Susancpv1 · Post by **Susancpv1** » Wed Jan 08, 2020 7:29 am

I’ve been using a Cpap for about a year with a 3 month break during that year. After a few months, I started experiencing dyspnea and was more fatigued than ever. I stopped the cpap for a few months and got another sleep study to test for narcolepsy (it was negative). The doctor suggested I try the cpap again. I’ve been doing okay but have started experiencing dyspnea again as well as fatigue. It’s not only when I exercise but all day. So frustrating! I feel like it’s associated with the cpap but my doctor says it’s not. I had a chest bc ray about a year ago and my lungs look fine. I’ve also had a stress test for my heart and it is healthy, too. My numbers on the My Air app are all excellent. Has anyone else experienced the dyspnea and fatigue issues? I’m using the AirSense 10 machine and AirFit face mask. Thanks in advance for your help!

harrywr2 · Post by **harrywr2** » Wed Jan 08, 2020 8:21 am

The standard that many doctors use to make the statement that your 'CPAP numbers are fine' leaves a lot to be desired.
It frequently means 'they are good enough that I won't be able to bill your insurance'.
It would be helpful if you would post OSCAR data if you can...so we can verify your 'CPAP numbers are fine'.
Info on OSCAR is in the 'sticky' section.

rick blaine · Post by **rick blaine** » Wed Jan 08, 2020 9:16 am

Hi Susancpv1,

Daytime dyspnea may have little or nothing to do with sleep apnea. It may develop for other reasons.

If you have been thoroughly examined for daytime breathing issues and yet there is "nothing to find", you may have hyper-ventilation syndrome or HVS – which colloquially is 'breathing too much – and badly'.

A typical HVS patient breathes 20+ times a minute and blows off CO2 – with the result that the acid-alkili balance of their blood is affected. And that can lead to all sorts of symptoms, including fatigue and breathlessness.

HVS can be found (but not exclusively) in athletes, people who talk or sing for a living, and wind-instrument players. People whose breathing rate and volume goes up for some reason – and then, out of habit, doesn't come back down.

The remedy is simple: 10 minutes of practice of certain breathing exercises five times a day, and spaced throughout the day. This bring the blood gas levels back into the normal range. And puts in place good breathing habits.

There are also some dietary tips because the effects of dis-ordered breathing get magnified when there is low blood sugar.

There is a book on the subject by Dinah Bradley, and most HVS patients find being diagnosed and supervised by a trained respiratory therapist is helpful.

Julie · Post by **Julie** » Wed Jan 08, 2020 11:39 am

Ask your MD for a pulm. function test - you could have e.g. early COPD (even if you personally don't smoke now).

joeljjk11 · Post by **joeljjk11** » Wed Jan 08, 2020 12:57 pm

I also have this every day pretty much. What are your pressures? I have noticed high pressures and caffeine intake affect this with me, I think general anxiety affects this with me also. I have noticed it does not happen as much when I use a full face mask and seems worse with nasal pillows, almost like I am not getting enough air with the pillows or something.

Edit: also dehydration makes this wayyy worse for me. And stress!

joeljjk11 · Post by **joeljjk11** » Wed Jan 08, 2020 1:04 pm

One more thing, I used an ASV machine for a short period of time but the dyspnea was so horrible with it that I went back to my Airsense APAP machine. I could never determine why this was so severe with the ASV machine with the settings and stuff, but it was something that happened to me.

Joel

Susancpv1 · Post by **Susancpv1** » Fri Jan 10, 2020 12:21 pm

Thanks so much for the quick responses! I really appreciate it! The reason I feel like it is associated with my CPAP use is because it started happening when I began CPAP use then went away when I discontinuted CPAP use. When I began using the CPAP again a few weeks ago, the dyspnea is happening again. Plus I am really, really tired all day. And that happened the last time. A friend of mine who is a doctor showed me this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863207/. While I couldn't understand most of it, the gist seems to be that breathlessness can happen as a result of high pressure settings in a CPAP in obese people (I'm overweight). So, I lowered my upper pressure setting two nights ago to around 12 from 20. Yesterday, I felt much better! I had half as many "events", too! Last night I used the same lower settings and I don't feel any better.

Although, I did have only 2.5 events again!

My machine didn't come with an sd card, so I didn't even know you could collect data from the machine! I inserted the card last night and I am attaching some screen shots. For last night, it shows the super-detailed graphs, etc. The other days show only pie charts. Let me know if I need to attach any other information. Like I said, I am super tired and, along with the dyspnea, I'm about ready to call it quits! Thanks in advance for your help!

susan
https://imgur.com/a/MbiFCsM
https://imgur.com/a/26lkjSq
https://imgur.com/a/s3sg9yq
https://imgur.com/a/X6TvNir
https://imgur.com/a/cObZErt
https://imgur.com/a/vpdq3a6
https://imgur.com/a/D2v54HD
https://imgur.com/a/QMo2b3M

Pugsy · Post by **Pugsy** » Fri Jan 10, 2020 12:41 pm

The upper limit reduction to 12 from 20 wasn't likely the cause of the reduction in your symptoms because the machine doesn't ever go to 20 anyway.
Last night it didn't even make it to 11 cm.
Coincidence only that your symptoms went away.

Question for you....if you take in a deep breath right now...awake while reading this....does it cause muscles in your chest wall to feel uncomfortable/sore/tight?

Susancpv1 · Post by **Susancpv1** » Fri Jan 10, 2020 1:21 pm

It's probably embarrassing that I have no idea how that machine works! And don't get me started on the graphs! lol. Anyhow, no, it doesn't hurt. Not at all. The only thing is I am yawning a lot, too. And did I mention that I am tired all day? >:-/

Pugsy · Post by **Pugsy** » Fri Jan 10, 2020 1:31 pm

Do you take any medications? If so, what?
Do you wake often during the night?
How many hours of actual sleep do you think you are averaging?

I know you probably don't want to hear this but I think you might do better with more minimum and just leave the maximum alone.
Your pressure is bouncing around all over the place and your flow limitation graph is more than just a little bit active so it's probably a significant factor in all the pressure changes. Flow limitations are part of what the auto adjusting algorithm is designed to try to kill.

The maximum pressure is no factor if it's never reached.
It's the minimum pressure that does the bulk of the work and is the most critical setting.

Susancpv1 · Post by **Susancpv1** » Fri Jan 10, 2020 1:58 pm

I take a med for ADHD, an SSRI, and synthroid for hypothyroidism. I've been on all of them for years. Typically (while using a CPAP), I get up 1-2x/night to use the bathroom. Without the CPAP it can be up to 5x. But I always fall back to sleep. I average 7.5-8 hours/night of sleep. Do you think the min pressure has anything to do with the dyspnea and fatigue? How much should I increase it? Thanks!

S

Susancpv1 · Post by **Susancpv1** » Fri Jan 10, 2020 2:00 pm

And what does it mean to have the pressure bouncing all over the place? And what is the flow limitation graph? Maybe I should do a little research as to what all this means. Can you point me in the right direction? Otherwise I will probably frustrate you with all my millions of questions!

Pugsy · Post by **Pugsy** » Fri Jan 10, 2020 2:47 pm

http://www.apneaboard.com/wiki/index.ph ... rpretation

Also take a hard look at your medications and their potential side effects list. Fatigue and sleep quality issues are common side effects.

We are in the middle of bad thunderstorms so I can't stay online very well but start reading.
Especially the Sleepyhead tutorial I have in the top announcements sections.
OSCAR is based on SleepyHead so substitute OSCAR for anything I say about Sleepyhead.
There's going to be a new tutorial later but not until we get an OSCAR update.

Susancpv1 · Post by **Susancpv1** » Tue Jan 14, 2020 11:54 am

Hi, again! I have been doing some reading and trying to sort out my data. I've lowered the pressure to 10.6 with the hopes that might help. I haven't noticed any difference -- still super tired and am having the dyspnea. I don't understand the pressure data. Why would my pressure be bouncing around? And what is the difference between the red line and the green line? Thanks in advance! Sign me, desperate and miserable.

Susancpv1 · Post by **Susancpv1** » Tue Jan 14, 2020 11:56 am

: Screen Shot 2020-01-14 at 12.50.41 PM.png (446.19 KiB) Viewed 2166 times

[/img][/img]

Dyspnea and CPAP use?

Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?

Re: Dyspnea and CPAP use?