Orthopnea When Sleeping Without CPAP

vsavatar · Post by **vsavatar** » Wed Nov 03, 2021 12:17 am

I've been using my CPAP machine for over 2 years now, but I was recently forced, due to having my wisdom teeth removed, to discontinue using my machine for about a week. I'm two nights in, and I find if I try to sleep without the machine, I feel like I'm suffocating long before I get to sleep. It doesn't matter what position I try to sleep in. I never had this problem before using a CPAP machine, and I weigh roughly the same. I also had a stress test done in the last six months, so heart failure is out. Any ideas on how to survive this week? Sleeping in a recliner seems to help, but it is anything but comfortable.

chunkyfrog · Post by **chunkyfrog** » Wed Nov 03, 2021 10:55 am

Get a second opinion--ask your sleep doctor.

zonker · Post by **zonker** » Wed Nov 03, 2021 11:00 am

welcome to the zoo!

Continuous
Positive
Airway
Pressure

for two years, you had your Airway held open by Continuous Positive Pressure.

without that pressure, the airway is closing back up. previous to cpap, you didn't notice so dramatically because your body took other steps and your mind just got used to it.

when you go back to cpap, things will get better.

good luck!

palerider · Post by **palerider** » Wed Nov 03, 2021 2:54 pm

vsavatar wrote: ↑
Wed Nov 03, 2021 12:17 am
I've been using my CPAP machine for over 2 years now, but I was recently forced,

By whom?

vsavatar wrote: ↑
Wed Nov 03, 2021 12:17 am
I find if I try to sleep without the machine, I feel like I'm suffocating long before I get to sleep. It doesn't matter what position I try to sleep in. I never had this problem before using a CPAP machine, and I weigh roughly the same.

Were you as old then as you are now? no? hmm,
You *did* have this problem before, which is why you got the cpap.

vsavatar wrote: ↑
Wed Nov 03, 2021 12:17 am
Any ideas on how to survive this week?

Use your cpap. sleeping better will help you heal.

Janknitz · Post by **Janknitz** » Wed Nov 03, 2021 8:07 pm

My apnea can occur when I'm very relaxed and nearly asleep but not all the way asleep if I forget to put my mask on--even if I am sitting straight up--e.g falling asleep in the car or on a plane. It feels like sucking on a straw and suddenly putting your finger over the other end. No question that this is apnea--I can't get any air in for a scary second. I've had an asthma attack where my airway closed up on me, and it didn't feel exactly the same, but similar--I think because I could still get a tiny bit of air in during the asthma attack, where apnea is a hard stop, NOTHING goes in.

From what I understand, orthopnea is shortness of breath or difficulty breathing because of the position of lying down, relieved when you sit or stand up. In most cases it's caused by heart failure--the fluid in the chest puts pressure on the lungs in a lying down position. When I worked in healthcare, we rolled up the head of the bed to relieve orthopnea in patients who experienced it.

You said:

I feel like I'm suffocating long before I get to sleep. It doesn't matter what position I try to sleep in.

. Sounds like apnea, not orthopnea, if a more upright position doesn't relieve it. Additional evidence is a better understanding of how CPAP works--it splints your upper airway open, it doesn't provide oxygen or "open the lungs", so if you had orthopnea you would experience it whether or not you were using your CPAP.

The only way to prevent apnea is to use your CPAP. For me, sleeping without CPAP is not an option--it's terrifying to feel those apneas. I know you are having difficulty because of recent dental work, but in your shoes I would find SOME way to use my CPAP. You mentioned you can't use a nasal mask but didn't say why. Have you looked into a total face mask (looks like the mask firefighters wear and covers the entire face)?

If you still think it's orthopnea rather than apnea you need to see your doctor because it can be a sign of a very serious condition.

vsavatar · Post by **vsavatar** » Wed Nov 03, 2021 9:51 pm

palerider wrote: ↑
Wed Nov 03, 2021 2:54 pm

vsavatar wrote: ↑
Wed Nov 03, 2021 12:17 am
I've been using my CPAP machine for over 2 years now, but I was recently forced,
By whom?

vsavatar wrote: ↑
Wed Nov 03, 2021 12:17 am
I find if I try to sleep without the machine, I feel like I'm suffocating long before I get to sleep. It doesn't matter what position I try to sleep in. I never had this problem before using a CPAP machine, and I weigh roughly the same.
Were you as old then as you are now? no? hmm,
You *did* have this problem before, which is why you got the cpap.

vsavatar wrote: ↑
Wed Nov 03, 2021 12:17 am
Any ideas on how to survive this week?
Use your cpap. sleeping better will help you heal.

By whom? By my oral surgeon who said that using it until the gum tissue healed over the bone would be a great way to end up with dry socket, which is exquisitely painful. I mean, I guess I could risk dry socket, but given that I've heard some women say the pain from dry socket was much worse than childbirth, I'm not sure I want to risk it.

Well, before CPAP I had a problem waking up a lot, getting headaches, and feeling fatigued. I didn't feel like I was suffocating or drowning before CPAP.

I mean ignoring advice from my oral surgeon is one option, I guess. I was hoping others might have a trick to get me through the next 5 days without doing so.

vsavatar · Post by **vsavatar** » Wed Nov 03, 2021 9:59 pm

Janknitz wrote: ↑
Wed Nov 03, 2021 8:07 pm
My apnea can occur when I'm very relaxed and nearly asleep but not all the way asleep if I forget to put my mask on--even if I am sitting straight up--e.g falling asleep in the car or on a plane. It feels like sucking on a straw and suddenly putting your finger over the other end. No question that this is apnea--I can't get any air in for a scary second. I've had an asthma attack where my airway closed up on me, and it didn't feel exactly the same, but similar--I think because I could still get a tiny bit of air in during the asthma attack, where apnea is a hard stop, NOTHING goes in.

From what I understand, orthopnea is shortness of breath or difficulty breathing because of the position of lying down, relieved when you sit or stand up. In most cases it's caused by heart failure--the fluid in the chest puts pressure on the lungs in a lying down position. When I worked in healthcare, we rolled up the head of the bed to relieve orthopnea in patients who experienced it.

You said:
I feel like I'm suffocating long before I get to sleep. It doesn't matter what position I try to sleep in.
. Sounds like apnea, not orthopnea, if a more upright position doesn't relieve it. Additional evidence is a better understanding of how CPAP works--it splints your upper airway open, it doesn't provide oxygen or "open the lungs", so if you had orthopnea you would experience it whether or not you were using your CPAP.

The only way to prevent apnea is to use your CPAP. For me, sleeping without CPAP is not an option--it's terrifying to feel those apneas. I know you are having difficulty because of recent dental work, but in your shoes I would find SOME way to use my CPAP. You mentioned you can't use a nasal mask but didn't say why. Have you looked into a total face mask (looks like the mask firefighters wear and covers the entire face)?

If you still think it's orthopnea rather than apnea you need to see your doctor because it can be a sign of a very serious condition.

I thought apnea only occurred when you stopped breathing. I still breathe when I'm lying down but feel like I'm suffocating or drowning if I'm lying flat. Sitting in a reclining position helps a lot, but it's not an ideal position for sleeping. I know it's not heart failure, because I just had a cardiac stress test mere months ago, and it was perfectly normal. I am however, quite obese, so maybe it's pressure of my weight causing it. I do know when I use CPAP, whether I'm asleep or awake, I don't feel that sensation, unless I have ramp up mode turned on. If I turn off ramping and just have it take full effect immediately, I don't have any problems. It's also possible it might just be sensational and not real. Last night, after waking up in the recliner due to how damn uncomfortable it is, I tried lying in my bed again and consciously monitoring my breathing for about 20-30 minutes. When I did this, I found that I could make the situation go away temporarily without having to do much special besides breathe through my mouth for a minute or less.

palerider · Post by **palerider** » Wed Nov 03, 2021 11:48 pm

vsavatar wrote: ↑
Wed Nov 03, 2021 9:51 pm
By whom? By my oral surgeon who said that using it until the gum tissue healed over the bone would be a great way to end up with dry socket, which is exquisitely painful. I mean, I guess I could risk dry socket, but given that I've heard some women say the pain from dry socket was much worse than childbirth, I'm not sure I want to risk it.

Yes, a doctor that doesn't have to worry about repercussions of their advice will often say things like that to CTA.

However, it's not a universal opinion:
https://www.manchesteroralsurgery.com/p ... tructions/

Dry socket something you want to avoid, any kind of sucking can enhance your chances of getting that. One would think that positive pressure in your oral cavity would do just the opposite, whereas gasping for breath because of your sleep apnea could make it more likely.

But, you do whatever you're comfortable with.

vsavatar wrote: ↑
Wed Nov 03, 2021 9:51 pm
Well, before CPAP I had a problem waking up a lot, getting headaches, and feeling fatigued. I didn't feel like I was suffocating or drowning before CPAP.

CPAP doesn't make you more liable to having these issues.

Janknitz · Post by **Janknitz** » Thu Nov 04, 2021 2:45 pm

I thought apnea only occurred when you stopped breathing. I still breathe when I'm lying down but feel like I'm suffocating or drowning if I'm lying flat. Sitting in a reclining position helps a lot, but it's not an ideal position for sleeping. I know it's not heart failure, because I just had a cardiac stress test mere months ago, and it was perfectly normal. I am however, quite obese, so maybe it's pressure of my weight causing it. I do know when I use CPAP, whether I'm asleep or awake, I don't feel that sensation, unless I have ramp up mode turned on. If I turn off ramping and just have it take full effect immediately, I don't have any problems. It's also possible it might just be sensational and not real. Last night, after waking up in the recliner due to how damn uncomfortable it is, I tried lying in my bed again and consciously monitoring my breathing for about 20-30 minutes. When I did this, I found that I could make the situation go away temporarily without having to do much special besides breathe through my mouth for a minute or less.

While heart failure is the most common cause of orthopnea, it's not the only cause. It could be pressure from your body weight, it could be reflux, it could be the position of your head on the pillow narrowing the airway (remember in CPR how the neck must be extended back to open the airway--if your neck is flexed forward that can make it more difficult to breathe). Elevating the head of your bed with a wedge pillow or bed risers might help. A soft cervical collar to keep your neck from flexing forward might help. And you should get it checked out at the doctor if none of these help--the fact that you had a cardiac stress test 3 months ago doesn't mean something hasn't developed since. And ideally, getting back to your CPAP as soon as you can.

Orthopnea When Sleeping Without CPAP

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