Anyone have a breast reduction?

I am looking for some information about breast reduction surgery and sleep apnea... and not finding much about it on the web to my surprise.

I am about 4 weeks post-op from my surgery. The doc removed a little over 6 pounds total. I am recovered for the most part and start back to work next week.

I was told by my sleep doc that I would probably not require a change in my pressure but to schedule another night there when I was fully healed (about 3 months post op). She also said that I "would know" if the pressure needed to be changed prior to that. I figured she was probably right - I have been very in tune with my CPAP since I got it 4 years ago. I have had the pressure reduced twice (after follow-up sleep studies) and both times I asked for the follow-up sleep study because I felt my treatment was becoming less effective as I lost weight. Of course, I also knew how to check my stats on my machine which allowed me to verify my "feelings" prior to going in. In other words, 1. I started to feel worse, 2. I checked my stats and verified I was having more occurrences than usual, 3. I went to a new sleep study, 4. the doctor lowered my pressure following the study, 5. I started feeling better and my stats went back to normal.

This time, though, my stats on my machine are normal, but I am having the same same "feelings" that I am not getting good sleep. I am having to sleep on my back (which I never do/did, usually, probably due to the twin reasons for the surgery ). I am draining my humidifier much faster than usual, and it is still hot and humid here in the south. The reservoir is empty or nearly so every morning, when I used to only use about half of it on a summer night.

I am curious if anyone else has had a breast reduction while on xPAP and if so, whether it changed your pressure at all initially or long-term? I am not a person who is looking to be off CPAP - ever - but I do want to get back to sleeping well. I am still uncomfortable moving at night and am restricted to sleeping on my back, as I mentioned, so I was not planning to schedule an overnight study sooner than the 3 months recommended, but if others of you have had pressure changes following this type of surgery I may get her to schedule me one sooner. Of course, my weird "feelings" may be just due to the healing and waking up at night as I bump into the surgery site... just looking for some other peoples' experiences if you are out there...

Thanks in advance,

Dawn

You may still be having issues due to the surgery procedures or due to the medication messing your sleep.

Play with your pressure. Up it a notch for a week and keep checking your stats and keep a journal of how you feel.

I agree with BlackSpinner, and would like to add 2 thoughts:
Your going through the humidifier makes me think you may be mouthbreathing more than you used to - this is certainl what happened to me when I lost weight.
A further possibility worth considering is whether your weight loss has changed your face enough for it to affect the mask's ability to seal properly.
Maybe you need a smaller mask?

Good luck, and keep us posted.

O.

Thanks for your responses.

I am curious about the mouth breathing - I definitely have always been a mouth-breather to greater and lesser extents and wear a full-face mask. My leak levels according to my machine seem to be in line with where they always have been, but it would certainly make sense that if I am mouth breathing more I would use more humidifier water. Hmmm.... wonder what the reasons behind more mouth breathing are? I have had horrible sinus issues since I was a kid and had surgery on those a few years ago (pre-CPAP and my apnea diagnosis) which gave me huge improvements in allergy relief and reductions in sinus infections, but did not improve my snoring (no surprise there) nor my mouth-breathing (that did surprise me).

I got off the narcotics about three days post op but I am not sure if that could still be a problem? I had absolutely horrendous gas and bloating - to where it looked like I had a full-term pregnancy in my belly - and when I went to my doctor in alarm he advised it was the narcotics slowing my digestion, so I stopped them as soon as I could. The swelling decreased the following day.

After posting it occurred to me that what I noticed before was a tired feeling which I could tie back to my stats showing more apnea events. But from what I understand, at the most mechanical level, apnea events are really partially waking and then going back to sleep, generally without ever being aware of it. Maybe the same thing is happening with my discomfort, where I am moving slightly, bumping something sore, partially waking and then falling back to sleep without realizing I awoke. This might give me a similar tired feeling, even without actual apnea events.

I really do not want to have a sleep study while I am still so uncomfortable while sleeping... that place is uncomfortable enough and it's hard to imagine I would sleep at all if I went today, but maybe in a few weeks.

Although I know how to adjust the pressure on my machine myself I have never actually done it. I guess it would be interesting to test it a little and see if I can resolve this myself at least in the short term.

Dawn

For me, back sleeping will cause me to mouth breathe, and to have more events because my tongue is positioned to fall back easily. While you are on your back more due to the surgery, maybe elevating the head of your bed a bit could help. If you are mouth breathing more than usual, maybe the different sensation is causing less deep sleep just due to being a change. Even being forced to change from your familiar sleep position can be disruptive. It may be that there are too many possible contributors right now for changing your pressure if yours numbers are good. If your numbers worsen, that's another story. But if it were me, I wouldn't automatically do another sleep study. I would wait until the surgery site is healed and I was sleeping "normally" for a while then reassess. It does seem reasonable that having less weight on the chest when trying to breathe could make a difference, exactly how and how much I don't know. Since you are experienced in cpap and in tune with your body, you'll be able to tell if anything is changed that needs addressed. It's probably too soon to know though. Looking forward to hearing if anyone has had your particular experience.

Besides the narcotics you also had tubes down your throat and your body is fighting to heal. I can tell you weeks after my Hysterectomy going to get groceries was a major challenge that left me exhausted and gratefull for the cart to hold me up at the cash.

DawnTCB wrote: After posting it occurred to me that what I noticed before was a tired feeling which I could tie back to my stats showing more apnea events. But from what I understand, at the most mechanical level, apnea events are really partially waking and then going back to sleep, generally without ever being aware of it. Maybe the same thing is happening with my discomfort, where I am moving slightly, bumping something sore, partially waking and then falling back to sleep without realizing I awoke. This might give me a similar tired feeling, even without actual apnea events.

Good thinking, Dawn. You may be suffering from fragmented sleep without breathing interruptions.

Hey just wanted to follow-up...

Turns out I had a tiny crack in my humidifier reservoir and overnight my water was dripping out very slowly. The crack was so small that even when I filled it up and stood there holding it to see if there was a leak, it took a minute or two to even get a single drip. But, overnight apparently it was enough to drain the tank. When I called my DME they said humidifer tanks should be replaced every six months... ummm, I was still using my original tank I got 3.5 years ago. I had no idea they should be replaced more frequently than the humidifier itself, although honestly I probably would not have even thought to order a new one since it was working fine before the crack.

So I ordered a new tank. It worked fine and I was feeling much better without the whole dry mouth thing, but still a little sleepier than I was used to. I figured I would go ahead and schedule a new study in January as I had planned when I noticed my machine started getting quirky... telling me there was a HIGH LEAK!!! then there was no leak, and a couple of times I woke in the night to find it off. I thought maybe I was shutting it off somehow so last night I propped up a book on the night table to make a little barrier between myself and the buttons so I would have to get really awake before shutting it off. Well last night the pressure was fluctuating up and down from extremely high to almost nothing, and before I was out of bed this morning it had a system error message and died. I don't know if it got slowly fried by the water leak or if there was something more seriously wrong with it. I sent it for a repair estimate so I guess we'll see about that part.

The good news is I was able to get a new machine today and I am looking forward to a "normal" night's sleep tonight!

Thanks again for your help and take care out there!


Dawn

Dawn, curious about one thing you said... You said that in the past you started having higher AHIs per your CPAP data and it turned out you needed a lower pressure? Were the events central apneas or obstructive ones (assuming your machine knows)? I had never heard of a higher AHI requiring LOWER pressure, except as due to central apneas, and I'm wondering how common this is. I had always thought higher AHI (if obstructive) required higher pressure. Am I wrong?

SleepingUgly wrote:Dawn, curious about one thing you said... You said that in the past you started having higher AHIs per your CPAP data and it turned out you needed a lower pressure? Were the events central apneas or obstructive ones (assuming your machine knows)? I had never heard of a higher AHI requiring LOWER pressure, except as due to central apneas, and I'm wondering how common this is. I had always thought higher AHI (if obstructive) required higher pressure. Am I wrong?

Wow it has been a long time since I spend time using the lingo of sleep apnea and I had to go google for a refresher so I could explain it properly!

Having the pressure too high on your CPAP can cause central sleep apneas (CSA), which are still apneas but have different causes and different effects. I try to never take my medical knowledge from Wikipedia but this article seems in line with how my sleep doctor explained it to me. The way she explained it, my AI number on my CPAP data screen increased because my overall apnea events were increasing in frequency, although my machine did not (and probably could not) differentiate between the two.

Once my pressure was lowered, the AI went back to normal (for me) which was in the 0.1 - 0.5 range.

As a side note, my new machine is a Respironics C-Flex and it looks like I can't get daily information from it, only a weekly or monthly average. I will search around a little but if anyone knows if this is true or false I would appreciate it. I don't have the clinician's manual but I do know how to access the menu - I just didn't see anything on the menu to change it.

which version of a Respironics CFLEX? It should say on top

It says "Remstar Pro CFLEX +" and over to the side - now I am not next to it so I am not sure but this was probably on the humidifier "System One".

it should be a PR S1 Remstar Pro with CFLEX + in the machine list