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Blood in sputum??
#1
Blood in sputum??
I woke up after 5 ½ hours of sleep around 2:30 AM and got fairly good scare.

As I peed I choffed a couple of time and spat into the bowl..OMG it was pinkest red.

I then spat into the sink and I was getting the same thing.

OK I took a check over everything I could, No pain, nothing from my nose, no breathing problems, no dizziness, no light head.

All I could find was Dry mouth, slight sore throat, fuzzy tease in mouth and lips.

I called the Dr. on call of my sleep Dr. and was advised that I should be all right unless it keeps up or gets worst and if I have ANY problem breathing. So far at 6AM I have not had any farther problems.

I am using a Respironics 960 ASV with a running pressure of 19.5 and an inhale pressure of 14. I use 15.5 and 10 on a 15 minute ramp to get settled in. I am 71 and have been on CPAP sense 2013.

I use distilled water and to get that to last a full 8+ hours run it on #2 setting for humidity.  (eems a little dry.)

I also use a lip balm to fight dry cracking lips.

I use Flow maze and antihistamine to control my alliagys, which uncontrolled can cause obstruction apneas.   

I always have a dry throat and mouth upon waking …

IF I run any higher settings on those damn humidifiers it will run out of water unless I wake up 1/2 way through the night and refill it.

Why can they not make a humidifier that holds enough water to make it through 8 hours on its higher setting???????

I checked my AHI and I have a fair high ratio of 2.86 Obstructions and .90 Clear Air way, and a .72 Hypopnea…that was a higher reading of Obstructions than is normal for me.

At my best guess the blood was coming from my dry throat…none the less I was unable to get back to sleep.

I wonder if the use of distilled water is not harsh water??

So I came to this site with three questions 1) has anyone had bleeding from a sore dry throat on a sleep machine??  

2) Has anyone found a more smoothing way to prepare the water if distilled water is harsh?

3) Has anyone found a machine with an all-night water tank?? Or an automatic refill system??

So have anyone else found blood in their sputum?? And been told it is caused by their sleep machines??

OR do I have something worst to be concerned about??

Rich
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#2
RE: Blood in sputum??
A greatly unsettling development, and you must feel quite rattled.  There's an answer to this, somewhere.

Firstly, if you're going through that much water in a night, humidity is not the problem...or lack thereof.  There must be a leak of some kind, or a defect.  Even at ambient 10%, the typical reservoir would have been designed to supply at least a full night on maximum settings for flow and humidity.  You'd almost have to boil it off with a defective heater, and that would tend to condense in the hose's lowest point and greatly impede the air flow if it got substantial accumulations.

We could help you concretely if you could find a way to give us hard data about your machine's current (known) settings, what it registers, if it can, in data, and so on.  We need to look at charts that show us flow limitations, pressure limits up and down, accommodation pressure drops (expiration pressure relief or EPR), and so on.

The machine would use corn syrup as a humidification medium if you were inclined to use it. The sticky mess next morning would be a nightmare to clean up. My point is....distilled or not, any water will evaporate cleanly and deliver itself cleanly to the airways of the machine and thence to your own. Except for really exceptionally dirty or heavily mineralized water (and it is out there), we advise people to use tap water if it is treated and potable, and to simply rinse out the vessel each morning to prevent mineral deposits over time.
Serial Tapist
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#3
RE: Blood in sputum??
Distilled water is not harsh. Even if it were it wouldn't matter because the humidification process is by evaporation so other than a minor aerosol you are getting what is essentially distilled water at your mask regardless of what water you are using. Even if you use hard water there is very little carryover of anything other than water vapor.

I have been on CPAP for over 10 years and have struggled on and off with bad dry mouth but have never coughed up blood.

It's impossible for us to know if you have something worse but if it continues you should definitely see a Dr.
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#4
RE: Blood in sputum??
dry throat: find a way to help keep your mouth closed. soft cervical collar, chin strap, tape, tongue suck method, for example. apparently there's something called xylimelt (sp?) to try too.

dry air: it's no surprise you go through a tankful of water in Phoenix in August. one alternative is to get a humidifier for your bedroom.

distilled water: is recommended by the manufacturers for use in the humidifier.

wayward blood: a lot depends on how this looked. I'm not qualified to say anything about this except in my own experience blowing or hacking up red-laced mucous in a dry environment is common. ambient dryness aggravated by cpap pressure and a humidifier that doesn't keep up. any free flowing bright red blood beyond what you might associate with a 'normal' bloody nose might should be checked out.
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#5
RE: Blood in sputum??
Blood in sputum, best case scenario, blood from throat, worst case scenario, tuberculosis. 

Go to doctor asap and order QuantiFERON-TB Gold from blood: <link removed>


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#6
RE: Blood in sputum??
(09-02-2019, 11:30 AM)Melman Wrote: Distilled water is not harsh. Even if it were it wouldn't matter because the humidification process is by evaporation so other than a minor aerosol you are getting what is essentially distilled water at your mask regardless of what water you are using. Even if you use hard water there is very little carryover of anything other than water vapor.

(09-02-2019, 11:36 AM)sheepless Wrote: dry throat: find a way to help keep your mouth closed.  soft cervical collar, chin strap, tape, tongue suck method, for example.  apparently there's something called xylimelt (sp?) to try too.

dry air: it's no surprise you go through a tankful of water in Phoenix in August.  one alternative is to get a humidifier for your bedroom.

Hi racprops,

When I’ve gotten streaks of blood or pink in my sputum it’s been caused by a cough (upper respiratory infection). 

Adding a humidifier sounds like it would help. 

Leaks increase water usage a lot.  Your profile says you use the FitLife FFM. When I used the FitLife Total Face Mask I needed to use a face mask liner to control leaks. The correct liner size is much larger than the common large liner size for a common FFM, so I ordered the liner directly from RemZzzs to get the right size. (Lately the Fisher&Paykel Simplus with a liner works best for me, and I alternate with the hybrid ResMed Airfit F30 whenever my face needs a change for a few days.)

I think the increase in obstructive apneas could be because of positional changes, or large leak, or may go away if the EPAP pressure is adjusted higher. I think if the pressures are allowed to go high enough then an ASV machine will always eliminate central apneas, so if you’re still getting a few CAs this may indicate the Pressure Support is sometimes not being allowed to go high enough to treat a few of the CAs, but in themselves the few CAs you’re getting should not be of concern.  Increasing the pressures may also worsen leaks, air swallowing, awakenings, Intra Ocular Pressure, TMJ problems, etc., so raising pressure settings should always be done cautiously.

Take care,
— Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#7
RE: Blood in sputum??
(09-02-2019, 10:53 AM)racprops Wrote: I woke up after 5 ½ hours of sleep around 2:30 AM and got fairly good scare.

As I peed I choffed a couple of time and spat into the bowl..OMG it was pinkest red.

I then spat into the sink and I was getting the same thing.

OK I took a check over everything I could, No pain, nothing from my nose, no breathing problems, no dizziness, no light head.

All I could find was Dry mouth, slight sore throat, fuzzy tease in mouth and lips.

I called the Dr. on call of my sleep Dr. and was advised that I should be all right unless it keeps up or gets worst and if I have ANY problem breathing. So far at 6AM I have not had any farther problems.

I am using a Respironics 960 ASV with a running pressure of 19.5 and an inhale pressure of 14. I use 15.5 and 10 on a 15 minute ramp to get settled in. I am 71 and have been on CPAP sense 2013.

I use distilled water and to get that to last a full 8+ hours run it on #2 setting for humidity.  (eems a little dry.)

I also use a lip balm to fight dry cracking lips.

I use Flow maze and antihistamine to control my alliagys, which uncontrolled can cause obstruction apneas.   

I always have a dry throat and mouth upon waking …

IF I run any higher settings on those damn humidifiers it will run out of water unless I wake up 1/2 way through the night and refill it.

Why can they not make a humidifier that holds enough water to make it through 8 hours on its higher setting???????

I checked my AHI and I have a fair high ratio of 2.86 Obstructions and .90 Clear Air way, and a .72 Hypopnea…that was a higher reading of Obstructions than is normal for me.

At my best guess the blood was coming from my dry throat…none the less I was unable to get back to sleep.

I wonder if the use of distilled water is not harsh water??

So I came to this site with three questions 1) has anyone had bleeding from a sore dry throat on a sleep machine??  

2) Has anyone found a more smoothing way to prepare the water if distilled water is harsh?

3) Has anyone found a machine with an all-night water tank?? Or an automatic refill system??

So have anyone else found blood in their sputum?? And been told it is caused by their sleep machines??

OR do I have something worst to be concerned about??

Rich

I had some blood as well because my nose was just too dry. My nose was bleeding in the morning just after I got up so it wasn't unexpected.
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