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[CPAP] ANOTHER CPAP PRESSURE CHANGE!!!
#1
I've read so much lately about the positive and negative impacts of higher pressure settings on CPAP that I need some answers to whoever might shed some light on this problem for me. I've been using CPAP (full face mask) for about 5 years now (diagnosed about 8-9 years ago through a sleep study). It took me a few years of trial and error to finally be able to use CPAP on a nightly basis. My AHI before CPAP was over 20 episodes an hour. I was started out at a pressure of 9, then it was upped to 10, then 11 then 12 and now it's been upped to 13. I'm still having about 8-9 apnea episodes per hour. Lately I've been reading that many CPAP users are having more and more lung/chest infections, lung nodules, breathing problems, headaches etc. on these higher CPAP pressures (and just generally using CPAP at night) and have actually become so "dependent" on their CPAP machines that their brains sometimes forget to tell them to breathe during the day when they're NOT using CPAP! These studies I've read about sometimes discourage the use of CPAP because of the problems that they bring on. Could using CPAP be doing more harm than good? I'm still tired during the day and I have breathing problems, terrible sinusitis, headaches and on and on and don't know whether these may be a direct result of my using CPAP night after night or another health condition all together. I also think about how that constant blowing of moist air into my lungs night after night could actually be causing damage to my lungs or fungal infections? [/font][/size] Night after night I toss and turn continuously (I even set up a night vision motion detector camera in my bedroom recently to see what goes on during my sleep) - I was shocked to look at the footage the next morning to see that every 3-4 minutes while I was asleep I was moving about flailing arms and legs and just moving very restlessly throughout the entire night! I set the camera up on several occasions and the same thing happened on these other nights. So I am getting ZERO quality sleep and wake up so exhausted that it sometimes takes 1-2 hours for me to just get enough energy to get out of bed in the morning. So this is my predicament - should I continue with CPAP and take a chance that it really is not helping me much (AHI's of 8-9 now as compared to AHI's of about 20 prior to CPAP) or maybe take a few nights off and see how I feel? Should I maybe seek another opinion with another Sleep Specialist? They've already said they will not so another Sleep Study so that's out. Very confused; NEED ANSWERS!
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#2
What is the makeup of your AHI? Obstructives, hypopneas, clear airways?

If mostly clear airways, then raising the pressure will not help.
If Obstructives or hypopneas, then a pressure increase would be correct.

I've read through your prior posts, and see that you were diagnosed with COPD. Are you seeing a Pulmonologist, and is he/she able to give you advice on pressure settings?


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#3
First, give some links to these studies. Many studies are poorly done.

Your flailing around is actually a different problem that needs to be addressed by your sleep doctor. It's something different from restless leg syndrome (RLS) so I will let someone else comment on it.

According to the PT at the hospital, those who get lung issues from Cpap never clean their equipment. Does not eliminate the moisture issue, but people in jungle forests do not have higher rates of lung infection than someone in say NYC on a cpap. You do NOT have to run any humidity at all, did you know that? It's there for comfort issues. My bro didn't run humidity on his machine until this year and he's had a machine for 9 years, but this is due to excessive leaking (he needs either a chin strap or new mask - to be addressed later this week).
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#4
Hi jennie54

Did the CPAP therapy used to help you and more recently it does not? I suspect if it has never helped you then you wouldn't have been on it for years. So maybe something else has changed that is relevant to your sleep quality.

There is a different condition called Restless Leg Syndrome that maybe you should look into with your doctor. I don't know enough to advise or even recognize it, but sounds like it would involve flailing around a lot.

You wonder if the CPAP is helping at this point. Might be that CPAP therapy is overwhelmed by another cause of restlessness over night.

As far as long term effects of CPAP therapy, I am not aware but it would be an interesting topic I bet around here. The only thing I can think of for infections would be failure to keep the equipment clean.

As for the forgetting to breathe, I gotta believe that would be a rare case and if it exists must be associated with a disease or condition beyond simple obstructive sleep apnea. As I understand it, CPAP pressures, even up to the 20cm max on the machines most of us use, are not enough for the machine to breath for you. It feels like a firehose on your face but try this yourself ... if you chose to simply relax and not breathe you would find that the machine will not inflate your lungs. All it does is blow in enough air to keep your wind pipes from closing up on you as you breathe on your own.

I am interested to know if there are long term complications of CPAP but up to now I have not heard about them and I am not worried about it. It would be discussed on this forum for sure. Plus, in this crazy litigious society with heavy handed oversight by the Government, I have to believe the CPAP company lawyers would make them post warnings and disclaimers on every box to keep them from getting sued. Also haven't seen any late night lawyer commercials about it like many drugs and other medical devices.

You are right to be asking questions about why you aren't getting any restful sleep. You may be on to something with the videos you made. I wouldn't think it is the CPAP machine that you have used all these years. An easy experiment is to set the pressure back down lower and see if the problem goes away. But more likely it is something else that has changed in your situation that is robbing you of sleep.

Hope you find the answer,

Saldus Miegas
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